Discussion: Ukraine: The humanitarian catastrophe

Ukrainian refugees wait for a transport at the central train station in Warsaw, Poland

The worsening humanitarian situation from the war in Ukraine has threatened millions of lives.

Nearly 4 million people have fled the country in the largest exodus that Europe has seen since World War II. More than half of children in Ukraine have been displaced, according to UNICEF. And people of all ages who’ve remained, or have been internally displaced, are faced with a faltering health care system. Many people are also experiencing shortages of heat, water, electricity and food.

Governments and humanitarian groups are trying to find the best ways to handle the situation. As part of our regular series of conversations with Harvard University’s T.H. Chan’s School of Public Health, The World’s reporter Elana Gordon moderated a discussion with Michael VanRooyen, director of the Harvard Humanitarian Initiative, about the dire situation. He is also the chairman of Emergency Medicine at Brigham and Women’s Hospital (@HHI).

You can watch the discussion by clicking above or logging onto our Facebook page.

A public health catastrophe

Humanitarian organizations are scrambling to avert a public health catastrophe in Ukraine. The conflict — which began with Russia’s invasion of the country on Feb. 24 — could upend decades of progress against infectious diseases throughout the region.

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Direct attacks on health care facilities are rising daily, according to the World Health Organization, which has verified at least 70 direct attacks on facilities and ambulances, 71 deaths and 37 injuries.

Ukraine also has high numbers of people living with HIV and Hepatitis C, and low vaccination rates against measles, polio and even COVID-19.

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Meanwhile, medical journal The Lancet said in a report last week that the “war in Ukraine could worsen what is already one of the world’s most serious tuberculosis (TB) epidemics.”

“Ukraine has the fourth-highest TB incidence in the WHO European Region and the fifth-highest number of confirmed cases of extensively drug-resistant TB in the world,” it goes on to say.

“Medical organizations already working in the country to deliver TB care before the war have said that they are continuing to provide services, including medicine deliveries, but are finding it increasingly difficult due to security worries and transportation issues, with roads clogged with refugees or Russian troops.”

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Tuberculosis was the world’s biggest infectious killer before the COVID-19 pandemic, and it spreads in a similar manner.

Not having access to a proper antibiotic regimen against TB can allow for infected people to spread it quickly to others. And the disease turns into multidrug resistant tuberculosis when it becomes insensitive to drugs if they’re not taken regularly, giving the bacteria time to mutate.

“This is the price of war. It’s not just the price of injuries,” Mike Ryan, WHO’s head of emergency operations said earlier this month. “Years of progress in important public health areas like drug-resistant TB are lost sometimes in days and weeks. And that threatens everyone.”

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