UKRAINE: REACHING THE VULNERABLE

Since May 2014, MSF has supported around 100 medical facilities on both sides of the frontline with medical supplies, as well as running a psychological support programme. In response to difficulties people in rural areas face in accessing healthcare and medicines after more than ten months of conflict, Médecins Sans Frontières (MSF) is running mobile clinics in 25 locations in Donetsk and Luhansk regions.

Photo: Amnon Gutman

Although fighting in eastern Ukraine has reduced since a ceasefire came into effect on 15 February, medical needs remain urgent on both sides of the frontline. Residents and displaced people are living in precarious conditions, many medical facilities have been damaged or destroyed and there are critical shortages of basic and specialised medicines and medical supplies. Photo: Amnon Gutman

With medical supply lines in the east of the country severely disrupted or cut entirely since last summer, and health facilities located in rebel-held areas not included in the 2015 Ukrainian government health budget, people face a critical shortage of medicines. Photo: Manu Brabo

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Medical facilities have repeatedly come under fire throughout the conflict. This health centre in the village of Stepanovka was destroyed by heavy shelling in August 2014, along with the local school and many homes. Photo: Amnon Gutman

Nurses set up a makeshift clinic in a nearby administrative building and an MSF doctor now visits twice a week to provide free consultations and medicines. In just the first month of running clinics in Donetsk and Luhansk, MSF doctors carried out more than 1700 consultations, illustrating the huge need for healthcare and medicines in these areas. Photo: Amnon Gutman

People crowd into the waiting room at MSF’s mobile clinic in Kuteynikovo. The village’s doctor was transferred to another town when the conflict began so the community has been without a regular doctor for months. Photo: Amnon Gutman

Many health staff have left the region since the conflict began and those who have remained behind have continued working without receiving salaries since last summer. Photo: Amnon Gutman

Banks have been closed and pensions have not been paid for many months, so people have been delaying going to see a doctor simply because they cannot afford the cost of transport or medication. Vavara picked plants to make tea to treat her hypertension as there were no medications available. Photo: Amnon Gutman

The local pharmacy in Kuteynikovo has been closed since last summer because it was not possible to get a supply of medicines. Residents must travel to the nearest larger town to purchase drugs at one of the private pharmacies, although the price of medicines has increased significantly and even basic medications such as painkillers are out of reach for people. Photo: Amnon Gutman

Patients with chronic diseases are particularly affected by the lack of medicines, with the majority of MSF’s patients in the mobile clinics needing treatment for heart disease, hypertension, diabetes or asthma. Photo: Amnon Gutman

Ludmila, 66, lives in Kuteynikovo with her husband: “I have diabetes as well as complications with my heart, high blood pressure and a gastric ulcer. I have enough insulin for the next month, but after that I don’t know. The only way to receive our pension is to cross the frontline and come back. The problem here is that drugs are not available, and if they are, they’re too expensive.” Photo: Amnon Gutman

While many people fled the fighting, most of the people who remained are the most vulnerable members of the community – the elderly, disabled, and sick – who did not have the means to flee the conflict. Antonyna, 79, lives in Kuteynikovo: “I haven’t received my pension for eight months. I have many health problems: angina, and problems with my ears, sinuses and joints. I can’t afford to buy medicines. I received some drugs I needed from MSF, but before that I lived without them. I was just using plants to treat myself. I can’t leave, I’m too old. I was born here and I’m going to die here.” Photo: Amnon Gutman