War in Ukraine
How MSF is responding
Fighting in Ukraine has killed or injured thousands of people, while more than 6.5 million refugees have fled to neighbouring countries.
Doctors Without Borders/Médecins Sans Frontières (MSF) teams are working to deliver emergency medical assistance to people still in Ukraine, as well as those now seeking safety in neighbouring countries.
The situation is extremely volatile and we have witnessed the devastating impact of the conflict on civilians – some cities are surrounded by military forces, under heavy bombardment and running out of food and water.
Many hospitals are facing dramatic shortages of medical supplies – from surgical tools to drugs for chronic diseases – while the mental health consequences of shock and suffering have been enormous, even in areas spared the brunt of the violence. And, every day, more people face a terrible choice: stay in an unsafe place or flee home into uncertainty.
The information about our response, below, is correct as of Dec. 22, 2022.
How is MSF supporting people’s medical needs?
MSF medical teams are experts at working in conflict zones and complex humanitarian crises, while our experienced logistics staff and robust supply chains ensure critical supplies reach where they are needed.
– Primary healthcare, including treatment for chronic illnesses, for people in vulnerable situations who’ve fled their homes and stayed behind in areas with heavy fighting
– Support to Ukrainian medics with supplies and training
– Medical evacuations for patients from overwhelmed hospitals to safer areas
– Support to Ukrainian psychologists and first responders to provide mental healthcare for people who’ve faced intensely traumatic experiences
We are working to focus our humanitarian response where people’s needs are greatest and where our emergency medical work can have the most impact.
Can I donate to support MSF’s work in Ukraine?
Thanks to the generosity of people like you donating to our general funds, we haven’t needed to launch an appeal for our work in Ukraine and surrounding countries.
Please consider giving an unrestricted donation, which will give our medical teams across the world the valuable flexibility to respond as needs arise.
Visit the following page to learn more.
Our response in Ukraine: In-depth
Our priority in Ukraine is getting Ukrainian medics the medical supplies they need.
We’re providing technical support and training on how to manage large numbers of wounded people, and relieving pressure by medically evacuating patients to hospitals in safer parts of the country.
While the focus so far has been on surgery, trauma and intensive care needs driven by the conflict, a worrying situation is also emerging for patients with chronic diseases such as hypertension, diabetes, asthma and heart disease who require key drugs and support.
However, with full-scale warfare in many areas, movements are difficult, dangerous or simply impossible. Communication networks are not always available and there is a significant amount of misinformation.
We’re helping ensure people in vulnerable situations with chronic illnesses continue to get the care and medications they need so their conditions don’t get worse.
We’re also seeing that people are absolutely shattered by what they’ve been through. Anxiety, panic attacks and trouble sleeping are common symptoms.
We have increased our focus on mental health activities, including strengthening the capacity of Ukrainian psychologists and training first responders to administer psychological first aid.
MSF’s work in numbers
- 801 MSF staff working in Ukraine
- 408 metric tonnes of medical cargo delivered
- 13 Ukrainian cities where MSF has medical activities
Medical evacuation trains
On April 1, MSF began running a two-carriage medical train to evacuate patients in serious but stable conditions to safety. We are now also running a more highly medicalized train, capable of providing intensive care.
The trains take patients from overburdened Ukrainian hospitals close to active warzones to Ukrainian hospitals with more capacity that are further from active warzones.
To date, 2,607 patients have been evacuated. The team evacuated 78 babies and toddlers from an orphanage in Zaporizhzhia, some of whom had been injured by the widely reported missile strike on Kramatorsk train station.
MSF’s team in Hostomel and other areas on the outskirts of Kyiv, continues to provide mental health and psychosocial support and are looking to further scale up this aspect of our work in the area.
In the city of Kyiv, in July we began to provide physiotherapy services in a hospital managed by the Ministry of Interior. There are approximately 300 beds entirely dedicated to war-wounded people. The need for post-operative care is enormous, as rehabilitation and physiotherapy was not particularly developed in the local healthcare system prior to the conflict and the high number of trauma patients are at risk of developing long-term mobility issues without proper care. MSF physiotherapists work side by side with local health staff providing bedside training and creating local capacity for physiotherapy.
As part of our collaboration with Ministry of Reintegration and Temporarily Occupied Territories, we are providing mental health training to the call centre personnel. The call centre is run by the Ministry in order to respond to the needs of IDPs and the populations remained in the non-government-controlled areas (NGCA) in Ukraine. So far, four sessions have been completed.
