This winter will endanger the lives of millions of people in Ukraine.
The devastating energy crisis, the deepening of the mental health emergency, the restrictions on humanitarian access and the risk of viral infections will make this winter a formidable test for the Ukrainian health system and the Ukrainian people, but also for the world and their commitment to support Ukraine.
The country is facing a thermal crisis in addition to a permanent crisis caused by the war and the pandemic.
Half of Ukraine’s energy infrastructure is damaged or destroyed. This is already having repercussions on the health system and on people’s health.
Simply put, this winter is going to be about survival.
The WHO has so far verified 703 attacks on health since the war began 9 months ago. This is a violation of international humanitarian law and the rules of war.
Ongoing attacks on health and energy infrastructure mean that hundreds of hospitals and healthcare facilities are no longer fully operational and lack fuel, water and electricity to meet basic needs.
Maternity wards need incubators; blood banks need refrigerators; intensive care beds need fans; and they all require energy.
It is to focus the world’s attention on this situation that I am here on my fourth visit this year and just days after the largest wave of missile attacks across the country, to meet with officials, health workers and patients. and offer WHO’s unwavering support to the Ministry of Health. Health, to the government and to the Ukrainian people.
And express my gratitude and respect for the doctors, nurses and other healthcare workers of Ukraine, who continue to show their heroism.
What we know is that hundreds of thousands of places throughout the country – including private homes, schools and hospitals – do not have a gas supply, essential not only for cooking but also for heating.
Today, 10 million people, a quarter of the population, do not have electricity.
Temperatures are forecast to plummet to -20˚C in some parts of the country.
As desperate families try to stay warm, many will be forced to resort to alternative heating methods, such as burning coal or wood, or using diesel-powered generators or electric heaters. These bring health risks, including exposure to toxic substances that are harmful to children, the elderly, and people with respiratory and cardiovascular conditions, as well as burns and accidental injuries.
We expect another 2-3 million people to leave their homes in search of warmth and safety. They will face unique health challenges, including respiratory infections like COVID-19, pneumonia, and influenza, and the serious risk of diphtheria and measles in undervaccinated populations.
All this is taking its toll on the mental health of Ukrainians. This week, the war enters its ninth month and already some 10 million people are at risk of mental disorders such as acute stress, anxiety, depression, substance use and post-traumatic stress disorder, or PTSD.
By training health workers on how to deliver mental health services, WHO has so far reached 1,400 people with serious mental health conditions in Ukraine.
Tens of thousands of mental health and psychosocial support consultations have been conducted for health workers and the general public, including by mobile mental health teams that go into the community to offer care. This would not be possible without the tireless support of the First Lady, Her Excellency Ms. Olena Zelenska, whom I thank for our meeting today.
I also met with the Prime Minister, His Excellency Mr. Denys Shmyhal, and the Minister of Health, Mr. Viktor Liashko, with whom I discussed energy supply, winterization and, perhaps most importantly, the meeting critical health needs in both recently recovered and occupied areas.
And this brings me to the next point: humanitarian access.
The war has affected both access to medical care and supply lines for the flow of humanitarian aid. Ukraine needs sustained resources to maintain the health system through the winter and beyond, items that will be high on the agenda at next month’s Ukraine Conference in Paris, under the leadership of President Macron and President Zelenskyy.
I am very concerned for the 17,000 HIV patients in Donetsk, who may soon run out of critical antiretroviral drugs to help them stay alive. I urgently call for the creation of a humanitarian health corridor in all newly recovered and occupied areas. WHO and our partners are ready to mobilize at any time.
I reiterate my call to both parties to allow urgent humanitarian access to meet the health needs of the people.
Access to health care cannot be held hostage.
Finally, let’s not forget that people are more likely to contract viral respiratory infections in winter than in other seasons. As in the rest of Europe, the many Omicron sub-variants are also circulating in the Ukraine. Yet with low baseline vaccination rates, let alone boosters, millions of Ukrainians have waning or no immunity against COVID-19. Combine that with an expected increase in seasonal flu and difficulties accessing health services, and this could spell disaster for vulnerable people.
We are helping Ukraine’s healthcare system prepare for winter. This includes emergency repairs to health facilities and heating infrastructure, and power maintenance.
We are also providing prefabricated structures in newly reclaimed areas, portable fuel heating devices, survival blankets, diesel generators and ambulances.
Ukraine’s healthcare system is facing its darkest days in the war so far. Having withstood more than 700 attacks, it is now also a victim of the energy crisis. It is being squeezed from all sides and the last victim is the patient.
In the short term, we must find practical solutions that allow health care services to continue through the winter as best they can. But this is not a sustainable scenario. This war must end, before the healthcare system and the health of the Ukrainian nation are further compromised.