In recent months, Moscow intensified its campaign to destroy Ukraine’s energy infrastructure with drones and missiles before the third winter of war sets in. On November 28 alone, Russian strikes left more than a million people without power. Ukraine now faces an energy crunch that could reportedly lead to daily blackouts of 10-12 hours during cold spells.

As the international community provides new equipment and funds for essential repairs, Direct Relief is supporting healthcare and other institutions in creating backup energy systems. As part of its global Power for Health Initiative, more than 2,500 13.5 kWh Tesla Powerwall 2 units were supplied, including 500 from the Polish government, to support critical and social infrastructure. Direct Relief’s contribution so far is valued at around $12 million.

This cooperation became an important element of national resilience, said former Deputy Minister for Digital Transformation Yegor Dubinsky, who worked closely with Direct Relief on much of the project: “Power for Health is an effective response which allows our hospitals, emergency services, and schools to work during the power outages, and our people to continue to live despite all attempts to break their will.”

Light and Life at Health Facilities

Almost half of the donated units will support healthcare facilities, allowing them to seamlessly maintain power in case of blackouts and instability of the power grid. Direct Relief is also looking into the supply of solar panels, also in coordination with the digital transformation ministry and a Kharkiv-based core partner the Yevhen Pyvovarov’s Charity Fund, or CFYP.

It all adds up to a buffer against the unthinkable — that patients may die on the operating table because lights or vital equipment suddenly powered off, urgently needed lab results are lost, or doctors cannot perform even basic procedures that require electricity.

“The Powerwalls provide a sense of security,” said Eduard Chekhovsky, a technician who installed and maintains 10 of the units donated to the National Cancer Institute in Kyiv. These now provide emergency lighting for 8 of its 17 operating theaters, as well as for equipment for anesthesia monitoring, the blood transfusion unit, an emergency laboratory, cold storage for genetic tissue samples, and three intensive care wards for 13 patients.

The hospital has generators as a secondary backup, but these are fuel-thirsty and prone to breaking down, unlike the Powerwalls, which are essentially large lithium-ion batteries that charge off the main grid and can instantly give several hours of power in emergencies. “For a generator to reach full working capacity it can take five minutes,” said Chekhovsky. “Our Powerwalls only have a fraction of a second delay [before activating.]”

Strategic Power Placement Where It’s Needed Most

Thanks to the efforts of CFYP, most of the units, each weighing 160 kg (352 lbs), have been distributed around the country, with an emphasis on frontline and border regions.

Of 2,519 units delivered, the largest number (1,231) was supplied to healthcare institutions. Educational institutions received 485 units, the State Emergency Service 349 units, the social sector 147 units, while 40 more comprise a reserve for replacing damaged units.

A major recipient (248 units) is the Chernihiv region, located north of Kyiv and sharing a highly vulnerable border with Russia and Belarus. At the Regional Children’s Hospital, two units were installed in its labyrinth-like basement, which is being converted to house small-scale specialized medical units during air alerts, with adjoining rooms with beds for children. The surroundings are spartan but at least brightly lit and reasonably safe in emergencies – direct hits notwithstanding.

Healthcare facilities have also been directly targeted. In September alone, 40 attacks on health facilities were verified, resulting in 12 deaths and 53 injuries, according to the Ukraine Health Cluster. Therefore, some recipients of Powerwalls used part of this capacity to make the hours spent underground during alerts less traumatic.

At the Medical Rehabilitation Center for Mother and Child in the southern port city of Odesa, as well as powering operating theaters and 19 small wards, Tesla units also work in the new basement bomb shelter. Close to completion when Direct Relief visited in November, the 300-square-meter premises were to include beds and a modest cinema hall so the children and parents are not in a state of fear during alerts.

“We are very grateful – this [donation of Powerwalls] has really helped us out in difficulty,” said hospital director Natalia Odariy-Zakharieva. “Now, as soon as the shelter is finished, we will be fully prepared for winter.”

Direct Relief has supported health services for Ukrainians with over $1.4 billion in medical and financial assistance since February 2022, including through resilient power systems.

The post Keeping Ukraine’s Healthcare System Running as Winter Energy Crunch Looms appeared first on Direct Relief.

Scenes of devastation, including damaged infrastructure and improvised graves, marked the city, according to Dr. Christian Carrer, co-founder of the Association Internationale de Coopération Médicale, or AICM.

“Since the beginning of the fighting, we were the first NGO to bring medicines and food to a population that had resisted the unthinkable. Many hospitals were devastated and hundreds of thousands of patients from the surrounding villages no longer had access to healthcare.”

Little did his team realize that this was the start of a unique relationship with hospitals in this frontline region bordering Russia and its ally Belarus. While continuing to deliver medical supplies and other essentials to Chernihiv city and region, AICM, supported by Direct Relief, has also been expanding one of its most innovative projects in Ukraine.

For the past two years, AICM has been working not just to restore destroyed ultrasound capacities in Chernihiv’s hospitals, but to rethink the paradigm altogether, providing fast access to specialists in other locations and slashing treatment timeframes.

The key to this is a portable ultrasound probe called Butterfly, designed by French doctors in 2021 for the company Santé Intégrale. Coupled with a smartphone or tablet, the handheld device enables medical staff to comprehensively screen patients anywhere, including in an ambulance, with real-time imaging on their phone or tablet screen.

Images can be shared with specialists in the regional capital for further examination and guidance on referrals if needed. This is a game-changer in Chernihiv, which is about the size of the U.S. state of Maryland and had a pre-war population of around one million. Tens of thousands fled for safety after the war began, especially young families, leaving many elderly people isolated in villages with limited access to medical care.

With bus services to Chernihiv city sometimes running just once a week, the Butterfly affords great savings in time and expense for patients whose local medical station can be up to 65km (40 miles) from the nearest hospital, said Oksana Logvynchuk, the director of 14 state-run ambulatory medical centers across the region.

A Pocket-Sized Lifesaver

The probe also proved to be a lifesaver for some patients, revealing serious issues during regular check-ups.
“This way we manage to catch many things before they get catastrophic,” said Logvynchuk. “Previously, there were delays of 2 weeks to 3 months when patients were sent for ultrasound screening. Now, it usually takes 2-3 days.”

“This was a discovery for us and we jumped on [the possibilities],” said the doctor, praising the device as a force multiplier in medically underserved areas. Currently, 130 doctors share a dedicated Telegram group – patient confidentiality is of course still paramount – where pathologies and paths of treatment are discussed by experts in a particular field.

Fifteen local doctors under her supervision have been trained so far. Another 20 are in line for training as this component of the project grows steadily, as do overall hospital capacities in Chernihiv, despite the constant military pressure on the region. All hospitals have air raid shelters in their basements.

Multiple Applications

AICM began the Butterfly project in 2022 in conjunction with its French partner, distributing 47 units in Chernihiv with accompanying training of scores of medical staff. Direct Relief supported the project’s expansion this year with a $110,000 grant to supply 25 more probes and conduct training. In addition to the units provided to AICM, Direct Relief also conducted a 2023 training that equipped first responders with ultrasound training and portable devices.

The device, which is designed in France and manufactured in China, can quickly detect situations like internal bleeding and is used in such specialties as cardiology, oncology, nephrology, and endocrinology. It also enables preliminary screening at busy health facilities, freeing up larger stationary ultrasound equipment for more detailed analysis.

At Chernihiv’s impressive Medical Center of Modern Oncology, the Butterfly is often used for essential but simpler tasks like measuring stomach liquid levels, a key indicator of oncological conditions, said medical director Dmytro Tsvir. “But it also has applications like establishing the presence of tumors.”

“It has been useful in many diagnoses,” agreed Nataliia Serhiichyk, medical director at the Regional Children’s Hospital, where three donated Butterflies are in service. “We have one that is jointly used by four doctors and they all want one now,” said Serhiichyk, who recalled the device’s effective use by two surgeons trying to extract an air-gun pellet moving around inside a boy’s knee.

‘Risky Bet’ That Paid Off

AICM, which is based in the east-central Ukrainian city of Poltava, began its ultrasound project in Chernihiv by donating four stationary machines from an American donor, but that was not enough. It then worked with its French partner to deploy the probe as close as possible to patients in small local medical stations.

“It was a risky bet because family doctors had never used such devices,” said Dr. Carrer. “But we were helped by the specialized hospitals of Chernihiv in oncology, pediatrics, cardiology, and surgery.”

Therein lies the success of this project, he believes. “The war brought to the medical network of this region a fundamental social element: solidarity. There is no more hierarchy or rivalry between specialists and general practitioners. They now work together for their patients.”

In 2023, AICM also donated three of the probes to the state ambulance service in the Poltava region. Funds allowing, it plans to roll out the project there and in other Ukrainian regions in the future.

Direct Relief has supported health services for Ukrainians with over $1.4 billion in medical and financial assistance since February 2022, including through partnerships with organizations like AICM and the Society of Critical Care Medicine.

The post How Portable Ultrasound Devices Strengthened Medical Expertise in a Frontline Ukrainian Region appeared first on Direct Relief.

They are veterans who overcame the loss of limbs and found a new vocation after regular soldiering became hard or impossible. Today, the life-changing events they endured enable them to help others with similar injuries, both military and civilian, along the road to recovery and a fresh start.

“When we started our work, we realized that for the guys who are new amputees, it’s very difficult to adapt and understand what’s going on and what they can expect from life going ahead,” said Kyiv-based surgeon Oleksandra Mostepan.

Her NGO, U+ System, an emerging partner of Direct Relief, has trained and employed two amputee veterans to great effect, with two more now starting the process: “When a technician is an amputee himself it’s easier to share this negative experience and [help the patients] realize how he or she can recover after such a trauma.”

Mostepan, who works at a large hospital in the capital, operated on some future trainees herself after their evacuation from the front. Through frequent doctor-patient interaction she not only saw their potential as individuals, but also for the sector’s overall development if they are integrated into existing teams of prosthetists.

After all, no one understands the issues of functionality and comfort of an artificial limb like a user, as her team found while fitting more than 350 prosthetics for war-injured patients.

“This cooperation between amputee technicians and experienced technicians working together will be a great achievement in prosthetics fitting,” said the surgeon. “I think it’s the future of prosthetics in Ukraine.”

A Growing Trend of Inclusivity

Other organizations supported by Direct Relief seem to have come to the same realization. The U.S.-based Protez Foundation, established in 2022 by Ukrainian surgeon Yakov Gradinar and its CEO Yury Aroshidze, has launched a new “veteran direction” at its two prosthetics clinics in Ukraine.

“We are attracting military veterans to the project to work as points of contact and event organizers for veterans,” said Aroshidze. “We already have two veterans working, Danyl and Mykola. Danyl had four amputations and was in [Russian] captivity. Also, in our new clinic project, we are equipping workplaces for the disabled so that our military personnel who have undergone prosthetics can become prosthetists.”

The gravitation of amputees to the prosthetics field will quickly become the norm in Ukraine as patient numbers continue to soar, predicts Lasse Madsen, founder of the Danish prosthetics company Levitate: “I’ve been in more than 600 clinics globally. And I’ve never in my life anywhere seen anything like this in terms of the amount of people [needing prosthetics].”