Bilal Tserkva and Fastiv
In Bilal Tserkva and Fastiv, our teams are focusing on elderly and displaced people suffering from chronic diseases who may have been cut off from healthcare. This involves donations, as well as medical and mental health support, while training will be carried out with staff at healthcare facilities.
Since April 5, around 60 medical consultations have been carried out with elderly people living in the area.
An MSF team is doing ad-hoc medical donations, trainings for health workers and first line responders, distributing relief items and doing rehabilitation work in IDP shelters and carrying out psychoeducation sessions with groups of displaced people and individual mental health consultations both in the town and peripheral areas. We are also supporting a maternity hospital to make more accessible services for survivors of sexual and gender-based violence (SGBV).
The focus in Zhytomyr is gradually returning to resuming our former activities supporting the treatment of drug-resistant tuberculosis.
In and around Zhytomyr, we donated trauma-related supplies and conducted mass casualty training in nine hospitals during the phase when frontlines of fighting were close.
MSF teams continue to provide social support (food parcels and hygiene kits) and psychological support to all active TB patients to help them to keep taking their medication correctly and complete treatment. In collaboration with health authorities, MSF has recently started doing contact-tracing for children who have been in close contact with TB patients.
MSF also transports samples to the TB hospital for testing so that patients’ progress can be monitored.
At the same time, we continue to support the regional TB Hospital by providing them with TB and other drugs as well as laboratory consumables and food for patients.
We are running mobile clinics in 10 neighbouring villages around Chernihiv to respond to health needs. We are providing outpatient consultations for non-communicable diseases as well as mental health support and identifying cases of sexual and gender-based violence. We are also reaching patients in Chernihiv with our sexual and gender-based violence hotline, located in Kyiv.
In Kharkiv, we are running mobile clinics for thousands of people sheltering in subway stations (more than half the total stations in the city), many of whom are suffering stress and psychological trauma due to the war. More than 1,000 consultations have been performed. We have also installed water filters to secure clean water.
Following the developments of the security context and subsequent resumption of the functioning of the underground system, MSF ‘underground’ activities have been moved above ground and restructured to assist people who have no home to go back to and/or still need medical support. Inside Kharkiv, we are currently supporting the city’s displaced people at various locations via mobile clinics. While some of the clinic activities are carried out in the locations of volunteer networks, some others are conducted in dormitories assigned for IDPs. However, the strikes in the city (and in the surrounding areas) have intensified again in the last weeks, which causes interruption of activities.
Kharkiv city continues to receive shelling on a daily basis. Although they appear to be rather targeted attacks, the trends and precise details remain challenging. Meanwhile, many areas in the north remained out of reach due to security reasons this week. However, OCA teams were able to visit 9 locations, conducting 14 mobile clinics inside and outside the city between 28 July and 10 August. 14 mobile clinics conducted between 11 and 24 August in and around Kharkiv city.
In the city of Lviv, expert teams have been training hospital staff to deal with mass casualty events and to treat war wounds.
We also have a surgical team working to support the burns unit of one of the big referral hospitals in Lviv.
In Vinnytsia, we provide support to people who have fled from other parts of the country and taken refuge in temporary and longer-term accommodation and shelters.
In the shelters our teams run mobile clinics, providing medical consultations; continuation of care and medications for people with chronic illnesses such as hypertension, asthma, diabetes, heart disease, epilepsy; referrals to hospital for severely unwell patients; psychological first aid and mental health consultations; and basic relief items.
Our teams provide kits with essential household and relief items, including items such as toilet paper, toothbrushes, toothpaste, soap, shampoo, nappies and towels.
In Vinnytsia, we are facilitating the referral of elderly and vulnerable people who are evacuated from the eastern frontline regions and require medical follow-up for chronic disease. The ‘medicalised train’ and local ambulances are used for transportation, and our teams in Vinnytsia coordinate with local health authorities on the arrival of patients and hand them over to them.
In July we opened a physiotherapy project on a 60-bed hospital, providing bedside training and care, working to increase the local capacity to respond to an acute need similar to our approach in Kyiv.
Mukachevo and Berehove
A team is running mobile clinics along the border with Hungary, where there are significant numbers of people gathered, centred for the moment on Berehove.
