March 8, 2022 – Russia’s invasion of Ukraine has prompted a massive humanitarian crisis, with mounting military and civilian casualties and more than two million people on the move to escape the violence. In this Big 3 Q&A, Michael VanRooyen, director of the Harvard Humanitarian Initiative, talks about the biggest threats people are facing and how humanitarian organizations are helping.
Q: What are the biggest humanitarian threats to Ukrainians right now?
A: The conflict in Ukraine is escalating rapidly, leading to large-scale displacement within the country and refugee movements across borders. Within Ukraine, the greatest threat, aside from traumatic injuries, is the collapse of health care services. In a conflict, medical services are severely restricted. Clinics and hospitals can be damaged, or are unable to function without supplies or staff.
In areas of active warfare, health care facilities are severely constrained. Smaller clinics and hospitals may have to scale up to care for an influx of injuries. In other areas without active conflict, conditions are strained because of supply chain disruptions—hospitals and clinics may be unable to get antibiotics or surgical equipment, all of the supplies needed to do normal day-to-day operations. So while those directly involved in the conflict will see more deprivation and more challenges, the whole country will be affected.
As refugees move across the border they will start to overwhelm the health infrastructure of neighboring countries as well. So Poland, Hungary, Moldova, and other border countries will struggle to care for the large number of refugees. In those places, health systems will be overwhelmed with the rapid influx of displaced people needing health care and may not have the providers, equipment, supplies, and health care facilities needed for this growing population.
We’ve been working with the World Health Organization to evaluate the anticipated health threats that will face Ukrainians as they become displaced. The health care problems facing Ukrainian refugees are very different than the types that, for example, would cross borders in Somalia or Sudan or Yemen or Syria. In Ukraine, the main health threats are not infectious diseases, such as malaria or dengue, but chronic diseases that can be exacerbated during this crisis, such as heart disease, cancer, kidney disease, and diabetes.
There are a number of particularly vulnerable subgroups – such as immobile, handicapped, or elderly patients; young kids and pregnant women; and people with chronic illnesses. All of those people are going to be dealing with the shock of moving and the lack of access to health care. Even the stress of moving is considerable, with people forced to leave their homes and walking for hours or days in the winter weather.
Q: What kind of support has HHI been able to provide in Ukraine?
A: We are working to support services of hospitals affected by conflict within Ukraine and along border areas. We are coordinating the placement of physicians from Harvard-affiliated hospitals to work with relief agencies to bolster health care services. A priority will be to increase access to hospitals and clinics, particularly for people with chronic diseases. Since Ukraine has a relatively robust health care system, with many doctors, nurses, and medical staff who can continue to work, the priority would be to support those people and to provide additional supplies and equipment.
We are also supporting the World Health Organization in helping train first-line responders in emergency first aid. Brigham and Women’s Hospital and Massachusetts General Hospital are providing supplies to support medical organizations on the ground. We also helping to train health providers in the techniques of negotiation so that they can safely access populations in need.
We’ve had a longstanding relationship in eastern Ukraine in response to the country’s ongoing border conflict with Russia, which has caused a low-grade crisis for years, and will continue to look for ways to support health care and public health services for those affected.
Q: How is this humanitarian crisis in Ukraine different than crises elsewhere in the world?
A: This humanitarian catastrophe is the worst refugee crisis since the 1990s. But I would emphasize that the suffering that’s caused by war is profound wherever it occurs, and populations elsewhere are facing the devastation of war—in Yemen, Syria, the Tigray region of Ethiopia, and across central Africa. These crises affect millions, and are compounded by the challenges in accessing vulnerable populations. Yes, what’s happening in Ukraine is awful and it is a true humanitarian emergency, but it’s important to remember that we are dealing with several major humanitarian emergencies around the world at the same time that are, in my opinion, equally as important.
Without a political solution in Ukraine, the situation will continue to deteriorate, with truly terrible consequences for civilian populations. In the meantime, humanitarian aid agencies can only try to help and protect those affected by the conflict.