“We’ve been visiting other clinics as well in Ukraine and it’s not uncommon that you see that one of the technicians doing sockets or something similar who is an amputee,” said Madsen, who lost a leg in an accident at the age of 14 and went on to work within the prosthetics industry. “You can see they’re so fired up to learn more and train and go to different places to learn.”

A Bigger Challenge Than Just the Prosthetics

At the same time, Madsen stresses the need to build networks for all of Ukraine’s new amputees, having gone through a profound sense of solitude following his injury two decades ago.

“Having a network of people that you can talk to who are in the same situation as you can be equally as important as actually talking to a specialist,” said Madsen, whose enterprise helps to build such resources through its regular sporting events for amputees in Ukraine.

Someone he sees as a great fit is Volodymyr Rudkovskyi, a 32-year-old infantryman who lost his right leg below the knee in combat in June 2023. Volodymyr became the second Ukrainian to receive a prosthetic from Levitate when it came to the country later that year, and he regularly participates in events organized with local partners.

As well as being a motivator for amputees at the Unbroken National Rehabilitation Center in Lviv, also a partner of Direct Relief, Volodymyr is a voluntary ambassador for this area of disability, performing various types of advocacy work.

“This includes trips to different forums, not only in Ukraine but also abroad, to different events, where people who are not involved in military matters would like to hear about how to treat veterans, military personnel, and their families,” Volodymyr said of his new role.

“We also take part in sporting events to promote the idea that everything should be barrier-free, that we should think about veterans, about the boys and girls who experienced the worst of this war.”

Painful Experience Shared

Two other injured veterans shared detailed accounts of their journey from combatant to casualty to prosthetist. Oleksandr Kushnerenko, 21, joined the army after school in 2020 and fought against Moscow-backed separatists in eastern Ukraine before the full-scale Russian invasion in February 2022. He was then sent east again and was injured in heavy fighting for the city of Bakhmut.

On September 27 of that year, a Russian tank that his unit had observed in the distance suddenly reappeared at close quarters and began shelling their position. Oleksandr suffered fragmentation injuries to his lower left leg and his right arm and was evacuated first to the city of Dnipro and then to Kyiv. There, Mostepan operated on his leg, which had to be amputated below the knee. She was able to save his arm, which has since regained full function.

In 2023, Oleksandr met his surgeon again in Lviv at an event hosted by U+ System and Levitate. At the time, he was considering returning to active duty. Seeing his suitability for a different role, Mostepan invited him to train as a prosthetist with her NGO.

“I wasn’t against the idea and a month later I was already working in Oleksandra’s team,” he said. “I studied and went on some prosthetics courses and started my practicals at various prosthetic centers, and now I work at U+ System.”

Oleksandr has since helped fit sports prosthetics for more than 100 male and female amputees. “I have simply found the thing that I love doing,” he says of this change of course. “As for what happened to me, I almost don’t think about it now.”

His advice for others facing life after amputation: “Keep moving and don’t get fixated on the thought that you lost a limb.”

Elyor Abdulaev, 27, completed his two-year military service in 2021, after which he worked briefly according to his earlier training as a chef’s assistant. When Russia invaded, he served as an infantry squad commander in eastern Ukraine. He was injured on December 3, 2022, near Kreminna, where an anti-personnel mine blew off his left foot.
“I remember everything up to the point when they got me in an ambulance, where I could finally relax. From the loss of blood, I just wanted to sleep,” he said.

Two months of surgeries ensued as doctors at different hospitals battled a persistent infection that could have resulted in the loss of his knee. Finally, in Lviv, after the sixth surgery to open and cleanse the wound, the limb was ready to receive a prosthetic.

When Elyor was sufficiently healed he returned to his family in Dnipro, where he chose a local organization, Bez Obmezhen’ (Without Limits), to manage his prosthetic treatment. Two weeks later he received his first artificial limb and an hour later he was standing again.

“I thought it would be painful,” he said. “I took my first steps while supporting myself against some logs and found that it didn’t hurt. I can’t describe that feeling of knowing that you are on two legs again and can move without hopping or using a wheelchair.”

After building up resilience he can now wear a prosthetic almost all day long. In March, Elyor received a running blade from Levitate as well as an upgraded daily wear foot. “I’m very grateful that they decided to donate two prosthetics to me. The first time I used a sports blade I was over the moon that I could run again,” he said.
Then it was time to find his new path in life. He already knew that he would not work again as a chef’s assistant.

Despite his newfound agility, it would be “too much running back and forth for 12 hours.” In spring 2024, after six months of assembling children’s furniture, he was also thinking of returning to the army when Bez Obmezhen’ invited him to work for them. Elyor has since been learning to make artificial limb sockets and will soon start formal training as a prosthetic technician.

“In the future, I will be a prosthetist, there is a big demand, and I will study and work – there’s a lot to learn,” he said.

For now, he is focusing on the intricacies of his own artificial limb type and will progress from there: “When I understand that fully I will progress to the upper leg, then to the arms and on to sports prosthetics.”

His advice to other amputees: “I told myself then and I tell everyone now, don’t give up, life goes on, prosthetics are growing and improving all the time. People live with this, do sports and even win in Olympic events. Do not give up!”

Direct Relief has provided over $1.4 billion in medical and financial assistance to Ukraine since Feb. 2022. The organization has supported rehabilitation efforts, including those of U+System, the Protez Foundation, Levitate, and Unbroken National Rehabilitation Center, the four groups mentioned in this story. Read more about Direct Relief’s work in Ukraine.

The post Wounded by War, Ukrainians Living with Amputations Find New Purpose as Prosthetists, Advocates appeared first on Direct Relief.

Fourteen months later, Mission Kharkiv, based in the eponymous eastern city, has grown into a robust healthcare provider. It is also garnering kudos from international agencies for a ‘first’ in this highly specific field.

According to organizations that form the Ukraine health cluster, “no one provided a complete course of chemotherapy in a city under siege before,” said Ross Skowronski, who founded Mission Kharkiv 18 months ago.

“So it looks like we are the first NGO in the world, despite that we are very small, who did that,” he adds with some wonderment at how far the NGO with 15 employees has come in such a short time.

It’s not just the large number of unique oncological cases it handles – up from 700 patients last year to more than 2,500 today. The last piece of the chemotherapy cycle was the provision of niche therapy sessions for people grappling with a harsh new reality.

“Since our team members communicate on a daily basis with the patients, for us it became evident very early that mental health is needed for them and their relatives as well,” said Skowronski, a mathematician who relocated to his birthplace Kharkiv from Spain just before the Russian invasion in February 2022.

A survey conducted among the NGO’s patients and their relatives showed that 68% needed mental health support, and 35% expressed a strong desire to participate in any mental health sessions offered.

In collaboration with large international organizations, the first two attempts to organize support in both online and offline formats incurred a high dropout rate among participants. “Obviously there is a stigma surrounding mental health in Ukraine, which is very substantial,” said Skowronski. “What was interesting to know was that the oncology patients felt detached from sessions conducted by very big organizations because they perceived this [as a] corporatized and standardized approach.”

The elusive successful pilot project finally came about with the hiring of Ihor Prokopiuk, a Ukrainian psychotherapist living in Spain who has 16 years’ experience working with terminally ill patients. “Regardless of the setting, this [group therapy] helps, it provides a means of living differently,” said Prokopiuk.

“If we are talking about really difficult situations, like cancer sickness and war on top of that, it’s obviously terribly difficult for people to deal with, to find meaning in their life and to stop wanting to hide themselves away every morning.” He also noted the entrenched stigma, linking it to the former Soviet authorities’ use of psychiatric institutions as a punitive measure, often causing deep psychological harm to people in the process: “These prejudices are now easing, but Ukrainians are still very ‘specific’ in this regard.”

The pilot project in Kharkiv lasted two months, with one two-hour online session a week for ten participants. It produced extremely positive feedback at the end.

“Only one patient dropped out and the others reported that for them it was a life-changing and life-supporting experience and expressed a strong desire to continue,” said Skowronski. “It looked like we had finally cracked this problem into a mental health project for oncology patients. Now we want to continue.”

According to the Ukrainian Ministry of Health, the country currently has almost 1.2 million registered oncology patients, with the addition of some 100,000 new patients each year. State cancer treatment is free, but in war conditions, specialized medicines are often unavailable at hospital dispensaries, leaving patients to find and buy them themselves. That’s where Mission Kharkiv comes in.

The work is complicated by the dispersal of its patients across Ukraine. The country covers more than 600,000 km2 (230,000 square miles), or almost the size of Texas, making the transportation of costly medicines at controlled temperatures difficult.

In the early months of the war, however, there were cases where people came to war-torn Kharkiv from as far as Lviv and other western cities, making a more than 2,000-km (1,240-mile) journey in hazardous conditions to collect their medication.

Today, in addition to its bomb-proof, temperature-controlled storage “bunker” in Kharkiv, the NGO uses secure storage facilities in the cities of Dnipro, Kyiv and Lviv to make collection easier for patients and their relatives.

One medicine supplied to Mission Kharkiv by Direct Relief is Trastuzumab, which is typically administered at three-week intervals over several months to treat different types of cancer, often in combination with chemotherapy and other drugs.

If privately purchased, a single dosage costs more than ten times her monthly pension, said Lyubov, 68, who lives in the Lviv region. Now, thanks to the organization, she either receives the medicine there or it is relayed from the stocks in Kharkiv in a cold box via a courier.

“It’s a really good organization, they helped me so much, and their people really understand oncology,” said Lyubov. She is frank that while the treatment doesn’t ultimately change the outcome for her, it does change her outlook. “This is incurable, that’s just the way it is. But right now, life goes on, and it goes on normally.”

Of several Mission Kharkiv patients with different oncological conditions who were consulted for this article, it is notable that no one dwelled on themselves when asked about the future. The focus was rather on the greater good as Ukraine fights for its survival.

“I want there to be peace,” said Galina, a 68-year-old former sports school administrator, also from the Lviv region, who has received support from Mission Kharkiv since January 2023. “Everyone dreams of things being like they used to be, when you just went to work and there were no air alarms, and it was just peaceful.”

At the start of the year, Skowronski took a much overdue break and went to Pakistan. While there, he also contacted local oncology specialists to inquire about the situation in the South-Asian country.

What he discovered opened his eyes to the possibilities of transferring Mission Kharkiv’s expertise to other countries burdened by some of the same problems as Ukraine: “Their energy grid is quite bad, there is a lack of supplies of chemotherapy medicine, they are facing a corruption situation, and cancer data is not collected properly.”

After 18 months developing Mission Kharkiv, he believes they are ready to launch something further afield, be it in Pakistan or beyond: “We have our standard operating procedures, we know how to build the bunker, we corrected lots of mistakes that appeared and that we were not aware of, so we now have the experience and can replicate that in other countries.”

Meanwhile, there is still a missing part in Ukraine’s oncological system. Another project in preparation is for Mission Kharkiv to assist the Ukrainian government to gather exact data on where active substances are prescribed.

While its medical statistics department records cancer incidence rates, the prescription of active substances and dosages are not monitored. As a result, government procurement is based on approximated data, rather than actual demand.

“If we do that [data gathering] on a sustainable basis we can close completely the medication aid project and the government can hopefully take care of it forever,” said Skowronski.

Mission Kharkiv is among Direct Relief’s core partners in Ukraine. Since 2022, Direct Relief has provided the organization with more than $40 million in medications and supplies to care for patients across Ukraine.

