Ukraine war and refugee crisis
Fighting in Ukraine has killed or injured thousands of people, while more than 5.6 million refugees have fled to neighbouring countries.
The situation is extremely volatile and we have witnessed the devastating impact of the conflict on civilians – some cities are surrounded by military forces, under heavy bombardment and running out of food and water.
Many hospitals are facing dramatic shortages of medical supplies – from surgical tools to drugs for chronic diseases – while the mental health consequences of shock and suffering have been enormous, even in areas that have been spared the brunt of the violence. And, every day, more people face a terrible choice: stay in an unsafe place or flee home into uncertainty.
The information about our response, below, is correct as of 2 June 2022.
Our emergency response in Ukraine
MSF medical teams are experts at working in conflict zones and complex humanitarian crises, while our experienced logistics staff and robust supply chains ensure that critical supplies reach where they are needed.
We are providing:
- Primary healthcare, including treatment for chronic illnesses, for vulnerable people who've fled their homes and stayed behind in areas with heavy fighting
- Support to Ukrainian medics with supplies and training
- Medical evacuations for patients from overwhelmed hospitals to safer areas
- Support to Ukrainian psychologists and first responders to provide mental healthcare for people who’ve faced intensely traumatic experiences
We are working to rapidly scale up our medical and humanitarian response where the needs are greatest and where we can have a life-saving impact.
Help us prepare for the next emergency
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Our response in Ukraine: In-depth
Our priority in Ukraine is getting Ukrainian medics the medical supplies they need.
We're providing technical support and training on how to manage large numbers of wounded people, and relieving pressure by medically evacuating patients to hospitals in safer parts of the country.
While the initial focus was on surgery, trauma and intensive care needs driven by the conflict, a worrying situation is also emerging for patients with chronic diseases such like hypertension, diabetes, asthma, and heart disease who urgently require key drugs and support.
However, with full-scale warfare in some areas, movements are difficult, dangerous or simply impossible. Communication networks are not always available and there is a significant amount of misinformation.
Our teams are now working to ensure vulnerable people with chronic illnesses continue to get the care and medications they need so their conditions don’t get worse.
At the same time, we’re also seeing that people are absolutely shattered by what they’ve been through. Anxiety, panic attacks and trouble sleeping are common symptoms.
In response, we have increased our focus on mental health activities, including strengthening the capacity of Ukrainian psychologists and training first responders to administer psychological first aid. Between mid-April and mid-May, our teams provided over 1,000 mental health consultations in Ukraine.
Ukraine war: Our work in numbers
MSF STAFF WORKING IN UKRAINE
METRIC TONS OF MEDICAL CARGO DELIVERED
UKRAINIAN CITIES WHERE MSF HAS MEDICAL ACTIVITIES
Updated 2 June 2022
Medical evacuation trains
On 1 April, MSF began running a two-carriage ‘medical train’ to evacuate patients in serious-but-stable conditions to safety. We are now also running a more highly-medicalised train, capable of providing intensive care for more serious patients.
The trains take patients from overburdened Ukrainian hospitals close to active warzones to Ukrainian hospitals with more capacity that are further from active warzones.
As of 31 May, 594 patients have been evacuated along with family members. On 11 April, the team evacuated 78 babies and toddlers from an orphanage in Zaporizhzhia, some of whom had been injured by the widely-reported missile strike on Kramatorsk train station.
Since the conflict began, MSF has transported medical supplies to treat war-wounded people arriving at hospitals in Kyiv, including specialised ‘mass casualty’ kits for dealing with incidents where large numbers of injured patients arrive at the same time.
MSF teams have also conducted mass casualty training with staff at several Kyiv hospitals, while an expert surgical team carried out hands-on war-surgery training at a paediatric hospital.
We provided support to healthcare centres in the wider Kyiv area in the treatment of patients with chronic diseases and other non-trauma needs. Our teams have so far followed up with more than 1,000 mainly elderly and vulnerable patients.
Elsewhere in Kyiv, MSF is running confidential support services for survivors of sexual and gender-based violence (SGBV). This includes a telephone hotline, medication to prevent HIV, STIs and unwanted pregnancies, as well as mental health support. We are also supporting shelters for survivors around the city and training staff.
In Hostomel, on the outskirts of Kyiv, our teams have been working alongside Ukrainian doctors to restart healthcare for a community devastated by weeks of active fighting, including 35 days of occupation by Russian forces. This work includes mobile clinics, emergency consultations and referrals, as well as mental health support.
