It is important to note that Ukrainian health staff and civil society organizations are leading the humanitarian response. MSF's interventions focus on filling the gaps: our teams are treating patients near the front lines, running mobile clinics, evacuating patients to safer areas, offering mental health care, and providing supplies and training to health facilities. MSF is now unable to access areas controlled by Russian forces, including areas in the east where we have been present since 2014.

Medical evacuation train

MSF runs a medical evacuation train to safely transport patients from overburdened hospitals near the fron tlines tosafer facilities with more capacity. The train began operating on March 28, 2022. In 2022 it completed 79 trips, referring 2,558 people. Seven hundred of these patients were trauma cases and 136 were admitted to the train’s intensive care car. So far, in 2023, the train has referred 216 patients on 11 trips. Family members or caretakers accompany patients on all train trips.

Eastern Ukraine

Donetsk oblast

Supporting hospitals

MSF sends donations to primary, secondary, and tertiary health care services and supports training for specialized emergency response. After months of disruption and decreased activities, the health care system is slowly recovering. Meanwhile, medical needs are increasing as some people who fled the fighting return to their homes. In response, MSF has launched an agile emergency response, running an ambulance in Sloviansk and Pokrovsk.

Ambulance referrals

MSF ambulances refer patients between health care facilities, serving 16 different facilities in the Donetsk region. Many of these patients require transport from facilities close to the front line to hospitals further away from the fighting where they can continue their care. Of the 1,180 people transferred by this service, most suffered severe trauma. Some ambulances are also equipped for intensive care unit (ICU) support. In 2022, 41 patients who were intubated or needed specific medical monitoring were transported.

An emergency department in Kostiantynivka

MSF has supported the emergency department and surgical and intensive care units at the Kostiantynivka hospital since late July. In 2022, MSF teams treated 752 patients in the emergency room (ER) with 168 surgical interventions performed in the operating theater. These teams work alongside and in partnership with staff from the Ukrainian Ministry of Health. Most of the patients they see are trauma cases.

Supply donations and a mobile clinic in Lyman

The Lyman area was retaken by Ukrainian forces in late 2022. In the last quarter of the year, MSF teams conducted 3,152 primary health care consultations in Lyman and the surrounding areas and donated medical supplies. We will continue to work in this area and will further explore how MSF can best respond to the evolving needs.

Support for internally displaced people (IDPs)

In and around Dnipro, MSF supports vulnerable people in more than 40 shelters who fled parts of Donetsk and Luhansk oblasts, where the conflict is particularly intense. In Zaporizhzhia we provide support to thousands of people who were displaced from Mariupol.

Mobile Clinics

Our mobile clinics provide medical consultations and medications for people with chronic illnesses such as hypertension, asthma, diabetes, heart disease, and epilepsy. We also refer severely ill patients to hospitals, provide psychological first aid and mental health consultations, and distribute basic relief items. These mobile clinics are being scaled down as many people can once again access these services through Ukraine’s national health system.

Support to hospitals

In Zaporizhzhia, MSF continues to support hospitals near the front line through supply donations. Mental health activities are also being scaled up to include workers close to the front line as the burden of mental health trauma related to the continuing conflict grows.

Sexual and reproductive health care

MSF also runs a clinic providing sexual and reproductive health services, including contraceptives and care for people who have experienced sexual violence. The team also provides health promotion and information and connects people to health services via social media. In 2022, MSF teams provided 372 consultations for sexual and reproductive health in Dnipro.

Emergency room and surgical support in Apostolove

In Apostolove hospital, MSF provides emergency room and direct, hands-on surgical support. This includes assisting with, and working on, triage and surgical interventions. In the hospital our teams provided 972 consultations in 2022 andadmitted 403 patients suffering from violent trauma injuries.

Care for carers

MSF teams continue to support local health care professionals experiencing burnout and stress. Activities include psychological group support and stress management trainings focused on providing coping mechanisms.

Northeastern Ukraine

Kharkiv oblast

Mobile clinic and mental health care

We run mobile clinics in rural villages and towns in the Kharkiv region, providing primary health care, including sexual and reproductive health, and mental health support. Most of MSF’s patients are women over the age of 60. The major medical needs are chronic illnesses, such as hypertension and diabetes.

We also provide non-food items such as hygiene kits and medical supplies to health facilities. Many health facilities in the region have been damaged or destroyed, and communities have been living without electricity and heating for months. The weather and lack of public transportation makes it difficult for people to reach health care. We are seeing an increase in acute diseases, including upper respiratory tract infections and exacerbation of asthma.