The post Mission Kharkiv Sets New Standard for Cancer Care Amid Ukraine War, With Support from Direct Relief appeared first on Direct Relief.

Now, a Ukrainian project supported by Direct Relief has supplied portable power stations for Larisa and 79 other kidney patients in Kharkiv and other parts of the country. This means that even when the city is dark because of the intensified Russian attacks on the power grid, she and others can perform daily health procedures for the essential eight hours uninterrupted.

“This [device] doesn’t just improve life, it prolongs it,” Larisa told Direct Relief during a recent visit, the motif on her t-shirt neatly summing up the change: “Got Super Power.”

Peritoneal dialysis, or PD, is a treatment for kidney failure that uses the lining of the abdomen to filter the blood inside the body via a catheter, through which bags of dialyzing fluid are pumped. The solution is a type of cleansing liquid that contains water, salt and other additives.

Larisa has used a dialysis machine for the past three years. Like the monthly volumes of fluid (5-10 liters per day, depending on the person’s size), it was provided free of charge by the local health service. But without a steady power supply, patients can spend exhausting hours at night manually performing their treatment.

The donated type of unit, an Anker PowerHouse 757, is a 1500W battery that charges when the power supply is on and maintains a steady feed when activated. This means the patient can hook up to the dialysis machine and sleep during the procedure.

That is, if missiles, guided bombs and drones don’t rain down that night. That always wakes people, even when it’s in the distance, but “you get used to it,” said Maksim Chernyak, another Kharkivite who received a station.

Maksim, 31, is living with diabetes, and his condition deteriorated last year after an operation and left him dependent on peritoneal dialysis and at the mercy of power outages. “Because of the shelling, the situation is very unpredictable,” he said, sitting beside his equipment and an impressive collection of Star Wars figures that he amassed from childhood.

He received his power station in March, which happened to coincide with a series of strikes on the city’s electricity infrastructure. Since then, the power usually goes on and off five or six times a day, traffic lights die, causing chaos at road junctions, and lines of generators start up outside shops.

“It was fortunate timing – we were thinking that we had to buy a generator,” said Maksim, who used to work in his uncle’s fabric business until his health failed him. He now leads a very modest life on the state disability allowances paid to him and his father, Yuriy, a former fireman, who was involved in the hazardous cleanup after the Chernobyl nuclear reactor explosion in 1986.

This year, Direct Relief’s core partner in Kharkiv, the Charitable Fund Yevhen Pyvovarov, delivered 37 units in the city and region, which are among the country’s hardest hit in the more than two-year-long war. The initiative originated in Kyiv, from the president of the Ukrainian Association of Nephrologists, Dr. Dmytro Ivanov. Direct Relief learned of the need for the batteries through a collaboration with the European Renal Association.

After some number crunching, he found that of the pre-war total of 10,708 people with severe kidney disease in Ukraine, 206 on automated peritoneal dialysis are still in the country and need such power units in the current conditions. Ivanov approached his contacts in nephrological circles for assistance. A batch of 40 stations was donated by the Netherlands and 12 by the Slovenian Society of Nephrologists, while a nephrologist colleague working with Direct Relief helped kickstart a project to supply 80 more. That leaves around 70 still to source, which the doctor will try to do through the same networking route.

“Given the current risk of blackouts, it’s crucial to ensure that all remaining patients using automated peritoneal dialysis have access to charging stations,” said Ivanov. He also wants to create a reserve of charging stations for some 400 patients who do not have dialysis machines and are still on manual PD.

“The ultimate objective is to transition all patients from manual to automated dialysis. Additionally, there’s the challenge of providing PD amid military operations, a responsibility typically shouldered by military medical personnel.”

The third patient visited is Tetyana Kozyna, 63, who, with her husband, Viktor, left their home about 15 kilometers (10 miles) from the border with Russia in June 2022. She recalled how they fled to Kharkiv with what belongings they could carry, not knowing how much of their old life would survive. “In September, we went home to find the whole house gone, walls, roof, everything,” said Tetyana.

She was already living with one kidney when the war broke out, but the organ failed amid the fear and stress caused by the fighting, and she was hospitalized when they reached the city. Then her husband was diagnosed with cancer, which he managed to successfully battle.

“First, I was sick, and he helped me get through it, then he was sick, and I helped him – that’s how we do things,” said Tetyana, with an evident strong love forged over decades of shared life.

They now rent a one-room apartment in Kharkiv while they wait for the war to end. Tetyana also received her power station in March and says that this boost to her dialysis machine affords her a degree of peace of mind that she hasn’t had for a long time.

“It’s thanks to this that I can live on,” she said, echoing Larisa’s words. “It cleans my system and makes everything easier, including going out and doing normal things.”

After everything they endured and still do, they are confident that despite the hardships, they will eventually rebuild their lives.

“We just need peace,” said Viktor. “We will take care of everything else.”

The post Ukrainian Dialysis Patients Power Up Their Health Amid Bombings and Blackouts appeared first on Direct Relief.

The population has braced for more of the same as the mercury fell to the current level of around 27 degrees Fahrenheit (-3 Celsius).

The recent holiday season in Ukraine was also overshadowed by massive Russian missile and drone attacks on cities across the country. But almost two years into the war, Direct Relief’s local partners are redoubling efforts to bring quality healthcare to the population despite power interruptions and missile attacks.

“We went through a complete blackout, we were cut off when the biggest mobile operator was hacked, but we only became stronger and more resilient,” said Yuliia Dmitrova, head of the TAPS foundation in Dnipro, one of the country’s hardest hit cities.

As well as distributing medicines to hospitals and providing dental and other services, the organization will again this year hold healing retreats for the children and widows of those lost to the fighting.

Among Direct Relief’s core partners and other NGOs receiving support, 2023 produced a broad springboard of initiatives with long-term application: prosthetics production, fitting and rehabilitation; psychosocial services for war-affected citizens; mobile health clinics for children in rural communities, and many more initiatives that will be carried over into 2024.

This was in addition to supplying medical products. Last August marked $1 billion of these delivered since the war’s start in February 2022 through Direct Relief’s partners to the people of Ukraine in the largest humanitarian aid response in the organization’s 75-year history.

Now totaling more than $1.1 billion, these resources have been invaluable in supporting the country’s healthcare system in the darkest times.

There Will Be Light – and Operations

“We know that this winter will be worse than the last,” said Katya, a specialist working with a DR-supported psychological care project in the Kyiv suburb of Bucha. “The other night, we were attacked with 70 drones, and Russia will have elections,” she said after the first big attack in late November and referring to President Vladimir Putin’s predicted fifth-term victory in March. “We are getting ready.”’

Among other measures, Ukrainian technicians have been fitting health facilities with Tesla Powerwalls donated in Summer 2023 by the Polish government and delivered with logistical support from Direct Relief and its Kharkiv-based partner Charity Fund Yevhen Pyvovarov.

The 508 units – rechargeable 14 kWh lithium-ion batteries that can provide power during peak times, power outages, and at night – will work in several regions along the 620-mile (almost 1000-km) frontline. Direct Relief is now working with the Ukrainian government on further steps to keep hospitals and clinics running.

Smaller civil society initiatives also aim to fill gaps in Ukraine’s preparations this winter. One is a project by Mission Kharkiv, an NGO that primarily distributes cancer medicines for Direct Relief, to provide first aid training and blast-proof medical kits for thousands of workers at the country’s power plants.

Most had no such training during decades on the job, so a 90-minute course recently delivered to workers at a plant in the eastern city of Kharkiv was entirely new for them. Realistically, they may retain only 50% of the skills demonstrated, said trainer Darya, a lawyer at a Ukrainian bank, but this can still make a difference in a crisis.

Darya decided to qualify as a first aid trainer so she could make a personal contribution to the war effort in her spare time: “I wanted to help people in Kharkiv to learn to do things like apply a tourniquet and be able to save lives.”

There is palpable fatigue among people you meet on the streets these days, but the spirit of volunteering is still strong across Ukraine. This was apparent on the International Volunteer Day on December 5. In Kyiv, more than 5,000 people visited an exhibition venue for diverse talks, awards and displays by dozens of NGOs from all fields of activity.

Ukrainian President Volodymyr Zelensky separately honored this contingent of society as “another strength of ours, our guard of those who care, our army of active Ukrainians.”

No one is slacking off – there is simply too much to lose after the trials and gains of recent months.

“Despite ongoing challenges, the humanitarian sector in Ukraine remains resilient and demonstrating unwavering commitment,” said Anton Gulidin, an advisor to Ukraine’s ombudsman for human rights and the head of NGO Friends of Ukraine Foundation, which had a stand at the event. “The sector continues to innovate, develop new projects and sustain its momentum.

The next morning, on the ‘new’ St. Nicholas’ Day – Ukraine last year moved its Christmas holidays to Western dates in a permanent break with the Russian Orthodox church – a blue-clad Ukrainian Santa visited young patients at the Okhmatdyt National Children’s Specialized Hospital in Kyiv.

The day brought surprises for children and adults alike: “I checked my mail and received good news [about] our project for mobile pediatric services for children,” said Marina Makarenko, the head of Direct Relief’s partner Charity Fund Modern Village and Town, or CFMVT. She had stopped by the event at the hospital to add some donated gifts to the pile.

The mobile clinic project, implemented last year by CFMVT together with Okhmatdyt, is being further funded by Direct Relief starting in January, ensuring that expert medical care reaches children in rural communities across a wider area of Ukraine – regardless of the weather.

The post Amid Freezing Temperatures, Ukrainian NGOs Double Down on Humanitarian Projects for 2024 appeared first on Direct Relief.

A full-scale war raged as Russia assaulted its neighbor by land, sea and air, forcing Ukraine’s population to hide from the bombing and shelling wherever possible. Many lives were still lost due to the lack of underground shelters or because shelters were locked, as happened on June 1 in the capital, Kyiv.

“Shelters must be accessible,” President Volodymyr Zelensky said later on national television. “The situation like last night in Kyiv, when people came to the shelter, and it was closed, must never happen again.” Three days later, media reported that 1,078 shelters had been inspected in the city, half of which were found to be in a non-operable condition – either unsuitable for use or locked.

Legacy of the Soviet Planners

Ukraine had actually been well prepared by the former Moscow-led Soviet authorities. For decades, planners built deep shelters under public buildings against potential attacks by mainly Western enemies. Many of these were Cold War-era radiation shelters, while others dated to WWII and earlier.

“They protected first against the Nazis, then the Americans and now against the Russians,” said the head of a medical organization that recently converted part of a long-disused bomb shelter in the eastern city of Kharkiv. Ten feet (three meters) below ground and with a thick concrete ceiling and walls, it now makes an ideal secure storage for valuable refrigerated medicines, including those provided by Direct Relief.

Some 350 miles (560km) to the west, in the city of Zhytomyr, a subterranean shooting range built under a school for Soviet military preparation courses underwent a huge transformation. Today, the long cavern and adjoining rooms totaling 13,000 square feet (1,200 m2) form a state-of-the-art shelter, refurbished since 2016 with UNICEF funding to enable 1,250 children to study even during emergencies.

The school’s director says she did not exactly have a premonition of impending full-scale war but a “sense of alarm” after hearing stories of colleagues about students scrambling for cover during shelling in Ukraine’s eastern Donbas region, which Moscow-backed rebels seized in 2014.