The team is seeing signs that mental health support is becoming a priority. We will focus in this direction, and also on the continuity of care for patients who were previously following medical treatment that risks being interrupted by their rapid departure to a place of safety.
Uzhhorod and Ivano-Frankivsk
We have established bases in Uzhhorod and Ivano-Frankivsk and are building a network for transporting supplies to hospitals in frontline areas. We are also assessing nearby healthcare needs and will be carrying out chemical, biological, radiological and nuclear training with local healthcare teams.
We have carried out trainings with local health professionals, including on mental health for psychologists and first responders, and provide group therapy sessions and individual mental health consultations with internally displaced people.
We are supporting a clinic focusing on IDP patients run by doctors who are displaced from the conflict themselves and in Uzhhorod we are running a mobile clinic focusing on IDPs who are staying in public shelters.
We keep doing donations to health facilities in these two locations and distributing non-food item (NFI) kits for displaced people, particularly in nearby rural areas, as well as doing rehabilitation works at IDP shelters.
To help Ukrainian health facilities cope with a potential influx of injured people, MSF teams have trained hundreds of medical doctors and nurses to triage patients according to the severity of their injuries.
This step is essential to ensure that patients are treated appropriately in an emergency situation.
In Odesa and Mykolaiv, we were able to donate medical supplies to hospitals preparing to accept wounded. Consultations for displaced and people in vulnerable situations will be provided soon.
In Mykolaiv, MSF is also funding the work of local volunteers who bring medical and logistic equipment in and out of the besieged city. We support several hospitals in the city with medical and logistic donations and water & sanitation services. We provide mental health services in three sites in the rural areas around the city, where we witness the extremely severe impact of war on the psyche of the population. This is an area that needs attention as mental health issues are still frequently stigmatised in the country and there aren’t enough psychologists and psychiatrists, especially with experience of war-related trauma.
In the broader Kryvyi Rih area, MSF has started running mobile clinics providing basic healthcare, including sexual and reproductive health. In Apostolove hospital, MSF supports the emergency room for mass casualty response capacity and provides medical equipment for surgical activities. On the request of local authorities, a team is assessing the situation in villages near the frontline in order to perform mobile clinics if possible.
We have expanded our work in eastern Ukraine in response to the growing needs in areas close to the frontline and in places hosting people who have fled their homes.
In and around Dnipro, we are supporting people in vulnerable situations who have fled parts of Donetsk and Luhansk where the conflict is particularly intense, and who are now staying temporarily or longer-term in more than 40 shelters.
Many are at-risk, including the elderly, people with disabilities, unaccompanied children and people who cannot afford to make the journey further west in Ukraine or abroad.
In the shelters our teams run mobile clinics, providing medical consultations; continuation of care and medications for people with chronic illnesses; referrals to hospitals for severely unwell patients; psychological first aid and mental health consultations; and basic relief items. MSF also provides consultations and referrals for people who have experienced sexual violence.
In Zaporizhzhia, we are providing support to displaced people thousands of whom were displaced from Mariupol, and other areas where fighting is intense.
Our teams run mobile clinics in the main reception centre and support more than 30 shelters throughout Zaporizhzhia, providing medical consultations; medicines for people with chronic illnesses such as hypertension, asthma, diabetes, heart disease, epilepsy; and referrals to hospital for severely unwell patients; psychological first aid and mental health consultations; and basic relief items.
MSF has started providing psychological first aid to people arriving from Mariupol in reception areas and shelters. We have also donated medical supplies and carried out mass casualty training for staff at the main hospital in Zaporizhzhia.
We are increasing our efforts to support the medical facilities across the frontline within the Zaporizhzhia oblast remaining in the non-government controlled areas. MSF team has managed to establish contact with health professionals and volunteers across the oblast in order to understand their needs to continue providing medical care to the conflict-affected populations. Lack of physical access and presence in those areas remains a main challenge, but the team is looking into alternative and creative solutions to address some of those needs soon.
Donetsk and Luhansk regions
We are working with hospitals and primary health facilities close to the frontline in Donetsk to make sure they have enough of the right supplies and training to be able to keep treating patients if they get cut off from supply lines by intense fighting. This includes support to primary healthcare, treatment for chronic diseases, maternal healthcare and trauma.
For some facilities we are also providing logistical support to ensure an autonomous supply of electricity through generators and solar power, and clean water to continue functioning for up to a week.
