The Neglected of the Ukrainian Conflict: Caring for the Elderly on the Frontlines

Dr. Deane Marchbein of Doctors Without Borders (MSF) comes to campus for the MAHA Speaker Series.

The conflict between Ukrainian forces and pro-Russian separatists has already forced over a million people to flee from the ravaged conflict zone. But those that are too sick, too poor or too old to leave are often forgotten on the frontlines. They are stranded when public transport breaks down, hungry when local supply chains collapse, and suffer from the lack of medical attention when drugs become unavailable. In the conflict’s buffer zone, where 77% of the population reported that they reduced their food intake since the start of the fighting, the elderly are disproportionately affected by the conflict without a state-run medical network to support them.

Dr. Deane Marchbein, the local physician from Arlington, who went to eastern Ukraine as part of her work with Doctors Without Borders to bring medical care for the ederly in war-torn villages there, was recently on campus to give a talk about her experiences. She was the latest featured speaker for the MAHA – or Master of Arts in Humanitarian Assistance – speaker series. The MAHA degree is a joint program between The Fletcher School and the Friedman School at Tufts that provides an integrated, one-year study program to mid-career humanitarian professionals.

In Ukraine, Dr. Marchbein and her team stepped in to provide medical care where no one else would. Through mobile clinics visiting 28 villages across the conflict’s buffer zone, she and her team treated diabetes, high blood pressure and other non-communicable diseases. However, one of the most pressing needs in the region, Dr. Marchbein noted, was for mental services. When shelling becames the norm and the social tissue of a society was under strain, anxiety, depression and grief became widespread. State-run mental health services were either inadequate or non-existent, Dr. Marchbein said.

Coordinating medical teams in an active conflict poses a unique set of security challenges. “Every morning I [spent] two hours on the phone to figure out if it’s safe for us to go”, Dr. Marchbein explained. The political confrontation further complicates an already precarious situation: NGOs are regularly expelled from the region and are victims of disinformation campaigns.

What’s more, humanitarian emergencies have intensified globally. The United Nations reported a 29% increase in those needing humanitarian assistance over the last five years, totaling to over 132 million people today.

In her struggle to bring attention to the ‘hidden people’, Dr. Marchbein pointed out an institutional shortcoming. She is convinced that the humanitarian system of today is not suited to cater the special needs of the elderly, and she believes that with aging populations, this problem will only become more pronounced in the coming decades.

How do we change this? “We need to be loud,” Dr. Marchbein declared. A powerful vehicle to change humanitarian priorities is to directly address the funders and explain whythe elderly need special attention in humanitarian work. Funding priorities can change the global agenda, she argued.

Inside her own organization, Medcins Sans Frontiers – or Doctors Without Borders – Dr. Marchbein is championing efforts to recognize the special status of elderly as a single vulnerable population. This, she hopes, will ensure that those that are too often left behind will receive the care that they need.

This piece was republished from The Fletcher School website.