So she started a superior conversion of the basement, complete with a small kitchen and medical center – just in case. This paid off after the February 24, 2022 invasion, as Zhytomyr was subjected to multiple bombing raids and missile strikes.

“We would spend hours down here in winter, and we also let in neighbors, dogs, too – what else are you going to do during a bombardment?” says the director, who envisions that after the war, the shelter will function as a “second school” with a wide range of activities and sports classes.

Ukrainian authorities say almost 3,800 educational institutions have suffered from bombing and shelling, 365 of which were destroyed completely. According to the UN’s children agency, UNICEF, only a third of Ukraine’s schoolchildren currently study in-person, while the rest study online.

In the northeastern city of Kharkiv, Mayor Ihor Terekhov recently declared his intention to build Ukraine’s first completely underground school, without giving details.

However, schools and other institutions aside, public discipline has ebbed as wailing sirens warn of possible strikes, often several times a day. People got tired of traipsing below ground at all hours when often nothing happens, and many no longer react to the alarms – sometimes with tragic results.

“Ukrainians are already used to living in war conditions,” Ukraine’s DSNS civil defense service says on its website. “However, it is extremely important for everyone to remember that you should never get used to ignoring the Air Alert signal! The enemy is counting on this!”

Not Quite a Bomb-Shelter

There is a crucial distinction between an ukryttia and a bomboskhovyshche in the Ukrainian language, rendered in English as shelter and bomb shelter, with a corresponding difference in sturdiness, depth and effectiveness.

Igor Gresko, the director of the hospital in Okhtyrka in the northeastern Sumy region, must strike a balance between the two in safeguarding his staff and patients: Built in the mid-1980s, the five-story building has a large, partially reinforced basement complex just below ground level that can serve as a shelter – but only up to a point.

“If something really heavy hits the hospital, then it’s a grave,” he says in a blunt appraisal of its protective qualities. Nevertheless, he is obliged to evacuate patients to the ukryttia during threats to the town located 25 miles (40 km) from the Russian border.

Much of the hospital’s equipment is outdated and in desperately short supply, but it still managed to set up an emergency operating theater underground, complete with an incubator for newborns.

“It has to be at least as good as what we have upstairs,” says Gresko, only hours after the latest security alert, when explosive-laden suicide drones buzzed overhead until they were shot down: “No one slept much last night in Okhtyrka,” he adds.

The post Gimme Shelter: Ukrainians Make the Most of the Soviet Underground appeared first on Direct Relief.

And those who still fear a premature, violent death like Oleksandr. The infantryman in his fifties is about to return to the frontline 60 miles (100km) away at Kupiansk, where Ukrainian forces are fighting hard to prevent a major Russian breakthrough.

“In our platoon of 30 guys, we lost five… and one who lost both legs in just the past month,” he says, standing on the central Pushkin Street in uniform with a backpack and sleeping mat, freshly discharged from hospital after treatment for an injury. “It’s roulette. You spend two days on the line, trembling in a hole, looking up at the sky and waiting for a Russian drone to drop something on you.”

Kharkiv is badly damaged, inside and out, but walking through Ukraine’s second-largest city on a balmy, early-fall evening, there are still places displaying no obvious signs of war. No defiant patriotic banners, billboards mourning fallen soldiers, or the ubiquitous planked-up windows. Music wafts through the air, parents push strollers, and children play around whimsical bronze statues in public gardens.

But no one reacts when sirens sound for the fifth time that day, even though it may mean guided missiles are speeding in from Russia, just 25 miles (40 km) away. People got tired of running because of false alarms and now simply trust in their luck.

“The abnormal became normal,” says Iryna Lysikova, who runs a new psychological support center organized by the NGO Razom for Ukraine. Compared with a year ago, the less frequent enemy strikes, in a way, became harder to cope with, she says. “Back then, it was constant, but when it happens now, you get retraumatized.”

Employing five psychologists on its staff of seven, the “Together with You” center in Kharkiv is one of a ten-center network that Razom for Ukraine is developing around the country with support from Direct Relief. Lysikova’s team immediately received a flood of requests for appointments when they opened to the public in late July.

Some are from internally displaced persons (IDPs) from Kupiansk after their compulsory evacuation due to the fighting. Others are from residents who endured the worst shelling from February to September 2022, when the Russians were finally pushed out of artillery range – even if their drones and missiles continue to smash into the city on bad days.

“Some people lived for months down in the metro,” Lysikova says, while opposing the recent decision to conduct classes for around 2,000 children in some of the city’s metro stations from September 1. They are not deep enough to afford protection from attacks and are too poorly ventilated, she believes.

Sure, the center’s capacity is a “drop in the ocean” of the psychosocial care needed among Kharkiv’s current estimated 1.2 million civilian population (the military runs its own psychosocial services). But together with similar initiatives, Lysikova is confident it will help get the ball rolling: “Our task is to help reduce the overall pressure in society.”

The center is looking to cooperate with another that was recently opened by the Kharkiv Renovation Fund, one of Direct Relief’s core partners in the city. The shiny new “Kimnata Pidtrymky” (Support Room) is located a couple of streets over. Offering free psychological services for children, it was also inundated with requests for sessions and expects to receive more than 1,000 clients a month at its 310m2 premises, as well as offering online consultations.

The city’s children present a huge emerging need for psychological assistance and speech therapy.

“These children were not socialized,” says the center’s project leader, Alla Roitblat, referring to the months the youngest Kharkivites spent at home or in shelters, rather than enjoying normal interaction with their peers. “Many children, especially those of IDPs, have aged beyond their years.”

Nationwide Mobilization of Psycho-Social Care

Related initiatives sprang up across Ukraine in recent months. Some 200km to the south, in the city of Dnipro, the Tragedy Assistance Program for Survivors (TAPS) embraced the same issue from a different angle by organizing camps for relatives of fallen service personnel.

So far, it has run two one-week camps at a wood cabin complex in the Carpathian Mountains in April and July for 54 children who lost a parent serving in the military since 2014. There was also a camp for 30 war widows. Described as a “synergy of fun and psychological work,” the events were funded by the US aerospace giant Boeing and will continue as finances allow.

“It’s something that is only happening now, that people realize they need to take care of themselves,” says TAPS project manager Liudmila Cherkez. “We want to normalize the act of going to a psychologist.”

This remains a challenge in many Western societies, too. But in Ukraine, which is still burdened by its Soviet past, people are especially wary of admitting anything that may be perceived as mental weakness, much more so among men. “We are already seeing the consequences,” says Cherkez. “And after victory and the soldiers come home, the need is going to be immense.”

In an online survey that TAPS conducted among 200 members of bereaved families in late August, only 16 people said they required psychological help. After follow-up phone calls by a psychologist working with TAPS, the number jumped to 80 who wished to talk at length to someone qualified.

Fortunately, the issue now has some high-level support behind it. Championed by First Lady of Ukraine Olena Zelenska, the “How are you?” nationwide mental health program has been promoted on billboards and in other spaces since 2022 to address the trauma of war in reluctant Ukrainians.

“They don’t want to upset their family, they are afraid of being excluded from the team, they are afraid of a diagnosis, they remember the negative years of the Soviet medical system of punitive psychiatry,” Zelenska said in September during a discussion in Kyiv on the issue.

“All of this needs to be overcome, this stigma needs to be overcome. And not only in our country, but in the world. Everyone needs to understand that taking care of yourself is not selfishness, it’s a responsibility,” the First Lady said.

The post Ukraine Starts Unpacking Mental Trauma as War Rages On appeared first on Direct Relief.

Bringing also laboratory testing facilities, the capital’s Okhmatdyt National Children’s Specialized Hospital provided a day-long ‘one-stop shop’ of consultations – supported by Direct Relief and free of charge – to more than 200 children from local and displaced families living locally.

“I always dreamed of this,” says Olga Medvedeva, a hematologist who persuaded her management to launch the “Care for Your Health” project 16 months ago, starting in the Kyiv suburb of Bucha after it was freed from a brutal Russian occupation.

The project was an instant hit: So far, 54 mobile clinics reached more than 6,000 children in five regions of Ukraine, which has been battling Russia’s invading forces for the past 18 months. “Our soldiers are fighting on their front, and we are fighting on the medical front,” the doctor says.

Parents can opt to see selected specialists or all 16 if they wish. While medical outreach programs are not uncommon, there is no analog to this level of care anywhere in the country, according to Medvedeva, whose team arrives in a bus and an ambulance and sets up the clinics in local schools.

Apart from responding to urgent needs in war-affected areas, the project brings quality healthcare to communities that are simply remote. For example, while there is a small hospital nearby, Velyka Sevastyanivka’s around 3,000 residents must drive three hours to the Cherkasy Region’s capital to see certain specialists or get more complex treatment.

“It’s wonderful that people can come and care for their children without charge, especially in villages where health is neglected,” says Taia, an internally displaced person (IDP) from the southern Kherson Region who came to the mobile clinic with six of the eight children who have been orphaned that she and her husband are raising.

According to the organizers, the majority of children in rural areas visited never received specialized health screening. This is partly due to their location but also the tendency of many parents to address health problems only when they occur, rather than getting preventative checkups.

The new approach is producing clear results: around 20% of children seen at each clinic are referred to Okhmatdyt National Children’s Specialized Hospital for further examination, while 7-10% are hospitalized there for treatment.

Seeing is Believing

Direct Relief supported 13 of the mobile clinics, which were attended by 3,987 children, with financial and medical aid. The project’s extension to the Cherkasy Region was supported by Direct Relief’s partner there, the NGO Charity Fund Modern Village and Town (CFMVT). Its head, Marina Makarenko, is herself from Bucha and took her two children to see an endocrinologist at an Okhmatdyt clinic there last July.

She was so impressed by the care provided that she resolved to bring the project to Cherkasy, where her family sheltered during Bucha’s occupation and where her NGO had already worked for several years.

“In the district centers, there are no children’s specialists except for a pediatrician and a neurologist. And in the villages, the only doctor for everyone is a paramedic,” she says. “We see confirmation of this in the fact that with each visit, 60% of children are examined by narrow specialists for the first time.”

Another clinic visitor is Valentina, who marvels at how her three grandchildren can be fully checked over in the space of a few hours. “It would take three or four days to do the same at a hospital,” she says, citing also the high travel and accommodation costs that families may incur.

A queue of people also waits to see the team’s psychologist. Because of the relative rural calm in this region, it attracted thousands of IDPs from frontline areas. “Lots of children have trauma from explosions, for example, which, if not addressed, can cause a cascade of other psychological issues,” says the specialist.

Since mid-June, CFMVT facilitated seven Okhmatdyt clinics in the region. Eight more are planned until the end of August when the initial project ends and the NGO will seek funding to extend it: “We would like to share this project to as many regions as possible,” Makarenko says. “Children are our future; they must be healthy.”

Affectionately referring to the mobile clinic project as “her baby,” Dr. Medvedeva is also looking beyond the country’s current fight for survival and to the long term.

“Especially in such small settlements, the main goal is prevention – we are thinking ahead about what kind of young people will grow up and live and work in Ukraine,” she says.

The post “Children Are Our Future.” Specialty Pediatric Care Reaches Ukrainian Villages appeared first on Direct Relief.