We are also equipping some hospitals with ‘autonomy kits’ infrastructural support, such as solar panels, generators, and water reserves to allow them to continue to operate if their power or water is disrupted, with infrastructure that can allow them to keep working for up to a week.
MSF teams are supporting specific hospitals to reorganise and reinforce their emergency room capacity and to prepare for a possible mass influx of wounded patients as well as donating specific medicines and supplies in response to requests from facilities and medical staff. Since the beginning of August, Kostiantynivka hospital has received support to rehabilitate its emergency room and OT with regular presence of an MSF surgical team.
Our emergency response in neighbouring countries
MSF is committed to providing medical assistance to people affected by the conflict no matter where or who they are.
MSF emergency teams are operating from bases in Poland to bring essential medical staff and supplies into Ukraine.
According to the United Nations, more than 4.6 million people have fled from Ukraine into Poland as of July 18, 2022. In the first few days of the response, we donated supplies to the Red Cross Lublin and a reception point in Horodlo, and we intend to start providing psychological first aid, self-care and counselling training to volunteers helping with the response.
MSF is actively working to support the Ministry of Health to provide treatment for patients with drug-resistant tuberculosis, including patients previously supported by MSF in Ukraine.
The UN reports that around 530,000 refugees have crossed into Hungary. However, our assessments have found that the immediate needs of many people are being met.
We have now started working in partnership with local organizations to provide primary healthcare consultations and psychological support. Meanwhile, we will continue to monitor the situation, focusing on identifying less visible needs of individuals and groups that are in vulnerable situations that are missing out on essential services.
As of May 3, nearly 500,00 people have crossed into Moldova from Ukraine. Although many people appear to be in transit, Moldova – which has a population of only 2.6 million people – now hosts the largest concentration of Ukrainian refugees per capita, according to the UN.
On March 12 in Palanca, MSF started providing primary healthcare consultations and psychological first aid sessions for people fleeing from Mykolaiv and Odesa. Our teams have also provided mental health support to people at reception centres in the capital Chișinău and are undertaking assessments at hospitals across the city to understand the medical needs.
More than 16,690 people have crossed the border from Ukraine into Belarus as of 23 August.
In Belarus, an MSF assessment team has moved to areas of the Belarus-Ukraine border to assess potential medical and humanitarian needs. In Belarus, our team has seen an increasing number of people forcibly displaced from Ukraine in need of medical assistance and social support. We are responding to the needs of patients from Ukraine, as well as other countries of origin, in Minsk, Grodno, Brest, Gomel, Mogilev and Vitebsk regions. Among our patients, there are many children and people with non-communicable and chronic diseases including diabetes and hypertension. A majority of them is in need of urgent psychological support. In Belarus, MSF continues to run its regular programmes. We support the national tuberculosis (TB) programme in the civil sector and in prisons.
Over 2,300,000 people have crossed to Russia from Ukraine as of 23 August 2022.
MSF has been present in Russia for 30 years. Currently, MSF’s teams in Russia work with health authorities in Arkhangelsk and Vladimir regions to support crucial, life-saving treatment for patients with drug-resistant tuberculosis. In the last few months, MSF scaled up its assistance to partner organisations in St. Petersburg and Moscow ensuring continuation of HIV treatment for people from Ukraine and other people in need. We have seen an increase in the number of people from Ukraine living with HIV and hepatitis C in need of refills for their antiretroviral medicines.
Alongside this, MSF has recently started to support people displaced to Rostov and Voronezh (since February 2022), in coordination with local authorities. In May 2022, a dedicated MSF hotline was launched with an aim to provide referral services to medico-social support to the refugees and from Ukraine. As of end of August, MSF with the support of local specialists responded to the medical needs of more than 490 people on a case by case basis. In collaboration with local NGOs, MSF delivered essential relief items including food, glucometers, and consumables to diabetic patients from Ukraine in Voronezh. As of mid-August, MSF-supported local initiatives provided for more than 2360 beneficiaries, prioritizing the immediate needs of recently arrived displaced people in Southern Russia.
We are continuing the support with food and hygiene items. MSF through local organisations, social workers and local health providers, aims to link populations in need to existing medical and humanitarian services and improve their ability to receive the needed medical and humanitarian support. As in any country, our work in Russia is focused on providing medical care where we can, based on medical needs alone.