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The assault on Ukraine has massive and wide-ranging health implications

*** This article was updated on 28 February and 2 March ***

Amid reports from Ukraine of babies born in bomb shelters, a children’s cancer hospital under fire, acts of heroic resistance, and the shooting of two Danish reporters, from Russia comes reports of scientists and doctors going public in opposing the invasion.

As hundreds of thousands of Ukraine refugees flee across borders, the European Public Health Association (EPHA) has joined other health and medical organisations in condemning Russia’s attack on Ukraine.

EUPHA, representing around 23,000 public health professionals, called for an immediate cessation of hostilities, followed rapidly by a withdrawal supervised by international monitors from either the United Nations or Organization for Security and Cooperation in Europe.

The Association called for respect for the Geneva Conventions, and in particular the protection of health workers and facilities, noting that an attack on a hospital was a clear violation of the Geneva Conventions.

The EUPHA statement also called for respect for the rights of those in the Russian Federation who are calling for peace.

“EUPHA further stands in solidarity with its member associations in countries that may also face future threats from external aggression, and especially those in the Baltic states,” said the statement.

As previously reported at Croakey, many health and medical organisations have condemned the Russian invasion of Ukraine, including the World Medical Association and the World Federation of Public Health Associations.

In a statement on 27 February, the World Health Organization (WHO) warned about a shortage of life-saving medicinal oxygen supplies, which are crucial for patients with COVID-19 (who number 1,700 in hospital now), and those with other critical illnesses (from neonates to older persons) stemming from complications of pregnancy, childbirth, chronic conditions, sepsis, and injuries and trauma.

“The oxygen supply situation is nearing a very dangerous point in Ukraine,” the WHO said. “Trucks are unable to transport oxygen supplies from plants to hospitals across the country, including the capital Kyiv. The majority of hospitals could exhaust their oxygen reserves within the next 24 hours. Some have already run out. This puts thousands of lives at risk.”

As well as shortages of other essential supplies, critical hospital services are also being jeopardised by electricity and power shortages, and ambulances transporting patients are in danger of getting caught in the crossfire, the WHO said.

Médecins Sans Frontières/Doctors Without Borders said it remained in the Ukraine for now but had to make the painful decision to halt activities, including HIV care in Severodonetsk, TB care in Zhytomyr, and improving healthcare access in Donetsk in eastern Ukraine.

“Although these programs have now mostly stopped, we did all we could to ensure some continuity of care for our patients,” MSF said. “The needs were already high as people had been living through more than seven years of conflict, and we are worried about the impact prolonged fighting could have on patients, many of whom are elderly and suffer from chronic diseases.”

The conflict is also causing concern about the spread of COVID and other infectious diseases, especially as crowds shelter and flee in close proximity, whileThe Bulletin of the Atomic Scientists reports concerns about risks to a network of US-linked labs in Ukraine that work with dangerous pathogens.

Writing in the BMJ, Dr Julian Sheather, a special adviser in ethics and human rights to the British Medical Association and an ethics adviser to Médecins Sans Frontières, outlined the acute and longer term health impacts of war, citing crude estimates that for each person killed directly by war, nine will be killed indirectly.

The mental health impacts of the conflict are likely to be extreme and enduring, with intergenerational effects, he said. “The Ukrainian people have been living with anxiety about the intentions of its powerful neighbour for many years. They watched Russia annex the Crimea, and wage proxy wars in the Donetsk and Luhansk oblasts in Eastern Ukraine.”

Other recent conflicts had shown that the health effects of war can be displaced far beyond the borders of the countries involved. “Among the most significant global issues in health and human rights arises from the health needs of millions of people displaced by modern conflict. People leaving war zones take their trauma with them.”

Sheather said the invasion was not just a tragedy for today’s Ukrainians but “will also lie heavily on the wellbeing of future generations”.

Some of the wider consequences are described by a United States academic, Paul W. Kahn, Robert W. Winner Professor of Law and the Humanities at Yale Law School.

“A world that is worried about conflict between states is not one that will address climate change. It will not address global poverty or disease. It will, instead, invest in weapons and national defense. Governments will not advance human rights but will instead quash dissent,” he wrote in The Hill.

Other concerns

Offering support

1. The link sharedd by the Australian Association of Social Workers is from Global Citizen: Nine meaningful ways you can help support Ukraine.

2. From Time Magazine: Here’s What You Can Do to Help People in Ukraine Right Now.

3. Associate Professor Tetyana Shippee, a public health academic from the University of Minnesota, has tweeted a thread listing various organisations providing support to people in Ukraine, and encouraging donations.

4. The charity mentioned below by Trisha Greenhalgh, Professor of Primary Care at Oxford University, is Malteser International.

5. Support local media at this crowdfunding campaign mentioned in the tweet below.6. Also check this Twitter list, compiled by Croakey’s Mitchell Ward, which includes details of independent journalists reporting from Ukraine and seeking funding support.

7. The online letter circulated by journalism academic Dr Bonita Mason is here.


Previously at Croakey

Health leaders express solidarity for Ukraine and urge protection of health workers and facilities

As the world watches Ukraine, here are some of the global health stakes

 

 

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Acknowledgement