It’s been four hard months since the 35-year-old Ukrainian civilian was cut down by flying shrapnel as he entered his home in the eastern town of Bakhmut, the scene of some of the heaviest fighting in the almost 17-month-long war in Ukraine.

“I don’t know what [kind of projectile] it was – all I heard was whistling for a second,” recalls Oleh, who was taken to Dnipro, where the shattered limb was amputated above the knee. He was then transported on an evacuation train 500 miles (800km) across the country for treatment at the “Unbroken” National Rehabilitation Center in Lviv.

Oleh is among approximately 15,000 Ukrainian patients to pass through the center since the start of the war. It is located on the premises of the First Medical Union of Lviv, Ukraine’s biggest healthcare facility consisting of two hospitals for adults and one children’s hospital. As well as its prosthetics capacity, Unbroken has surgical and burns units and offers extensive physiotherapy and mental healthcare, all provided for free to patients.

“Our goal is to help Ukrainians remain UNBROKEN and get all the necessary help here, in their own country, near their families,” declares the website of the center, which is supported by the government, Lviv city, private donors and international organizations, including Direct Relief.

Next-Generation Care Under One Roof

Bright and modern, the center exudes positivity and pride at every turn: Portraits and the stories of former and current patients hang on the walls, artworks embody human fragility and resilience, and scarred but upbeat care recipients stop and chat as they wheel themselves in chairs or hop on crutches around the complex.

In addition to around 450 patients at the other hospitals and units, there are presently 39 patients living here. From their admission to receiving and learning to use the prosthesis can last a few months. This includes physical and mental health care, several weeks’ healing following any additional surgeries needed, up to three weeks of preparation of the prosthesis, and then fitting and adaptation. Around 160 people went through the whole process so far, with thousands more around the country also now needing care.

Patients with spinal injuries also receive treatment here, including individual care from social psychologist and life coach Pavlo, who is himself wheelchair-bound. “I coach them in how to live if you don’t have full physical function, moving from bed to wheelchair, using the bathroom, dealing with architectural barriers, how to do adaptive sports like bench presses.”

In an adjacent room, physiotherapist Maria works for the second day with Olha, a local woman who fell at home and broke her arm in two places, helping her regain full use of her hand through exercises. “There’s a big difference already; yesterday, I could only use two fingers. Today it’s all five,” Olha says.

At the end of the room, which is fitted with computers and a kitchen range where patients relearn daily activities, waits Mykhailo, who is missing a recently amputated leg. “I am not a soldier – I had an agricultural accident,” he tells visitors in English with a smile. His wife, still clearly shaken by the events, stands beside him.

However, around 90% of the patients receiving prostheses are military personnel, says head of prosthetics Nazar Bahtiuk, who has almost two decades experience in this field. He is one of only about 20 specialists in Ukraine, so it was a huge boost when he joined the team last year, says Solomiya Yakubechko, the head of Unbroken’s communication department.

Bahtiuk also conducts training within the eight-person prosthetics team, which, as well as using imported components, makes its own socket fittings, starting with a plaster mold taken of the stump of the amputated limb. The team’s most recent addition, Lyubomyr, is a local sculptor who volunteered his skills in the casting process and has been in training for the past three weeks.

A Long Journey in a Changing Society

Resident patients have regular sports and social activities, including excursions to do archery, horse riding and bowling. As well as being fun group activities to build confidence and stamina, the outings have a crucial broader effect – of making the patients visible in public: “Our society needs to see them, understand that this is a man with a prosthesis, and accept them as part of that society,” says Yakubchenko.

Physical trauma is often accompanied by inner turmoil, addressed in the center’s large mental health department, where 11 specialists work. As well as psychological and psychiatric care it offers body therapy, which incorporates touch, breathing and movement techniques to address various mental and physical health concerns.

Another medium is art therapy, where patients are encouraged to express themselves and unlock mental obstacles through drawing. Patients who suffered trauma from injury, captivity and torture often resist the idea at first, asking why they need to relive painful emotions.

“If we don’t go through these emotions again, a big part of our potential can stay arrested,” explains psychologist and art therapist Orest Vasyliuk.

It can take several sessions for the therapy to take effect, he says, showing three colored chalk drawings done on successive visits by a Ukrainian soldier who was badly tortured during months of captivity. It is a powerful triptych: From angry stabbings on the paper with a red chalk stick in the first drawing to a personification of horror in the second, and then a burst of sunlight, nature and color – juxtaposed with a scream – in the third.

A great sense of journey becomes apparent when visiting Unbroken. That journey doesn’t end with a successful skin graft or a new prosthesis but continues with new challenges and perspectives, some darker, some brighter. As one initially reluctant art therapy patient told Vasyliuk after he started to draw in his free time: “You opened my eyes to colors and then I started to see life more colorfully.”

Oleh from Bakhmut knows he has an arduous recuperation ahead of him but says he can at least contemplate that now, compared with the immediate aftermath of his injury. “At the beginning, it was…I don’t know how to describe it,” he says. “Now it is getting a little easier; I don’t have the depression of earlier. I know I must live, work, and build a family.”

Since the war’s start, supporting rehabilitation and recovery from war injuries, both physical and psychological, has been a core focus of Direct Relief. The organization has committed $15 million to specifically support rehabilitation and injury recovery efforts in Ukraine. Direct Relief has helped Unbroken procure rehabilitation equipment, develop treatment protocols, and train rehabilitation personnel.

The post Ukraine’s War Wounded Take Giant Steps at ‘Unbroken’ Rehabilitation Hub appeared first on Direct Relief.

The focus of the event is emergency psychological aid, which comprises techniques that trainees – in this case, first responders in Kherson – can use to assist people impacted by floods, earthquakes, war, terrorist attacks, fires, traffic accidents, or any calamity where people can become disoriented, distraught or angry.

“I [also] teach people who are not psychologists how to connect with victims from the first moment,” says Melinda Endrefy, emergency psychology coordinator at the Ukrainian NGO HromadaHub, based in the western city of Chernivtsi.

This can entail using concise speech, eye contact, breathing exercises, and sensory stimulation that will help bring a dissociated adult or child back into the moment and understand what is happening.

It can also mean quickly building trust with someone suffering from trauma accumulated over longer periods: “Many people are like an inflated balloon. You talk to them, and it pricks that balloon – you are the first person to talk to them like that,” adds Endrefy, who cites herformer professor and mentor Teresa Martinez during her teaching years in Spain: “We are the pillow that protects the glass when it falls.”

A professional psychologist, Endrefy honed her skills over the years working in various countries, including Nigeria, Spain, especially during the Covid-19 pandemic and the 2021 volcanic eruption in the Canary Islands, and Ukraine since the full-scale Russian invasion began in February last year.

The emergency psychological aid training in mid-June for nine first responders in Kherson was an extra element added to an ongoing six-month project aimed at qualified psychologists across Ukraine. During intensive five-day courses, more than 300 participants so far learned new skills that are applicable in crisis situations, rather than in serene surroundings one might expect in psychological care, like quiet rooms with deep armchairs and potted plants.

As recent months showed, it is just as likely to be dark bomb shelters, chaotic train stations or hospital wards following strikes on civilian areas.

The courses often segued directly into field missions to assist the population in locations that are prone to attack or have been liberated from Russian occupation. One training in Dnipro concluded as a Russian missile hit an outpatient clinic in the eastern city on May 26, killing two people and injuring around 30.

In coordination with the health authorities, the psychologists used their new skills while interacting with those impacted by trauma and their relatives. “Heavy day, but I am happy to be here,” Endrefy wrote that evening. “Right place, right time and right people.”

Some of the war’s ill effects on the population stem from the constant stresses: “In Dnipro, we had to deal with a woman, a volunteer at a shelter, who fainted every time there was an air alarm,” she says. “[A sense of] helplessness is a problem we will encounter more and more.”

It is also crucial to nip in the bud things which, if neglected, can cause serious mental and behavioral issues in later life: “If children saw a dead body, especially with a missing part, it is very important to take immediate action.”

In Kherson, which was occupied by the Russians for eight months, shelled for seven months, and partially flooded in the Kakhovka dam explosion on June 6, exhausted local volunteers specially requested the emergency psychological aid course. Although they were involved in daily rescue and evacuation efforts, they often didn’t know how to respond to emotional distress in people.

“The training is really useful,” says participant Lena. “We were doing a lot of things incorrectly, like hugging them when it was not appropriate.”

“We’ll not only use what we have learned, but we will build on it,” adds her colleague Sveta.

HromadaHub, which together with Endrefy, founded the “Food4Body, Food4Soul” emergency psychology project with support from Direct Relief, also wants to build on the experience gained by expanding the project in Ukraine.

“By organizing the training we are not giving the fish but the fishing rod to the psychologists so they can start helping their communities,” says the NGO’s head Lily Bortych. The goal is to build up the resilience and sustainability of the country’s psychological support system: “Ukraine doesn’t have to rely only on foreign specialists but can build up an army of trained emergency psychologists speaking the same language, living in the same area, and sharing the same problems with the people they help.” 

Meanwhile, Ukraine’s DSNS civil defense authority has already started to implement the principles of emergency psychology in its staff training after attending the project’s events.

In further recognition of its impact, Endrefy, who served as the Euroasia representative of the International Federation of Emergency Psychology, was also named President of the World Association of Emergency Psychology for Ukraine in late June.

Direct Relief supported the Food4Body, Food4Soul program with a $320,000 grant to expand psychological services in Ukraine.

The post Emergency Psychology Earns Its Stripes in Ukraine War appeared first on Direct Relief.

“My ten-year-old son took off his shoes and started hitting himself when the flood happened,” Natalia recalled of the fear that gripped her three children, including also a two-year-old girl and fourteen-year-old boy, as the waters engulfed whole areas of the city. “It was the last straw.”

Irina and Natalia are now among thousands of internally displaced persons, or IDPs, who left Kherson and the surrounding region after the apparent destruction of the dam with explosives, which Ukraine and Russia each blame on the other. The disaster caused untold misery on both sides of the Dnieper River, flooding an estimated 230 sq. miles (600 km sq.) of land.

The flooding did not reach Natalia and Irina’s houses. But the decision to leave on June 8 was reinforced by the intensified Russian fire on Kherson, even as rescuers worked to save people and animals.

“They are shelling heavily now,” said Irina, who has a daughter and son aged 15 and 7. “If before it was from tanks and mortars, now they are using missiles as well.”

Not a day too soon

On the day their families left Kherson by bus, Direct Relief staff on the ground observed fresh damage to buildings and rubble strewn in the street by Russian missile impacts during evacuation operations, a few hours after Ukrainian President Volodymyr Zelensky visited the city.

Shelling occurred daily after the flooding, with the Russians also accusing the Ukrainians of firing indiscriminately across the Dnieper. On June 16, some two dozen civilians were reported injured in shelling in Ukraine-controlled Kherson, with 15 impacts heard over around 90 minutes.

Incredibly, the civilian population went about its business even during shelling, often with children, having evidently adopted an extreme form of fatalism during the traumatic events of recent months.

“You get no warning when the shells come in, it happens before you can take cover – even if [a shelter] is right next to you,” said a Kherson resident waiting at bus stop beside a concrete shelter. “They are there more to reassure people,” she added, shrugging off the danger.