Bilal Tserkva and Fastiv
In Fastiv, our teams are focusing on elderly and displaced people suffering from chronic diseases who may have been cut off from healthcare. This involves donations, as well as medical and mental health support, while training will be carried out with staff at healthcare facilities.
In Bilal Tserkva, our teams are carrying out mass casualty training at a hospital that specialises in surgery.
In Kropyvnytskyi, MSF teams are donating medical supplies and training healthcare workers and first responders. Here, we are also focusing on supporting displaced people, distributing relief items to shelters and carrying out group and individual mental health consultations.
We recently began to support a maternity hospital in the area, improving access to care for survivors of SGBV.
MSF’s previous focus in Zhytomyr is gradually returning to pre-February activities in supporting the treatment of patients with drug-resistant tuberculosis (TB). This includes medication, mental health care and social support such as food and hygiene parcels.
In and around Zhytomyr, we donated trauma-related supplies and conducted mass casualty training in nine hospitals during the phase when frontlines of fighting were close.
We are running mobile clinics in 10 neighbouring villages around Chernihiv to respond to health needs. We are providing outpatient consultations for non-communicable diseases as well as mental health support and identifying cases of sexual and gender-based violence (SGBV). We are also reaching patients in Chernihiv with our SGBV hotline, located in Kyiv.
Until recent weeks, MSF teams in Kharkiv have been running mobile clinics for the thousands of people sheltering from the conflict in metro stations beneath the city. Many people here have also been suffering from stress and psychological trauma due to the bombing.
More than 1,000 consultations were carried out by our teams, while water filter systems were installed to secure access to clean water for those living in the stations.
As of 24 May, the majority of people have been evacuated and the metro system is functioning again. Although our underground clinics have largely stopped, we are now following up with vulnerable patients and continuing clinics at sites across the city while the security situation remains unstable.
Outside the city, we are working to reach remote villages, supporting local volunteer organisations with donations of food and essential items, and transporting medical supplies to healthcare posts. We have also established a further telephone hotline to provide medications and psychological support.
In the city of Lviv, expert teams have been training hospital staff to deal with mass casualty events and to treat war wounds.
We also have a surgical team working to support the burns unit of one of the big referral hospitals in Lviv.
In Vinnytsia, our teams are working with local hospitals to prepare for mass casualty events, and have made donations to healthcare facilities across the region. We are also exploring how to provide support for water and sanitation needs.
Mental health support has begun in Nemyriv district, with a focus on destigmatisation and psychological support in an environment that previously relied on medication and institutions. We are also planning physiotherapy care for war-wounded patients.
Across Vinnytsia, we are providing support for people who have fled from other parts of Ukraine. Our mobile clinic teams here are visiting shelters, providing consultations, medication, psychological aid and relief items.
We have also rehabilitated a medical facility to care for elderly people who have been evacuated from frontline regions and require care for chronic illnesses.
Mukachevo and Berehove
A team is running mobile clinics along the border with Hungary, where there are significant numbers of people gathered, centred for the moment on Berehove.
The team is seeing signs that mental health support is becoming a priority. We will focus in this direction, and also on the continuity of care for patients who were previously following medical treatment that risks being interrupted by their rapid departure to a place of safety.
Uzhhorod and Ivano-Frankivsk
We have established bases in Uzhhorod and Ivano-Frankivsk and are building a network for transporting supplies to hospitals in frontline areas. We have also assessed nearby healthcare needs and have began training local health professionals in mental health care, while supporting a clinic for people displaced to the area.
In this area, we have previously carried out chemical, biological, radiological and nuclear training with local healthcare teams.
Odesa and Mykolaiv
To help Ukrainian health facilities cope with a potential influx of injured people, MSF teams have trained hundreds of medical doctors and nurses to triage patients according to the severity of their injuries.
This step is essential to ensure that patients are treated appropriately in an emergency situation.
In Odesa and Mykolaiv, we were able to donate medical supplies to hospitals preparing to accept wounded. Consultations for displaced and vulnerable people will be provided soon.
In Mykolaiv, MSF is also funding the work of local volunteers who bring medical and logistic equipment in and out of the besieged city.
An MSF team based in Kryvyi Rih is working with a hospital near the southern frontline to help develop their emergency room and mass casualty response. The team has also delivered medical supplies to the Kherson region, which was recently retaken by Ukrainian forces.
We have expanded our work in eastern Ukraine in response to the growing needs in areas close to the frontline and in places hosting people who have fled their homes.
