Russia’s invasion of Ukraine has driven millions of Ukrainians from their homes. Thousands have fled to nearby countries such as Poland, Hungary, and Romania. 34 hospitals, including a maternity and children’s hospital, have been destroyed.
The sudden loss of health care infrastructure and medical supply lines are exacerbating pre-existing health inequities among residents of Ukraine. The war could set public health efforts in Ukraine back by decades as the conflict continues to break down a health care system that was already struggling in the aftermath of Soviet-era corruption, health misinformation, and distrust between the public and health providers.
Pre-Existing Vulnerable Populations
Among the most worrying pre-existing health inequities in Ukraine are a higher than average rate of HIV incidence, multi-drug resistant tuberculosis incidence, and hepatitis C incidence, not to mention the continued presence of COVID-19. Ukraine’s measles and polio vaccination rates are also well below the average for a European nation.
Displaced Ukrainians who left their homes with whatever medication they had on hand are now experiencing severe and long-term disruptions in their treatment. As refugees continue to flee, the mass migration is likely to lead to new outbreaks of infectious disease, which could spread quickly throughout refugee camps and beyond.
Amidst the struggle, healthcare workers are at risk for increased stress-related health outcomes as they struggle to meet the needs of the population without centralized support. Many healthcare providers working in Ukraine now are refugees themselves. They are no less susceptible to the effects of displacement than other Ukrainians, especially as hospitals and other medical centers continue to be targeted. Without careful management and proper protections, Ukrainian healthcare workers are likely to experience severe burnout, endangering themselves and those who rely on them for care.
A Reproductive Health Crisis
Reproductive health is a particular area of public health concern; Ukraine already has higher than average maternal mortality rates, and mothers who successfully give birth during the crisis still require all the supplies needed for taking care of a newborn—supplies that are now in incredibly short supply.
Reproductive health supplies such as menstrual products, contraceptive medication, emergency contraception, and condoms, are also in short supply with limited accessibility. This poses a great risk for displaced young women and LGBTQ+ individuals, who are at increased risk for sexual violence. Refugees seeking abortion services must abide by the reproductive laws of the country they flee to, which has reduced access for many. Poland, where 1.8 million refugees have landed, has strict anti-abortion policies. For the 80,000 Ukrainians who were expected to give birth between March and June, the war has put them all at even higher risk for pregnancy-related health complications.
Consequences for the Next Generation
The consequences of the war in Ukraine will continue to impact the lives of those displaced long after the conflict has ended. Children, estimated to make up half of the Ukrainian refugees, are extremely susceptible to the lifelong effects of displacement. The trauma of war and displacement will affect their physical and emotional development, putting them at higher risk for stress and anxiety related disorders, mental illness, and physical and sexual violence. These effects can then be translated into generational health problems, putting their own children and grandchildren at higher risk for negative health outcomes.
The exact extent of the conflict in Ukraine’s implications on public health will be unknowable for some time but what is certain is that the consequences will be long-lasting. More robust aid is needed now to mitigate these pressing problems as much as possible. However, restoring Ukraine’s healthcare system will require years of dedicated support. The experience of Ukraine is a wake-up call for the international community. Leaders must act now to safeguard public health around the globe.