|
 
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| LETTER TO THE EDITOR |
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| Year : 2022 | Volume
: 1
| Issue : 2 | Page : 78-80 |
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Impact of Russia: Ukraine war on healthcare
Sai Kiran Kuchana1, Rohith Kode1, L V Simhachalam Kutikuppala2, Sri Harsha Boppanna3
1 Department of Medicine, Kakatiya Medical College, Warangal, Telangana, India
2 Department of Medicine, Konaseema Institute of Medical Sciences and Research Foundation (KIMS&RF), Amalapuram, Andhra Pradesh, India
3 Department of Medicine, Dr NTR University of Health Sciences, Vijayawada, Andhra Pradesh, India
| Date of Submission | 22-Jul-2022 |
| Date of Decision | 25-Oct-2022 |
| Date of Acceptance | 07-Nov-2022 |
| Date of Web Publication | 20-Feb-2023 |
Correspondence Address:
Dr. L V Simhachalam Kutikuppala
Department of Medicine, Konaseema Institute of Medical Sciences and Research Foundation (KIMS&RF), Amalapuram 533201, Andhra Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JIMPH.JIMPH_4_22
How to cite this article:
Kuchana SK, Kode R, Kutikuppala LS, Boppanna SH. Impact of Russia: Ukraine war on healthcare. J Integr Med Public Health 2022;1:78-80 |
How to cite this URL:
Kuchana SK, Kode R, Kutikuppala LS, Boppanna SH. Impact of Russia: Ukraine war on healthcare. J Integr Med Public Health [serial online] 2022 [cited 2023 Mar 27];1:78-80. Available from: http://www.jimph.org/text.asp?2022/1/2/78/370075 |
Dear Editor,
Because of anti-totalism protests in Central and Eastern Europe and the fall of the communist regime, which resulted in the establishment of newly sovereign republics, the Union of the Soviet Socialist Republic disintegrated in 1991.[1] However, many independent states continue to be influenced by the Russian Federation, which has resulted in disagreements with neighboring post-communist nations such as Armenia and Azerbaijan.[2] Currently, tensions exist between the Russian Federation and Ukraine.
The conflict between Russia and Ukraine is characterized by different resource derangements. When Russia participated in the takeover of Crimea from Ukraine in 2014, the conflict officially started.[3] The partnership between the two nations has been contentious ever since. The Russian Federation invaded Ukraine on February 24, 2022, defending its action by claiming that it was necessary to safeguard Russian nationalists’ interests in the Ukrainian land. This move was denounced and attacked by every international body. For the first time since World War 2, there is a military war in Europe that, if it worsens, might spread to the rest of the world.[4]
Healthcare is one such sector that is affected and is the most required service in this wartime. Various healthcare centers are demolished in this warfare. This deficit in the healthcare sector not only affects the present but also future situations.
Limited amounts of healthcare supplies and medical amenities will pose a great threat of exhaustion of medical services needed. Rapid usage of current stocks of medicines and supplies especially due to increased demand for treating the injured victims thereby depleting the antibiotics, dressing and suturing materials, painkillers, hemostatic drugs, and bandages, thus getting depleted earlier than other supplies.
The issue threatened not only the physical borders between Ukraine and Russia but also the geopolitical, economic, and medical interests of the surrounding nations. Our goal through this paper is to give a thorough overview of the literature covering various healthcare implications and prevention techniques advised post-war by various organizations and to highlight the effect of war on the healthcare system. There are very few sources describing the overall health effects owing to the conflict between the countries.
| War-Healthcare | |  |
Healthcare resources from across the country are now concentrated in conflict zones. There is a shortage of qualified healthcare professionals because many are attending to mass casualties of war and COVID duties. The treatment of critical diseases such as tuberculosis, cancer, and diabetes is now in jeopardy. There are a lot of patients in the emergency room, but there aren’t many people there to help them. In addition, the invasion disrupted transportation, making oxygen supply to hospitals scarce. According to the World Health Organization (WHO) Director, “the oxygen supply situation in Ukraine is now approaching a very dangerous point,” with a few hospitals already running out of supplies. Along with destroying homes, schools, bridges, and nuclear power plants, shelling and bombing in regions of active conflicts also targeted hospitals and pharmacies, which influence the provision of healthcare and medical services. Russian troops were blocking cities, preventing injured citizens, including mothers and babies, from receiving the proper medical care.[5]
| Healthcare Disruption | | |
The World Medical Association Declaration on the protection of Healthcare Workers has been flagrantly violated by Russia’s onslaught on medical facilities. The WHO reported on August 9, 2022, that Russian military forces had attacked medical facilities more than 432 times (366 on health facilities and 72 on healthcare personnel causing death and grievous injuries).[6] Healthcare disruption consists mainly of a break in the supply chain and administration of immunization leading to a drastically reduced vaccine coverage. The storage and transport chain is affected due to destruction and hence decreased supplies of medical and vaccine materials. This makes the major section of the population vulnerable to serious infections and can lead to epidemics. Measles and polio vaccination delay can lead to most fatal outcomes in children. In addition, the lack of a safe water supply and poor hygienic conditions can lead to superadded infection spread. The women population is affected adversely due to the lack of amenities and medical support.
Healthcare surveillance against the spread of diseases is not effectively practiced during times of war and destruction. Hence the statistical data for planning effective control measures are not available. Thus, the vulnerable population and epidemiological determinants are not known to health officials.
Polio prevention requires adequate vaccine coverage in the community and sufficient herd immunity. One case of polio was detected in Ukraine in October 2021.[7] This attracted major attention to combat the spread by active measures and immunization by international health organizations. But due to war situations, vaccine coverage has declined drastically and raised the risk of the spread of polio cases thus can lead to widespread issues.