Supporting psychiatric patients

MSF teams also provide medical and psychiatric care in two “care houses” that host people with severe psychiatric and neuropsychologic conditions. Most of these patients hadn’t received proper psychiatric or medical care for since February 2022. We also provided group and individual psychological sessions for the staff of these facilities. In January 2023 we briefly supported three more such facilities in the region.

Kirovohrad oblast

Donations and training

MSF has made donations of medical supplies to 23 health facilities Kirovohrad oblast, where the city of Kropyvnytskyiis located, and the northern part of neighboring Mykolaiv oblast. From April to December we provided 146 training sessions for health professionals, psychologists, and first responders on things like managing influxes of war wounded people, decontamination, trauma, and mental health. A total of 2,301 people participated in these training sessions. Since April, our mental health team has seen 299 patients in individual sessions and 9,463 patients in group psychoeducation sessions. MSF is also distributing relief items (bedding kits, hygiene kits, food, firewood, electrical materials, and mnore) and doing rehabilitation work in IDP shelters, particularly in the area of water and sanitation.

Vinnytsia oblast

Rehabilitation Project

Our rehabilitation project at the Ministry of Health hospital in Vinnytsia continues. MSF teams provide physiotherapy and psychological counseling to war-wounded people, following a similar approach to the project we operate in Kyiv. This approach focuses on providing hands-on treatment to patients and capacity-building through training for local staff.

Mobile clinics and mental health care

In Vinnytsia, we run mobile clinics, particularly in the southern part of the oblast and rural areas where IDPs have settled without access to primary health care. Other mobile teams focus on mental health and health promotion.

Training

We have carried out training sessions on decontamination, mass casualties, sexual and gender-based violence, and mental health with local health professionals, psychologists, and first responders. From March to December 2022, we provided 41 training sessions attended by 764 people in Zakarpattia oblast and 69 sessions in Ivano-Frankivsk oblast, with the participation of 1,146 people.

Donations

MSF continues to donate medical supplies on a regular basis. We have made 84 donations of kits in about 20 facilities in these two oblasts. We also distribute relief items (bedding kits, hygiene kits, food, and more) for displaced people, particularly in nearby rural areas. We also offer rehabilitation work at IDP shelters. In 2022 our mental health teams in both locations saw 797 patients in individual sessions and 4,593 patients in group psychoeducation sessions.

Neighboring Countries

Poland

More than 9.4 million people have crossed from Ukraine into Poland since February 24, 2022, according to UNHCR. More than 1.5 million people have registered for temporary protection. MSF is actively working to support the Ministry of Health to ensure that patients are able to access treatment for drug-resistant tuberculosis, including displaced patients previously supported by MSF in Ukraine.

Russia 

More than 2,800,000 people have crossed to Russia from Ukraine as of October 3, 2022, according to UNHCR.

MSF has been present in Russia for 30 years. Currently, our teams in Russia work with health authorities in Arkhangelsk and Vladimir regions to support lifesaving treatment for patients with drug-resistant TB. In the last few months, MSF scaled up its assistance to partner organizations in St. Petersburg and Moscow to ensure the continuation of HIV treatment for people from Ukraine and other people in need. We have seen an increase in the number of people from Ukraine living with HIV and hepatitis C in need of refills for their antiretroviral medicines.

To respond to the needs resulting from the conflict in Ukraine, MSF has started to support displaced people in the Voronezh, Belgorod, and Rostov-on-Don regions. Through regional nongovernmental organizations, MSF has organized a team of local social workers, medical doctors, psychologists, and legal counselors that are working to ensure that people from Ukraine—mostly newly arrived ones—receive all the necessary qualified medical services in licensed medical clinics and have access to other state social services. When necessary, we have been covering any medical care gaps and paying for the necessary medications and medical consultations. We also regularly support organizations working in these regions with essential supplies like food, hygiene items, and more.

So far, we have provided medical support to around 4,800 migrants, which also included nearly 1,020 mental health support sessions.

As in any country, our work in Russia is focused on providing medical care where we can, based on medical needs alone.

MSF first worked in Ukraine in 1999, supporting the Ministry of Health to treat HIV. From 2011 to 2014, MSF ran a drug-resistant TB program within the regional penitentiary system in Donetsk. We have been responding to the war in eastern Ukraine since 2014 and have continued to run specialized programs to treat infectious diseases like hepatitis C. When the conflict escalated in February 2022, MSF was running a drug-resistant tuberculosis project in Zhytomyr and an HIV project in Sievierodonetsk and was working to improve access to primary health care for people affected by years of fighting in the east. These projects were suspended as we reoriented our activities to respond to the urgent needs stemming from the escalation of the war.