Three Years of War: How Ukraine’s Health Care System Is Battling Unprecedented Challenges

Three years after Russia’s invasion, Ukraine’s health system faces major challenges. Attacks, staff burnout, and rising disease risks have pushed the system to adapt in unexpected ways.

On July 8, 2022, Dr. Lesia Lysytsia was preparing for an eye cancer surgery at Okhmatdyt, the largest children’s hospital in Ukraine, when air raid sirens blared. Instead of seeking shelter, she focused on her patient. Stopping for every alert would halt the care for many children needing treatment. The pressure was real, especially as she thought about her own two young kids waiting at home.

Then disaster struck. A missile hit Okhmatdyt, killing three and injuring dozens. At the time, around 630 children were in the hospital. Just a week later, the hospital partially reopened. Lysytsia described the atmosphere, saying it felt almost normal, even as the staff grappled with the mental toll of the conflict. “We changed mentally,” she shared, adding that they remain focused on their responsibilities.

Since the invasion began on February 24, 2022, experts note that Ukraine’s healthcare system was unprepared for the chaos and rise in combat-related injuries. The war has caused significant turmoil and led to a sharp decline in population, with over 10 million people displaced, according to the United Nations.

Dr. Eric Adrien, who coordinates medical evacuations for the European Commission, emphasized that no healthcare system is ready for a full-scale war. Health workers are now treating patients amid constant threats, performing surgeries without electricity, and facing high levels of psychological stress.

A World Health Organization report noted that Ukraine’s healthcare system, bolstered by reforms in 2017, has shown notable resilience in adapting to wartime challenges. These reforms aimed to modernize the sector, improving access to care and reducing corruption.

However, disparities remain between the eastern regions, directly affected by the conflict, and the western parts of the country. Doctors and aid groups report rising threats from infectious diseases and shortages of medical staff. “Traveling from Lviv to Kyiv may seem like life is normal, but that’s not the case for those in the east,” said Dr. Tankred Stöbe from Doctors Without Borders.

The reality is stark. Since the war began, Russian forces have attacked medical facilities more than 1,760 times. These strikes have hampered the ability of healthcare workers to provide for those suffering from injuries, chronic conditions, and infections. Attacks on hospitals continue, with recent strikes damaging facilities just days after diplomatic talks aimed at ending the war.

Access to medical care is becoming increasingly limited, with a survey indicating that nearly 16% of households cannot receive treatment due to destroyed facilities or a lack of available staff. This is even worse in war-torn areas where the risks of visiting a hospital have grown.

Moreover, the conflict has led to heightened risks of diseases, including tuberculosis and HIV, as well as gaps in cancer screenings and regular medical care. Many people now face serious health issues without adequate support or treatment options.

Experts highlight that shortages among healthcare workers add to the challenges. Many have either fled the country, retired, or served on the frontlines, resulting in a significant gap in the workforce. In cities like Kyiv, there may be enough doctors, but specialists are hard to find. Rural areas and those closer to the frontline suffer more. Dr. Yevheniia Poliakova, an obstetrician from Zaporizhzhia, noted that nurses are particularly scarce, citing a long-standing issue of nursing shortages even before the war began.

As the war continues, Ukraine’s healthcare system remains under immense strain. Mental health is becoming a pressing concern, with many healthcare workers experiencing burnout. Dr. Lysytsia expresses common sentiments among her colleagues: “We want to be calm and brave, but deep down, we are all afraid.”

Despite the numerous challenges, Ukraine’s healthcare system is still functioning, helped by international aid and support. Many believe that this resilience offers hope for the future, even as the country navigates this ongoing conflict.

Check out this related article: Transforming Mental Health: Exploring Innovative Science and Future Treatments for Lasting Change

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