UKRAINE – January is historically Ukraine’s coldest month, and memories are still strong of the Russian missile attacks on the energy grid last winter that left millions of people without power and affected many hospitals. In extreme cases, surgeons were forced to perform operations beneath flashlights.

The population has braced for more of the same as the mercury fell to the current level of around 27 degrees Fahrenheit (-3 Celsius).

The recent holiday season in Ukraine was also overshadowed by massive Russian missile and drone attacks on cities across the country. But almost two years into the war, Direct Relief’s local partners are redoubling efforts to bring quality healthcare to the population despite power interruptions and missile attacks.

“We went through a complete blackout, we were cut off when the biggest mobile operator was hacked, but we only became stronger and more resilient,” said Yuliia Dmitrova, head of the TAPS foundation in Dnipro, one of the country’s hardest hit cities.

As well as distributing medicines to hospitals and providing dental and other services, the organization will again this year hold healing retreats for the children and widows of those lost to the fighting.

Among Direct Relief’s core partners and other NGOs receiving support, 2023 produced a broad springboard of initiatives with long-term application: prosthetics production, fitting and rehabilitation; psychosocial services for war-affected citizens; mobile health clinics for children in rural communities, and many more initiatives that will be carried over into 2024.

This was in addition to supplying medical products. Last August marked $1 billion of these delivered since the war’s start in February 2022 through Direct Relief’s partners to the people of Ukraine in the largest humanitarian aid response in the organization’s 75-year history.

Now totaling more than $1.1 billion, these resources have been invaluable in supporting the country’s healthcare system in the darkest times.

There Will Be Light – and Operations

“We know that this winter will be worse than the last,” said Katya, a specialist working with a DR-supported psychological care project in the Kyiv suburb of Bucha. “The other night, we were attacked with 70 drones, and Russia will have elections,” she said after the first big attack in late November and referring to President Vladimir Putin’s predicted fifth-term victory in March. “We are getting ready.”’

Among other measures, Ukrainian technicians have been fitting health facilities with Tesla Powerwalls donated in Summer 2023 by the Polish government and delivered with logistical support from Direct Relief and its Kharkiv-based partner Charity Fund Yevhen Pyvovarov.

The 508 units – rechargeable 14 kWh lithium-ion batteries that can provide power during peak times, power outages, and at night – will work in several regions along the 620-mile (almost 1000-km) frontline. Direct Relief is now working with the Ukrainian government on further steps to keep hospitals and clinics running.

Smaller civil society initiatives also aim to fill gaps in Ukraine’s preparations this winter. One is a project by Mission Kharkiv, an NGO that primarily distributes cancer medicines for Direct Relief, to provide first aid training and blast-proof medical kits for thousands of workers at the country’s power plants.

Most had no such training during decades on the job, so a 90-minute course recently delivered to workers at a plant in the eastern city of Kharkiv was entirely new for them. Realistically, they may retain only 50% of the skills demonstrated, said trainer Darya, a lawyer at a Ukrainian bank, but this can still make a difference in a crisis.

Darya decided to qualify as a first aid trainer so she could make a personal contribution to the war effort in her spare time: “I wanted to help people in Kharkiv to learn to do things like apply a tourniquet and be able to save lives.”

There is palpable fatigue among people you meet on the streets these days, but the spirit of volunteering is still strong across Ukraine. This was apparent on the International Volunteer Day on December 5. In Kyiv, more than 5,000 people visited an exhibition venue for diverse talks, awards and displays by dozens of NGOs from all fields of activity.

Ukrainian President Volodymyr Zelensky separately honored this contingent of society as “another strength of ours, our guard of those who care, our army of active Ukrainians.”

No one is slacking off – there is simply too much to lose after the trials and gains of recent months.

“Despite ongoing challenges, the humanitarian sector in Ukraine remains resilient and demonstrating unwavering commitment,” said Anton Gulidin, an advisor to Ukraine’s ombudsman for human rights and the head of NGO Friends of Ukraine Foundation, which had a stand at the event. “The sector continues to innovate, develop new projects and sustain its momentum.

The next morning, on the ‘new’ St. Nicholas’ Day – Ukraine last year moved its Christmas holidays to Western dates in a permanent break with the Russian Orthodox church – a blue-clad Ukrainian Santa visited young patients at the Okhmatdyt National Children’s Specialized Hospital in Kyiv.

The day brought surprises for children and adults alike: “I checked my mail and received good news [about] our project for mobile pediatric services for children,” said Marina Makarenko, the head of Direct Relief’s partner Charity Fund Modern Village and Town, or CFMVT. She had stopped by the event at the hospital to add some donated gifts to the pile.

The mobile clinic project, implemented last year by CFMVT together with Okhmatdyt, is being further funded by Direct Relief starting in January, ensuring that expert medical care reaches children in rural communities across a wider area of Ukraine – regardless of the weather.