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Europe's second largest country, Ukraine has a population of over 44 million people. Médecins Sans Frontières first began working in Ukraine in 1999 and is currently responding to the ongoing "frozen war” in the east of the country.

The armed conflict between the self-proclaimed authorities of the Donetsk People’s Republic (DPR) and Ukraine continues to cause major disruptions to the public health system in the government controlled areas of the Donetsk Oblast. Thousands have been injured, or killed, and over a million have been displaced.

Villages inside the buffer zone have experienced a total collapse of the health system. Access to healthcare remains severely limited for people living along the front line, due to disrupted services, and damage to infrastructure. Many of the medical facilities are still shut down and medical staff who have fled have not come back to the villages.

Since the conflict began in eastern Ukraine in April 2014, MSF has supported more than 350 health facilities on the both sides of the contact line with donations of medical equipment and medicines to treat war-wounded, people with chronic diseases, provided primary healthcare and assisted safe deliveries for pregnant women.

Without transportation and isolated by poor weather, villagers in the east, mostly elderly people, have no choice but to live with the constant stress of the conflict in the region. 

Due to the unstable and insecure environment, the population is suffering from psychological disorders such as post-traumatic stress disorder (PTSD), depression, intense anxiety, trouble sleeping, hopelessness and an inability to function in daily life. 

The economic impact of the conflict, due to unemployment and inflation in combination with a lack of social services is putting further pressure on the residents of the region.

Internally displaced people (IDPs) with chronic diseases living outside the Buffer Zone are facing marginalization from the health system as they can no longer afford to pay for their treatments.

The majority of patients are suffering from chronic conditions, such as cardiovascular disease, hypertension, and diabetes, who are cut off from access to regular treatment and long-term monitoring.

Clinical psychology is not incorporated into the Ukrainian health system and, therefore, traumatized populations are left without access to mental health counseling and treatment.

Mobile health clinics allow increased availability of psychological and medical support to people living in areas controlled by the Ukrainian government, including those who have been displaced. MSF has also been providing training in psychological support to assist healthcare workers and teachers in the conflict zone.  

Treating Tuberculosis and Hepatitis C 

MSF runs a hepatitis C program in Mykolaiv region, providing treatment with two effective direct-acting antivirals – daclatasvir and sofosbuvir – as well as diagnostic tests, patient support, education and counselling services. Some patients are co-infected with HIV or on opioid substitution therapy; others are healthcare workers infected with the virus. 

At the end of 2017, MSF handed over care of patients with drug-resistant tuberculosis (DR-TB) in the penitentiary system in Dnipro and Donetsk. In order to ensure continuity of care, a transfer plan was put in place for each patient, including the provision of medication to enable them to finish their treatment. MSF is also now working to open a new program in Zhytomyr to treat DR-TB patients in the general population. 

Find out more about Ukraine