Health brief: The burden of war on Ukrainian doctors – EURACTIV

By EURACTIV's Health Hub and Giedre Peseckyte | EURACTIV
06-07-2022 (updated: 08-07-2022 )
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Healthcare staff in Kyiv have reported increasing numbers of patients, with many struggling to access health services and medicines in the country that has been under attack from Russia since the end of February. 
On 24 February, gastroenterologist Olena Baka was woken to loud explosions; a sound she immediately recognised as the beginning of Russia’s large-scale invasion of Ukraine.
“My life, life in my country [Ukraine] and Europe and all world had changed forever,” she told a room of journalists, four months later, at the International Liver Congress in London. 
Baka, who leads the gastroenterology department at Ukraine’s National Academy of Sciences, was flanked by Elina Manzhalii, president of the Ukrainian Liver Foundation (ULF) and professor at the Bogomolets Medical University in Kyiv.
As they talk, they are intermittently interrupted by sound of aeroplanes flying overhead – the event space is close to an airport. We are shocked when we hear these sounds,” Manzhalii said.
Manzhalii thought back to a conversation with her colleagues in the Kyiv hospital at the end of February. “We should organise working as teams: one team one day, next day another team,” she recalled the head of the clinic saying. 
But shortly after the first team arrived, it became impossible to go back home; they stayed for five days straight, she said. Tanks were in Kyiv and we were sitting in the hospital.”
“Nobody should feel this. It’s terrible. And it’s impossible to understand how in our peaceful life…” she trails off, her voice trembling, tears in her eyes.
Medical staff were sleeping on the ground floor in the department of pathology together with patients, she continued. “Everyone lived in the hospital – even our dogs and cats. We have photos when we are laying on the floor.”
“One of our directors stayed in the hospital for two months with his family because there was a very high risk of the bombing of his house,” she said, adding that other doctors stayed in the hospital because their houses were destroyed. 
Continuing work during the war for doctors meant not only living in the hospital but also having to ignore sirens. 
Hourly air raid sirens soundtracked the work of medical teams.
While her hospital was not hit, Baka said that around 600 medical facilities have been destroyed or damaged and 200 medical emergency vehicles have been shot or taken by Russian forces.
On Tuesday (5 July), the World Health Organisation announced they had verified 348 attacks on health services in Ukraine that took place between 24 February and 19 June, which resulted in 76 deaths and 59 injuries.
Both Baka and Manzhalii reported having lost colleagues from other hospitals. “A young 30-years-old woman was killed in Bucha, Irpin. It’s really tragic because you know and work personally with this person,” Manzhalii said.
Among those who escaped the war – a number now which has now reached nearly 5.5 million people, there are “a lot of doctors”. 
It’s a tragedy because our patients can’t get good medical care as they had before,” Manzhalii said. 
Baka highlighted that chronic disease patients, especially, are suffering as they cannot access medical care due to destroyed hospitals. In the meantime, “the number of patients with decompressed advanced cirrhosis, toxic hepatitis and autoimmune disease increased,” she said. 
One of the factors driving up case numbers of toxic hepatitis is the level of toxins released into the environment following explosions, Baka said.
Beyond physical health, psychological disorders including stress are also on the rise. We have psychologists, neurologists, and their work is very important because we need to prescribe drugs to help people normalise their psychological status,” Manzhalii said, adding that she is also concerned about increased alcohol consumption as a coping mechanism.
“It will be a problem in the future,” she said. 
Both doctors reported having stayed in touch with their patients abroad using telemedicine but emphasised that getting drugs to their patients remains a challenge. Over 400 pharmacies and drugstores have been completely destroyed, Baka said. 
While volunteers are working to bring medicines into the country, Manzhalii said that they do not always meet the needs of the hospital, and there is also a lack of coordination. 
At the same time, Manzhalii expressed her gratitude for the support Ukraine is receiving. “People try to do their best to help us, it’s really fantastic”. 
Asked by EURACTIV if they ever thought of leaving Kyiv, both, Manzhalii and Baka said “never”. Many doctors who left the country are now returning to Ukraine’s capital. “We don’t want live abroad, we love our country,” Manzhalii said.
There is a lot of work waiting ahead of them as the war turned around all the gains in the medical field. “We had innovative methods, we had modern equipment, liver transplantology was showing good results. But now we have nothing,” Baka said.
By Giedre Peseckyte reporting from London
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[Edited by Nathalie Weatherald]


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