Starting over

Ukrainian authorities said more than 3,000 people were evacuated from badly affected areas on the right bank of the Dnieper in the week after the initial flooding. Russian civil defense authorities said they conducted more than 8,000 evacuations on the left bank, under their control, between June 6-19.

Many people stayed with friends and relatives until the water dropped enough to assess the damage to their homes. Others who could no longer bear the chaos also went by bus to cities in more secure territory.

Natalia and Irina’s families traveled to Odesa, located 200km by road west of Kherson and the front line. They were among 400 people who evacuated there from June 6-15, according to city authorities, and were accommodated at a local center for victims of domestic violence.

Odesa is also prone to missile and drone attacks – a strike on a high-rise block in the city on June 9 killed a married couple internally displaced from Bakhmut – but the two mothers still regard it as a much safer option. Having arrived with only the possessions they carried, the families now face the challenge of building a new life in Ukraine’s fourth-largest city.

They said they will receive a monthly IDP payment of 2,000 hryvnias (US $54) per adult and 3,000 per child. But as Natalia notes, a small apartment costs 7,000 hryvnias a month before utility costs. Both women are looking for any work they can find, as well as childcare options, which are scarce in the city.

According to Ekaterina Shalyapina, women’s growth project leader at the Way Home Foundation, which runs the protection center, only four kindergartens are currently working, due mainly to the absence of bomb shelters in most others. Of the city’s 126 schools, only 33 are physically open, she said, while the rest work online only, which creates further complications: “The children are not just under stress because of the terrible things they experienced, but also because they live in a vacuum, without other children of their own age to mix with.

The two new families at the center, which has five other women and 12 children living there, can make use of its limited daycare facility and stay until their situation stabilizes. “We try not just to afford emergency help but help in the long term,” Shalyapina said.

The two mothers expressed relief at having moved away from the immediate danger, and Natalia already managed to get psychological support for her traumatized child. But they are essentially starting from scratch and much will depend on the war’s development going forward. They have no plans to go back to Kherson. “All we are waiting for now is victory,” she said.

As for Ukrainians and Russians being able to have close relations again in the future, Natalia is highly doubtful. “I am a kind-hearted person but I can’t understand what [the Russians] are doing. They shoot at houses with children in them, at evacuation efforts – how can we be friends?”

Since Feb. 2022, Direct Relief has provided more than 275 million defined daily doses of medication, totaling $930 million in material aid, to Ukraine.

The post What Now for Internally Displaced People from Flooded, Shelled Kherson? appeared first on Direct Relief.

“Sabotage groups [loyal to Russia] are targeting heads of hospitals,” said director Viktor Korolenko, who, together with his senior staff, refused to cooperate with Russian forces that seized Kherson in early March 2022, a week after the initial invasion.

It started with demands that they register as Russian employees and pledge allegiance to Moscow. “They took members of my staff to basements and beat and tortured them, but people still refused,” said Korolenko.

Three months into the nine-month occupation, Russian officials finally came to his office and gave him a stark choice: fully cooperate and run the health service for the entire Kherson region – or be jailed for 18 years.

“They gave me a day to think about it,” Korolenko said, recalling the painful decision to relocate to Ukrainian-controlled territory hastily. “I left that night in an armored ambulance.”

After working in Kyiv in the intervening months, Korolenko returned to Kherson a day after Ukrainian forces liberated the city on November 11. While some of his staff had also left and remained in the EU, his pre-war team is mostly back at the hospital, working hard to restore comprehensive health services.

The task was challenging enough amid the city’s power outages, supply shortages and heavy shelling. But the detonation of the Kakhovka Dam on June 6 caused widespread flooding and a further rapid breakdown in care systems. Both sides blamed the other for triggering the catastrophe.

With huge areas still waterlogged and water sources heavily polluted with oil and other contaminants, an epidemic of water-borne illness is now “inevitable,” said Korolenko. “But we are ready, the hospital is prepared, and we now have enough antibiotics.”

HUMANITARIAN NGOs RAMP UP FLOOD RESPONSE

Ukrainian and international organizations, including Direct Relief and its local partners, are scaling up operations to replenish medical stocks at local hospitals. On June 13, the Chernivtsy-based NGO Hromada Hub delivered two truckloads of medicines, hygiene products and 20,000 liters of bottled water to Korolenko’s hospital. Another 20,000 liters were trucked to Nikopol, 100 miles (160km) up the Dnieper River, after the city also lost its primary potable water source due to the Kakhovka Dam collapse.

Having first consulted with the hospital about its needs, Hromada Hub delivered a range of medicines, including more than 900lbs (400kg) of Moxifloxacin hydrochloride, an antibiotic used to treat bacterial infections.

Other Direct Relief-supported organizations in Ukraine also dispatched truckloads of medical products to Kherson. Since the dam collapse, Humanitarian Hub Zhytomyr, located in the eponymous western Ukrainian city, sent five tons of medicines and supplies. It also delivered gasoline-powered water pumps.

In the central city of Uman, the Ukrainian charity Modern Villages and Town sent a truck full of Direct Relief medicines, disinfectants and bottles of water. The organization has also been responding to the aftermath of Russian missile strikes in Uman on April 28 and June 8 that killed 23 people and injured dozens more.

In Ukraine’s east-central Poltava region, Direct Relief’s French partner Association Іnternationale de Сoopération Médicale (AICM) is coordinating a large planned delivery to Kherson with the local health authorities, given the looming threat of diseases like cholera.

“Only 200 beds are opened for CD (communicable diseases) in Kherson hospitals, and 20 cases have already arrived,” said AICM regional director Dr. Christian Carrer. “The tests of water are very bad, and the temperature is rising, so the next days will be very difficult, and [this concerns] 360,000 people not only in Kherson but also in Mykolaiv and Dnipro [regions].”

The most acute medical crisis can arise ten or more days after flooding, especially for people who are elderly or have pre-existing medical conditions and are already vulnerable.

“This is why we are working closely with the emergency services to assess the needs correctly,” Carrer added. “We are preparing a large donation with many different types of aid – medicines, food, hygiene, cisterns, disinfection kits, water pumps, pipes, generators – and we will give also a 20-ton truck to the emergency services to replace the one destroyed.”

However, the deteriorating security situation hampered AICM’s hopes to join UN agencies and access badly affected parts of the Dnieper’s Russian-held left bank. Around 70 percent of the Kherson region remains Russian-controlled, complicating efforts to assist the civilian population there.

“Yesterday [on June 12], our police and military spontaneously used boats to evacuate 120 civilians stranded on the left bank,” said Oleksandr Samoilenko, head of the Kherson Regional Council. “Russian soldiers opened intense fire on them with automatic weapons, killing two police officers and a 74-year-old man who died while shielding two women.”

Family homes devastated

More than 3,000 people have evacuated from the flooded areas on the Ukrainian-held side of the river, with 1,700 coming from Kherson city’s Karabel district, according to Samoilenko. Many also chose to remain, camping as close to their submerged homes as possible and waiting for the waters to drop, regardless of the danger. “They got used to the constant shelling and still believe that everything will be OK,” he said.

However, as the waters subside, houses will likely remain inhabitable, he noted, as many sustained too much damage to their foundations and walls. Since Friday, the water level has fallen more than six feet (2 meters), and people in many areas could start assessing the damage.

In the village of Fedorivka, located on the broken banks of the Ingulets River about 12 miles (20 km) from Kherson, Iryna and her husband and three children have little hope of moving back into their home any time soon. While the now drained house appears structurally sound, its contents were ruined by the waters that swelled high above the foundation on June 6.

“By 5 p.m. that day, our garden was flooded, and at midnight, we had to leave the house,” said Iryna, whose family is staying at a friend’s house further up in the village. “We came back the next morning to find the house was mostly under water. We couldn’t save anything. It’s easier now to just throw everything away. But what’s done is done.”

A total of 63 houses in Fedorivka were inundated, and residents are doubtful they will receive adequate help from the local authorities. However, material assistance in the form of food, clothing, and bedding is gradually reaching this and other villages thanks to a growing force of volunteers and NGOs working in the area. In Kherson, truckloads of supplies keep arriving from around Ukraine and neighboring countries to restore some normality despite the Russian harassment.

The hospital director Korolenko can attest to the power of life carrying on in the most extreme of circumstances. In early March 2022, a week after the occupation, two of his staff insisted on getting married according to Ukrainian practices. Under Ukrainian law, he, as hospital director, had the right to conduct a wedding ceremony during a state emergency.

So he did – “just like a ship’s captain,” Korolenko said, showing photos of the extraordinary event on his phone. “We did it with Ukrainian colors and symbols on the table in front of us. I thought the Russians would take me out and shoot me, but they didn’t interfere – they were probably too busy,” he laughed.

Editor’s note: Since the war began, Direct Relief has deployed more than 271 million defined daily doses and $930 million in material aid and $32 million in financial assistance to Ukraine.

The post Ukrainian Hospital that Defied Occupation Braces for Post-flood Epidemic appeared first on Direct Relief.

Aid organizations large and small, as well as many individuals in their own vehicles, have converged on the disaster area with emergency supplies from Ukrainian government-controlled parts of the country. People used rubber boats to rescue residents trapped in their homes on the riverbanks and in villages across the region, as well as many pets paddling in search of dry land.

An estimated 2,000 people have so far been evacuated since the collapse of the Kakhovka dam on Tuesday. Ukrainian and Russian authorities accuse each other of triggering the collapse, which affected land controlled by both sides, and according to Ukraine, affected an area of around 230 sq miles (600 km sq).

“We worked and built everything we had, and then it was gone in a moment.”

“People are giving their everything to save every person, every animal,” said Maxim, who drove a van with donated clothing, bedding, food and water and medicine three hours from Odesa. “There’s so much humanity on one side [of the river] and inhumanity on the other.”

As often happens in times of crisis, people who stepped up this week with one plan of action found themselves working in a totally unrelated capacity. The founder of NGO SaveUAmedia, Sergei Panashchuk, came to Kherson to report the story of the unfolding disaster – and became part of it himself. He received an unexpected donation of funds to buy cages to evacuate rescued dogs, and when he tweeted about it, it produced more donations from abroad to save more pets.

“I fed stray cats before the war,” he said. “But I never expected to deliver cages for dogs while being shelled, literally risking my life.”

The situation became more acute due to shelling of the city hours after a visit by Ukrainian President Volodymyr Zelensky on Thursday. Authorities in Kyiv said nine people were injured in the attack.

“People were running scared to the nearest bomb shelter,” said Panashchuk, who was in the city center when the shelling began. “All people in the bomb shelter were breathing heavily and prayed.”

The attack did not deter aid workers and volunteers from carrying on later. Sporadic shelling outside the city continued also on Friday, as did the aid effort.

Direct Relief staff accompanying vans full of supplies observed palls of smoke over the area as detonations ignited grassland and crops. The convoy to the village of Antonivka, five miles upstream from Kherson – the second delivery since Thursday – had to take cover in a dip in the road until the shooting abated.

Using the only serviceable road into the village from the west, British NGO MAD Foundation, working in close cooperation with Direct Relief’s partner in Odesa, Hospitable Hut, delivered a total of nine van loads of assorted supplies, including medicines.

“This is the first aid we received since the flood,” said Svitlana, the medical nurse running the small local clinic which now also serves as a sorting point for any supplies that can be sourced.