As of now, Ukraine has the fourth-highest rate of tuberculosis in Europe (drug-resistant cases make up 29% of all new diagnoses). However, the WHO study from 2020 reveals that only 81% of all tuberculosis infections are ever discovered, and only 70% of those cases receive proper treatment. Due to the scarcity of health care, these conflict scenarios make the treatment of many diseases much worse.[8]
People living with HIV (PLWH) need a regular dosage of antiretroviral therapy to maintain the viral load and improve the prognosis. The prevalence of PLWH in Ukraine was found to be 2.5 lakhs in 2019 according to the UNAIDS report. So, the curb in the medical supply chain can therefore affect a vast amount of the population in the period of their treatment loss.[9]
Chronic noncommunicable diseases (NCDs) surveillance and treatment are also disturbed due to the breach in medical supplies. The major NCDs constitute diabetes mellitus, hypertension, and cancers. The optimum level of prevention and control of NCDs can be achieved only through efficient adherence to life modifications and regular medicine intakes. The blocked supply and loss of a healthy lifestyle can predispose to the causation of NCDs and detrimental outcomes. Also, the cancer screening programs held regularly by the government and non-government organizations are affected. This can increase the loss of case registry and make it difficult to prevent cancer outcomes by early detection and treatment.
| Mental Health | | |
Wars can have serious mental health implications, ranging from depression and anxiety problems to post-traumatic stress disorder. People in the nations close to Ukraine have been significantly influenced by their fear of war, which has led them to act in ways that could lead to the end of the world. The COVID-19 epidemic and the temporary emergence of the Ukrainian crisis have combined to create a medical and military security threat that is manifesting itself in the affected population as an increase in reactive symptoms of depression and anxiety. The general public was suffering from an overwhelming amount of anxiety, which in some cases was as severe as actual panic attacks.[10] They can impact both fighters and innocent civilians, adults and children, those who are left behind, as well as internally displaced individuals and refugee populations. Children, in particular, can suffer substantial psychological damage as a result of war. It causes a major impact on the growing children’s mental health.[11]
| Environment and Health | | |
The war has a major negative influence on the environment, which ultimately destroys civilian health and puts more strain on medical services. The deterioration of industrial and commercial infrastructure contributes to water contamination, which has both immediate and long-term effects in the form of serious water-borne diseases. In addition, the war’s impact on sanitary conditions and the lack of water supply led to an increase the number of diseases. The frequent bombardment and troop movements harm the air’s quality, which raises the danger of airborne infections and puts more strain on the health of people who already have respiratory conditions like asthma. War fully destroys the physical, chemical, and biological characteristics of soil, which leads to the collapse of the agricultural industry and a subsequent shortage of food and long-term food crises.[12]
| Conclusion | | |
The war situation between Russia and Ukraine has a major impact on healthcare delivery and disease prevention. Thus, this can lead to the causation and spread of various deadly diseases and also can lead to an imbalance between the suffering population and healthcare services. Hence, the amount of destruction should be swiftly resolved and rehabilitated to prevent future implications. International organizations help with necessary resources and support will prevent the fatalities at the earliest.
Financial support and sponsorship
Not applicable.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Marcau FC Democratization of Central and Eastern European States after the Fall of the Iron Curtain. Targu Jiu: Academica Brâncuşi;2020.  |
| 2. | Hovorun C War and autocephaly in Ukraine. Kyiv-Mohyla Humanities Journal 2020;18:1-25. |
| 3. | Alexseev MA, Hale HE Crimea come what may: Do economic sanctions backfire politically? J Peace Res 2020;57:344-59. |
| 4. | Shinar C Ukraine’s struggle for independence. Eur Rev 2022;30:43-57. |
| 5. | World Health Organization (WHO). Emergency in Ukraine, 2022. Available: from: https://apps.who.int/iris/bitstream/handle/10665/352696/WHO-EURO-2022-5152-44915-64091-eng.pdf?sequence=1&isAllowed=y. [Last Accessed on 8 Apr 2022]. |
| 6. | WHO. Surveillance System for Attacks on Health Care (SSA). Available from: https://extranet.who.int/ssa/LeftMenu/Index.aspx?utm_source=Stopping attacks on health care. [Last Accessed on 14 Apr 2022]. |
| 7. | One Case of Polio Detected in Ukraine. World Health Organization. World Health Organization; 2021. Available from: https://www.euro.who.int/en/health-topics/communicable-diseases/poliomyelitis/news/news/2021/10/one-case-of-polio-detected-in-ukraine. [Last Accessed on 24 Mar 2022]. |
| 8. | The Straits Times. Ukraine’s Tuberculosis Progress ’Stopped in One Day’ after Russia Invasion; 2022. Available: https://www.straitstimes.com/world/ukraines-tuberculosis-progress-stopped-in-one-day-after-russia-invasion. [Last Accessed on 12 Apr 2022]. |
| 9. | UN Office of the High Commissioner for Human Rights. Ukraine: Civilian casualty update 29 March 2022. Available from: https://www.ohchr.org/en/news/2022/03/ukraine-civilian-casualty-update-29-march-2022. [Last Accessed on 31 Mar 2022]. |
| 10. | UNHCR Operational Data Portal (ODP). Ukraine situation flash update #24. Available from: https://reliefweb.int/report/ukraine/ukraine-situation-flash-update-24-5-august-2022. [Last Accessed on 15 Apr 2022]. |
| 11. | Murthy RS, Lakshminarayana R Mental health consequences of war: A brief review of research findings. World Psychiatry 2006;5:25-30. |
| 12. | Rawtani D, Gupta G, Khatri N, Rao PK, Hussain CM Environmental damages due to war in Ukraine: A perspective. Sci Total Environ 2022;850:157932. |
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