In and around Dnipro, we are supporting vulnerable people who have fled parts of Donetsk and Luhansk where the conflict is particularly intense, and who are now staying temporarily or longer-term in more than 40 shelters.
Many are highly vulnerable, including the elderly, people with disabilities, unaccompanied children and people who cannot afford to make the journey further west in Ukraine or abroad.
In the shelters our teams run mobile clinics, providing medical consultations; continuation of care and medications for people with chronic illnesses; referrals to hospitals for severely unwell patients; psychological first aid and mental health consultations; and basic relief items.
MSF has started running mobile clinics at more than 30 shelters and reception centres where many people have been arriving from Mariupol. This involves consultations, care for chronic diseases, psychological first aid and referral to hospital for severely unwell patients.
We have also donated medical supplies and carried out mass casualty training for staff at the main hospital in Zaporizhzhia.
Donetsk and Luhansk regions
We are working with health facilities close to the frontline in Donetsk to make sure they have enough of the right supplies and training to be able to keep treating patients if they get cut off from supply lines by intense fighting.
For some facilities, we are also providing logistical support to ensure an autonomous supply of electricity through generators and solar power, and clean water to continue functioning for up to a week.
The hospitals that we have visited in the Dontesk and Luhansk regions all have surgical capacity but at varying levels. We have a team based in Pokrovsk to provide guidance, coaching and ongoing training for hospitals to improve and expand their surgical capacity. We have also started an ambulance referral service to medically evacuate patients from hospitals that are closer to areas of active warfare in the east.
Our emergency response in neighbouring countries
MSF is committed to providing medical aid to people affected by the conflict no matter where or who they are.
MSF emergency teams are operating from bases in Poland to bring essential medical staff and supplies into Ukraine.
According to the United Nations (UN), more than three million people have fled from Ukraine into Poland as of 3 May. In the first few days of the response, we donated supplies to the Red Cross Lublin and a reception point in Horodlo, and we intend to start providing psychological first aid, self-care and counselling training to volunteers helping with the response.
The UN reports that around 530,000 refugees have crossed into Hungary. However, our assessments have found that the immediate needs of many people are being met.
We have now started working in partnership with local organisations to provide primary healthcare consultations and psychological support. Meanwhile, we will continue to monitor the situation, focusing on identifying less visible needs of vulnerable individuals and groups that are missing out on essential services.
As of 3 May, nearly 500,00 people have crossed into Moldova from Ukraine. Although many people appear to be in transit, Moldova – which has a population of only 2.6 million people – now hosts the largest concentration of Ukrainian refugees per capita, according to the UN.
On 12 March in Palanca, MSF started providing primary healthcare consultations and psychological first aid sessions for people fleeing from Mykolaiv and Odesa. Our teams have also provided mental health support to people at reception centres in the capital Chișinău, and are undertaking assessments at hospitals across the city to understand the medical needs.
According to the UN, more than 461,000 people have crossed into Slovakia from Ukraine as of 29 May.
We have signed a Memorandum of Understanding with the Ministry of Health to be able to import medical supplies and we are doing or have scheduled training for health staff on SGBV and TB and MDR-TB.
For the moment, the critical humanitarian and medical needs are covered by the local authorities and civil society.
MSF has existing projects working with healthcare authorities in Russia’s Arkhangelsk and Vladimir regions to support the treatment of patients with drug-resistant TB.
As of 26 May, over 971,000 refugees have crossed from Ukraine into Russia. We are now conducting assessments in the south of Russia to see whether new medical humanitarian needs have recently emerged. We have also made donations such as food, hygiene kits and medicines to support refugees.
In our project in Moscow and Saint Petersburg where we are partnering with local NGOs to support vulnerable groups, we’ve seen an increase in the cohort for HIV and HCV care, among them Ukrainians who are stranded in Russia and cannot get refills for their ARVs.
In Belarus, MSF continues to run regular programmes supporting hepatitis C patients and the national TB programme. In 2021, we assisted people on the move stranded between Belarus and the EU.
More than 27,000 refugees have arrived from Ukraine to Belarus, as of 12 May. MSF teams are currently assessing the situation to identify new medical and humanitarian needs.
Before the conflict
Before the escalation in fighting, MSF teams were already working in Ukraine’s eastern Donbas region, where conflict broke out in 2014.
Despite a ceasefire in 2015, regular violence and access to healthcare became a daily challenge for people living along the ‘contact line’. Our teams ran projects providing treatment for chronic illnesses including HIV/AIDS, TB and diabetes, as well as mental health support.