Like many parts of the Kherson region, there has been no electricity, gas or constant water supply here since the Russians withdrew last November. But with the river water and local wells now tainted beyond purification by oil and other spillages, the community is now dependent on bottled water. “I am now afraid that an epidemic will start,” said the nurse.

Barely forty paces away, the floodwaters lap at submerged houses and the community’s Finnish-built, modern – and now waterlogged – school, once the pride of the community: “When the Russians came, they simply couldn’t believe that our little village had such a modern, well-equipped school,” said resident Nataliia.

The remaining 1,000 people of 5,000 who used to live in Antonivka are in a state of shock at the events of recent days, especially after the months of occupation and then regular shelling that preceded them. Although the water level receded slightly since Tuesday, the emotional pain of this latest cataclysm is plain to see.

“We worked and built everything we had, and then it was gone in a moment,” said Ivan, 74, who nevertheless refuses to leave and join his daughter in Poland. “I was born here, christened here, and I shall remain here.”

Nataliia also echoed the spirit of defiance in Antonivka: “We will get through this, just to spite them,” she said, motioning to the Russian held-eastern bank of the river. “We’ll be like a bone stuck in their throat.”

“Miracles happen when you work with the right people.”

But as well as supplies, people in the entire region are in desperate need of moral and psychological support. A team of emergency psychologists working with Direct Relief’s partner organization Hromada Hub immediately headed for the affected area when the news broke of the dam collapse.

“Overall, we assisted people affected by the flood from the first hours,” said Hromada Hub’s emergency psychology coordinator Melinda Endrefy. “Twenty-four visits were done in three days. A team of 14 psychologists worked with us during the disaster. Miracles happen when you work with the right people.”

Because of the long-term need for such assistance, Hromada Hub’s training program aims for sustainability: “I usually empower [local] leaders as emergency psychology coordinators and make sure they can continue their work despite traumatic events,” said Endrefy.

The post Human Kindness Outweighs the Bad in Flooded Kherson  appeared first on Direct Relief.

Waters reportedly rose as much as 10 feet above normal levels in parts of the Kherson region, prompting a massive exodus of people.

“We are sending the basic goods [for survivors],” said Natalya, chief coordinator at the Odesa-based NGO Hospitable Hut, which since last summer, has supplied thousands of internally displaced persons (IDPs) and vulnerable people with essential medical and hygiene items.

“But we don’t just hand out things, we assess the situation, which people need what exactly. There will also be a much greater need [for assistance] in Odesa as IDPs start to arrive from [flood-] affected areas. They will need everything – food, bedding, clothing, cooking utensils.”

The organization estimates that some 4,000-5,000 people fleeing from the highwaters will soon arrive in the Odesa region, 200km west of Kherson.

A call for material donations announced on June 6 drew a massive response, said social media manager Oksana: “Two hours after we opened the next day, we could barely move for donations.”

Hospitable Hut will deliver the donations with the support of other Ukrainian and international NGOs.

As the Russians and Ukrainians trade accusations about who was behind the explosion of the dam, which supplied water across the southern region, including Russian-held Crimea, the scale of the devastation is becoming apparent.

Entire villages in the Kherson region are reportedly submerged, with volunteers struggling to reach civilians trapped by flooding and across battle lines.

The region was seized in the initial Russian invasion of February 24, 2022. However, large areas were liberated in the Ukrainian counter-offensive last November. On the western bank of the Dnieper River, Kherson remains under daily shelling by Moscow’s military.

On Wednesday, authorities and humanitarian organizations were moving to evacuate thousands of people from flood-affected areas and supply the remaining population in Kherson with essentials. The neighboring region of Mykolaiv, retaken by Ukrainian government forces, was also suffering from the effects of the flooding.

Editor’s note: Since the war began, Direct Relief has deployed more than 1,400 tons, 271 million defined daily doses and $930 million in material aid assistance to Ukraine.

The post Humanitarian Groups in Ukraine Respond to Flooding from Dam Explosion appeared first on Direct Relief.

A British NGO completes an aid drop anyway on the mighty Ukrainian river’s now liberated western bank. Nor do the Britons and their local staff, who drove vans from the port city of Odesa loaded with medicines, clothing and a generator, seem overly troubled by the danger.

“Operating in high-risk environments is something that we have signed up to accept as part of our work,” said Toby Illingworth, head of operations for the MAD Foundation (“Make a Difference”), which delivers donated supplies across the country and evacuates civilians. “But I am always concerned about the safety of the team.”

Today, they have a consignment of Direct Relief medicines and other donated supplies for the city’s Karabelesh clinical hospital. Medical director Anna Goseneva gladly receives the boxes for its gastrointestinal, proctological, stroke and burns units, which are saddled with shortages since the Russians abandoned Kherson in November and began shelling it daily.

“Supplies of medicines are being restored, contracts are being signed, but people are still afraid to deliver here,” said the doctor, who, with a now 60%-depleted staff, kept the hospital and its sub-clinics running throughout the nine-month occupation.

From Tourist Magnet to Humanitarian Hub

At this stage in the war, a crucial role in restoring normal life in Kherson and across the South falls to Odesa, located a 2.5-hour drive to the west. Founded in 1794 by Russian Empress Catherine the Great and known affectionately as “Odesa Mama,” this architectural gem on the Black Sea was not seized in the initial Russian offensive last year.

The fate of Ukraine’s fourth-largest city hung in the balance for several weeks as a naval landing seemed imminent. Russian “Ropukha” (toad) ships loaded with marines cruised offshore, deterred by rough seas and the failure of land forces to break through from Mykolaiv to the north-east – and the possibility that the Ukrainians had received Western anti-ship missiles.

The city largely emptied, and its streets were barricaded and controlled by military units, with occasional enemy missile strikes and shoot-outs with local collaborators passing information to the Russians.

“We were afraid that they would land; there were so many of them, like locusts,” said resident Denis, who used to go to the beach with his son and fill sandbags for the army to keep busy. He and others spoken to said they could finally exhale when the Russians were pushed back from Mykolaiv in mid-March and when the Ukrainians sank the Russian missile cruiser Moskva on April 14. These victories gave real hope that Russia’s vast military machines could be defeated.

Today, with the worst threat hopefully behind it, the former tourist magnet is a thriving humanitarian aid center for the entire southern region.

“Odesa’s geographic location near the EU borders lets it be a logistic hub for humanitarian work. Huge amounts of cargo are coming into Odesa first and are then distributed further to other cities,” said Oleksandr Cherepanov, a coordinator of the city’s Hospitable Hut Volunteer Center, which opened in March last year and is run by Direct Relief’s local partner Ukrainian Soul. “It also has financial capabilities, good defense, facilities, equipment, people.”

Effectively shielded against aerial attacks by its formidable air defenses, Odesa’s proximity to frontline areas created a huge IDP population – around 100,000 people, estimates Mykola Viknianskyi, a local businessman who established Ukrainian Soul last summer to help coordinate humanitarian efforts.

Employing their existing resources and skill set – needs assessment, procurement, logistics, accounting – he and a group of fellow entrepreneurs got so proficient in humanitarian operations that Viknianskyi was asked to become an adviser to Mayor Gennady Trukhanov. “Before the war, I was a businessman, but now I don’t know who we are and what we do – but we do our best to support the city,” he laughs.

Some of the results are visible directly across the street from the offices of his window fittings company. A banner over the entrance of a temporarily closed school declares, “You are not refugees; you are Odesa’s guests.” Hundreds of IDPs come here daily to receive donations of food, clothing, hygiene items, school supplies and children’s toys.

In the yard behind the building, medical and hygiene supplies are loaded into vans to be sent by the Nova Poshta postal service to other cities and regions or directly to hospitals and NGOs in Mykolaiv and Kherson with volunteer couriers.

“NGOs like ours can attract donors,” says Cherepanov. “But in 99% of cases, donations don’t imply direct financial contributions to NGOs.” Which means they must raise funds for logistics themselves. “It’s hard to find volunteers who would run transport for free because the war has been going on for almost 1.5 years and people got tired and financially drained. That’s why independent NGOs like MAD are so important and useful.”

Many other local and foreign NGOs, as well as UN agencies, the Red Cross and other international organizations also run supply operations from the city, either independently or pooling resources.

Food for Body, Food for Soul

But help doesn’t always arrive in boxes or on pallets. Another acute requirement near the frontline and in cities with many IDPs is psychological care. Odesa NGO Plechi o Plechi (“Shoulder to shoulder”) recently teamed up with Direct Relief’s partner Hromada Hub to bring emergency psychological support where the need is greatest.

Following five days of training by Hromada Hub’s emergency psychologist Melinda Endrefi, a group of local psychologists accompanied aid distributions, first in Odesa and then to Kherson. Here, 14 participants held individual sessions with almost 70 mothers and children, many of them struggling with the after-effects of Russian shelling.

“They shoot with artillery, tanks and mortars,” said Alla, a co-organizer of the event from Odesa. “There is no warning – people live in expectation of this, with the resultant psychological trauma. It’s important to address this as soon as possible, especially in the children.”

The interactions had a visible unlocking effect on many of the local visitors as they shared their experiences of recent months, but they also brought a change in perspective among the team members.

“This was a new approach – you have to immediately assess the need,” said Lyudmila, a psychotherapist from Odesa with eight years of work experience. “I used to do long-term work with clients, over 2-3 years, but now there is a tendency toward short-term work because of the demand.”

One of her conversations was with a mother who had managed to conceal that war was happening from her six-year-old daughter, explaining explosions as construction and other noise. Denial is a serious issue for many, says Lyudmila, who encouraged the mother to finally explain the reality to her child in an age-appropriate way.

The event lasted about 2.5 hours before it was cut short amid reports of renewed shelling. The team boarded the mini-buses and departed back to Odesa, satisfied with the positive effect on the visitors: “You can see the life shining in their eyes again,” said Alla.

“We made some history today,” said Hromada Hub’s trainer Endrefi. “This is the first time [in Ukraine] anyone came with such a group to such a destroyed place.”

The NGOs involved are already making plans to return to reach more families, including many elderly people who were left alone in Kherson after 80-90% of its pre-war population of 250,000 left the city.

Normal Life, For Some

The drive back to Odesa passes through ruined villages before the city looms down the highway. The contrast between Kherson’s oppressive feel and the animated seaside buzz here is palpable – and a source of irritation to some.

“Those people partying here don’t realize what’s happening less than 200 kilometers away,” said one of the local volunteers. “I’d like to take them by the scruff of the neck and drop them in Kherson for half an hour so they understand.”

But while frivolous luxury to some, Odesa’s reopened restaurants, clubs and beaches are also things that help to anchor normal life, avert a long-term exodus of the population, and encourage the city’s further development as a lifeline to communities further afield.

MAD Foundation is already moving to expand: “The plan is to develop a southern operation based out of Odesa over the next couple of months,” said Illingworth. “This will enable us to be closer to the locations we support, improving efficiency and substantially scaling up the amount of support we can provide.”

Direct Relief has shipped more than $900 million worth of medical aid to groups in Ukraine, including Hospitable Hut and Hromada Hub, since the conflict began on Feb. 24, 2022.

The post Humanitarian Hub in Odesa Throws a Lifeline to Struggling Neighbors in Ukraine appeared first on Direct Relief.

Pavlo, now 23, was studying applied chemistry in Hangzhou when the onset of the Covid-19 pandemic required him to return to Eastern Ukraine and reevaluate his future. Then the attack on his homeland upended his plans once again.

As the Russian military columns approached his village and “hundreds of vehicles drove through the streets and in the fields,” Pavlo, his mother and brother – and millions more Ukrainians – suddenly found themselves in occupied territory.

During the four weeks that the family stayed in their home, they were thankfully left alone. Russian convoys would rumble straight through the village, which wound up in a “grey zone” between the opposing armies. It avoided the devastation that befell other settlements largely due to its location in a depression in the high ground. Instead, Pavlo’s family got used to the sound of artillery shells passing directly overhead as the sides slogged it out.

Eventually, they made it safely to Ukrainian-controlled territory, he recounts, unlike some residents of the area who hit mines while leaving. The family’s home was later looted by the Russian military and sustained some shelling damage to its roof and facade.

Declared unfit for military service because of a long-time knee injury, Pavlo had a decision to make: To endure the constant bombardments in Kharkiv city or head elsewhere, abroad even. “I had an opportunity to leave but I declined. This is a decisive point for my country,” he said. “I want to be useful.”

Since then, he has worked full-time for the Yevgen Pyvovarov Charity Fund, set up in 2020 to help people and communities affected by the pandemic. His job in this hive of humanitarian activity comprises a bit of everything: administration, drafting projects in English for foreign aid organizations like Direct Relief, storing and delivering medical products to hospitals and clinics, as well as food and other supplies to isolated villages, many of which lived through seven months of occupation before the Russians were pushed out last September.

“The elderly people probably get hit hardest – their world view is turned upside down,” Pavlo said. “Children also get affected, of course, but they adapt more easily, I’ve seen it many times.”

Looking back at the first weeks and months after the invasion, Pavlo recalled two tragic deaths of former neighbors in his village: On the first day of the occupation, an elderly woman was fatally shot by a Russian soldier when she peeked over a wall. Much later, and still very hard to accept, he learned of the death in an explosion of a close neighbor called Oleksiy. This gentle man in his late eighties had been a kind of mentor, sharing with Pavlo, among other things, the skills and joys of beekeeping.

It’s now a passion of the volunteer, who carries an air of seriousness well beyond his young age. But his face softens when talking about the complexities of tending his beehives and keeping their populations healthy – and productive. He now has so many jars of honey stocked up that he struggles to give them away, he said, finally laughing.

Pavlo is adamant that Ukraine will be victorious over the Russian Army and only grow stronger as a result, while Russia will only grow weaker. When he feels that he is not letting down his organization, he will think about returning to his studies, he says. But for now, there is too much work to do.

They say fishermen have a philosophical streak, perhaps because of their solitary communion with nature. Talking to Pavlo, you could argue that beekeeping has a similar effect. He’s also evidently a fan of Tolkien. With a nod to Gandalf in “The Fellowship of the Ring,” he neatly paraphrased the wizard’s words: “You don’t get to choose what time you live in, you only get to choose what to do with the time that’s given to you.”

For Pavlo and many thousands of young Ukrainians, whether volunteers, military personnel, or coming from other fields that grew in response to the invasion, this is clearly their time to shine.

Direct Relief has provided more than $896 million in medical aid to groups in Ukraine, including Yevgen Pyvovarov Charity Fund, since Feb. 24, 2022. Direct Relief has supported the group with 41 tons of medical aid since the conflict began.

The post After Fighting Erupts in Eastern Ukraine, a Young Volunteer Steps Up appeared first on Direct Relief.

“If the Russians detect a large concentration of people, they can target it, no matter who they are,” says a volunteer of the NGO distributing bags to a waiting crowd of mainly senior citizens.

Russia’s Orlan drones often buzz over the area looking for opportunities, explains the head of the Kharkiv district military administration, Volodymyr Usov, adding that the villages and nearby military positions get shelled every week or two. Fearful of Western-supplied missiles, Russian jets bank as close to the border as possible before releasing laser-guided bombs, he says.

The bright spring day thankfully passes without incident as the food drop is repeated in three villages. Stories abound here of hardship, theft, abductions and outrages at the hands of the forces that took control on the first day of Moscow’s full-scale invasion on February 24, 2022. In the ruined school in Liptsi, Usov says the boiler room was used to torture detainees and that Ukrainian intelligence operatives recovered electrocution devices after the Russians left.

A stocky local fireman who says he was held here for six months and, according to his colleagues, weighed 100lbs (45kg) when released, confirmed to visitors that he was “treated badly” by his captors. “But I can’t complain,” he says with a good-natured but forced grin.

“That is a typical reaction of people,” says Pavlo, a 23-year-old volunteer with the Kharkiv-based Yevgen Pyvovarov’s Charity Fund (YPCF), one of Direct Relief’s medicine supply partners in the east. “No matter what awful things happened to them, they know someone else who had it worse.”

According to the locals, when the Russians were driven from the area in the Ukrainian counter-offensive last September, they promptly shelled positions they formerly occupied – schools, administration buildings, and medical facilities. The brand new hospital in Liptsi was hit and gutted by fire, and villagers now travel 20 miles to Kharkiv, Ukraine’s second-largest city, for medical care.

The whack-a-mole of medicine supply

Now that the immediate threat to the city has receded, municipal and regional authorities are working feverishly to rebuild housing, infrastructure and care systems, including the health service. Shipments of medicines are now reaching Kharkiv and other cities from US organizations like Direct Relief and Americares, the Canada-Ukraine Foundation, UN agencies and the International Committee of the Red Cross (ICRC).

“If we have another winter like the last, things are going to get very tough.”

But after months of neglect of peoples’ existing health issues and a surge of fresh ones caused or exacerbated by the war – strokes, malnutrition and PTSD, to name a few – it is like a constant game of whack-a-mole: Gaps in the supply chain get closed and new gaps open up as needs change.

A day after the food delivery to the villages, the Kharkiv Regional Clinical Hospital director, Kostyantyn Loboiko, peruses boxes of medications that YPCF delivered on behalf of Direct Relief.

“This is used for a very wide range of illness, from respiratory infections to sicknesses of the nervous system,” Loboiko says about the consignment of Prednol-L, a corticosteroid with an anti-inflammatory effect several times greater than hydrocortisone. It’s something they are not even free to buy locally due to regulations, he says, but these supplies should last the hospital a few months.

He also welcomed the large boxes of Norepinephrine Bitrate, used to treat life-threatening low blood pressure (hypotension): “This works against any kind of shock, be it traumatic or anaphylactic – practically every type of shock reaction can be treated with this, it’s really useful.”

However, the need persists in Ukraine’s towns and cities for hundreds of medicines, as well as basics like catheters, drips, syringes, masks, crutches, and orthopedic braces – the list is seemingly endless.

“We sent a special request for children’s vitamins,” said Dr. Christian Carrer, regional director of France’s Association Internationale de Coopération Médicale (AICM), Direct Relief’s core partner in the eastern Poltava region. “There are many children who spent many months in shelters and when they come out they need a lot of vitamins.”

Shouldering the weight together

In April, medical products from Direct Relief were supplied to hospitals and clinics across Ukraine, including a major delivery to replenish the near-empty shelves at the children’s hospital in the River Dnieper city of Kremenchuk. It currently treats some 250 children, many suffering from war injuries, but it has received no assistance, including from the state, since early February.

“We try to purchase medicines every month, but not all volumes, so the responsibility falls on the parents to buy them when their children are with us,” says deputy director Iryna Roman. “This assistance [received today] is multi-faceted and provided care items, consumables, and medical instruments, so it should sustain us for the next six months.”

Approximately a ton of medical products were brought to the vast regional psychiatric hospital outside Poltava city, which has around 800 patients, many of them transferred from hospitals in front-line areas. Again, the support eases the pressure on the hospital, says head doctor Viktor Voloshyn, who, in addition to medical care, must ensure other essentials are in place. The hospital’s bakery, for example, uses ten tons of flour a month, so AICM added two tons of flour to its delivery, along with hundreds of cans of food.

In all locations visited in April, directors faced the same challenge of insufficient funding and supply by the state as the country battles for its survival. Six months into his new job as head of Kharkiv’s Regional Clinical Psychiatric Hospital No. 3, Dr. Gennady Bondarchuk was still clutching for solutions. Even now, when the hospital has only 25 of the 80 doctors it should have, its budget barely covers staff wages.

When the hospital asks the authorities how it is supposed to keep going, the answer is blunt: “Go and raise funds!” That effort is hampered by negative perceptions of psychiatric care that still exist here and in many other countries. “Multi-profile hospitals are more successful at fundraising. Donors don’t much like hospitals like ours,” Bondarchuk says matter-of-factly. So donated medical products are a huge help as they continuously battle to fund food supplies and other essentials.

“If you experience something extreme, you either break because of it or you adapt and grow stronger, learn and make good use of it.”

Other hospitals visited, like Kharkiv’s Municipal Polyclinic No. 11, have the additional task of repairing war damage. Located in the city’s heavily affected northern Saltovka region, 80% of its windows were blown out by Russian shelling. According to the Kharkiv city council, 77 hospitals and clinics in the region have been damaged so far in the conflict.

The priority during the summer months is to optimize energy, water and other systems so that healthcare institutions are autonomous if the situation takes a turn for the worse, says Olga Demianenko, head of the city’s department for cooperation with international organizations: “If we have another winter like the last, things are going to get very tough.”

Healing for the long term

At the same time, there is a new understanding in today’s extreme conditions that health care must be broader and better geared to the future. Supplies of medicine and equipment are indispensable, but they are two pieces of the puzzle. Compared with the priority of fighting and surviving in the early war months, there is a clear sense now of the long-term need for physical and psychological recovery.

Local authorities and Ukrainian NGOs are developing their own rehabilitation programs. The Kharkiv Renovation Fund, an organization with 15 staff members set up by a local businessman at the start of the war, is creating a small rehabilitation clinic in the city center. This will be made as bright, welcoming and functional as possible for military personnel and civilians alike: “Every soldier who comes back is a citizen, not just a soldier,” says founder and director Oleksandr Bondar.

Other Ukrainian NGOs are following suit on different scales and with different concepts. Direct Relief’s partner in the city of Dnipro, TAPS (Tragedy Assistance Program For Survivors), is going all out with three distinct programs: The creation of a $1.3mn integrated rehabilitation department for soldiers and civilians at the city’s Hospital No. 16; the construction of a large recreational and rehabilitation center for military personnel and their families in the countryside outside Dnipro; and week-long ‘camps’ in the Carpathian Mountains for war-widows and bereaved children in rest facilities staffed with psycho-social care experts.

Despite the ordeals of recent months, it all makes for a stronger, more unified society as Ukrainians learn to pull in the same direction, says the volunteer Pavlo: “If you experience something extreme, you either break because of it or you adapt and grow stronger, learn and make good use of it.”

Editor’s note: Since the war began in 2022, Direct Relief has deployed more than 1,350 tons of medical aid, 254.1 million defined daily doses, $32.2 million in financial assistance, and $899 million in material aid assistance to Ukraine.

The post Anguish, Aid and a Return from the Brink in Eastern Ukraine appeared first on Direct Relief.