War in Ukraine: situation report from WHO Ukraine country office. Issue No. 50, 19 April 2023

Issue No. 50 19 April 2023 17H00 CET WAR IN UKRAINE Situation report from the WHO Ukraine country office BY THE NUMBERS (since 24 February 2022): AFFECTED 17.6 M LEFT UKRAINE 20 421 761 (UNHCR) INJURED 14 370 (OHCHR) CONFLICT-RELATED DEATHS 8534 (OHCHR) WHO KEY FIGURESHIGHLIGHTS 2353 SUPPLIES PROCURED USD 240 MILLION FUNDING REQUESTED 192 HEALTH CLUSTER PARTNERS 11.1 MILLION TARGET POPULATION 912 VERIFIED ATTACKS ON HEALTH 1 111 NUMBER OF PERSONNEL DEPLOYED & REPURPOSED IN UKRAINE WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 2058 PATIENTS RECEIVED TRANSFER & MEDEVAC SUPPORT Source: ERCC NUMBER OF AMBULANCES DELIVERED Since 1 March 2022 79 NUMBER OF GENERATORS DELIVERED Since 1 March 2022 163 (WHO) (WHO) (WHO) (WHO) (WHO) ▪ On 5 April, the WHO CO held a seminar in Cherkasy to improve the operation of the emergency medical care and disaster medicine system in Ukraine. The seminar was opened and attended by representatives of WHO, the Ministry of Health (MoH) of Ukraine and directors from the regional centre for emergency care and disaster medicine. Key findings were presented, including the fact that 12 500 people with limited access due to their location in the recently retaken areas have received medical care; and that up to 3000 people have undergone treatment abroad with support from the State Emergency Service of Ukraine and international partners. ▪ Supported by the European Union (Directorate-General for Neighbourhood and Enlargement Negotiations and Directorate- General for European Civil Protection and Humanitarian Aid Operations), the Canadian Ministry of Foreign Affairs, Trade and Development, the Swiss Federal Department of Foreign Affairs ; the United States Agency for International Development – Bureau for Humanitarian Assistance, the German Embassy in Ukraine, and the Ukraine Humanitarian Fund, the WHO Country Office (CO) in Ukraine took part in a UN interagency humanitarian convoy to deliver medical supplies and medicines to two hospitals in Toretsk, a primary care centre in Kurakhove in the Donetsk region, Velykyi Burluk in the Kharkiv region, and four medical facilities in Zaporizhzhya. The supplies included interagency health kits, kits for the treatment of injuries and emergency surgeries, kits for the treatment of non-infectious diseases, paediatric kits and pneumonia treatment kits. ©WHO SITUATION UPDATE 2 WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 Leadership and coordination WAR IN UKRAINE Situation report from the WHO Ukraine country office ▪ As of 18 April, the State Emergency Service of Ukraine reported 1564 households and 330 houses remain flooded with transport connections to 30 settlements are disrupted. The seasonal water level rise occurs in the territories of Volyn, Dnipropetorvsk, Zhytomyr, Kyiv, Kirovograd, Rivna, Poltava, Cherkasy, and Chernihiv regions. ▪ UN provided shelter materials and other vital items to 1500 people in a community along the Dripro River in Kherson. “This is the first time we managed to go to this area, only a couple of hundreds meters from the front line, where the level of destruction is appalling,” Denise Brown, Humanitarian Coordinator for Ukraine. ▪ According to a sociological research result, during the year of the full-scale war, 9 out of 10 Ukrainians experienced at least on of the symptoms of psycho traumatization. According to forecasts, 40-50% of the population of Ukraine will need psychological support. To meet his need, state authorities are coordinating efforts and working out specific solutions to provide Ukrainians with high- quality and affordable state services for psychosocial support. “A full-scale war brings not only direct losses, but also indirect ones […]. the topic of mental health is becoming increasingly relevant not only in Ukraine, but also in other countries. Attention to this direction is a worldwide trend that requires a comprehensive approach and timely response,” Minister of Health Viktor Lyashko. ▪ The development of primary medical care, strategic procurement and medium-term contracts and management of the Medical Guarantee Program are priority areas of work for 2023-2024. Specialist of the National Health Service of Ukraine (NHSU) and WHO identified the following points: formation of a methodology for assessing needs in the field of healthcare; launch of the project on forming the profile of the healthcare institution; refinement of indicators of universal primary medical care coverage; planning the modernization of the Medical Guarantee Program. "Stability and development are extremely important for both patients and doctors. Especially now, during the war. Every Ukrainian man and woman should have access to a quality medical service, and doctors should provide this service and receive a financial reward for it. In fact, this is the priority of the National Health Service and the mission of the WHO […],” the Head of NHSU, Natalya Husak. Issue No. 50 19 April 2023 17H00 CET ▪ The WHO Representative (WR) continued high-level engagement with the Ministry of Health (MoH), authorities, donors and partners in Kyiv. ▪ WR hosted visits of key people from WHO headquarter and regional office visiting Ukraine related to business operations, security, governance, and resource mobilization. ▪ The Incident Manager (IM), along with UN partners in Dnipropetrovsk, supported the Humanitarian Operations Planning Cell in planning the delivery of humanitarian interagency aid coordinated by OCHA. ▪ The IM coordinated the health service delivery through inter-agency humanitarian aid delivery in Zaporizhzhia (12 April), Velykyi Buluk and Kurachove, Donestk region (7 April) ▪ The IM coordinated four hospital visit and deliver donation in Zhaporizhzia city (10 April), deliverance of 20 donations to 20 hospitals in Dnipro city (6 April) 3WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 ATTACKS ON HEALTH Verified reports of attacks (1 January 2022 to date) For further information, click here. HEALTH INFORMATION Conflict-related health information ▪ From 24 February to date, the Office of the UN High Commissioner for Human Rights (OHCHR) recorded: 8 534 civilians killed; 14 370 civilians injured. From 1 to 17 April 2023, 85 killed (41 men, 21 women, 2 boys, 1 girl, as well as 20 adults whose sex is not yet known); 239 injured (80 men, 54 women, 3 boys, 2 girl, as well as 100 adults whose sex is not yet known). ▪ According to the United Nations High Commissioner for Refugees, as of 11 April over 20.4 million border crossings from Ukraine to neighbouring countries were registered, of whom just over 10.7 million and over 2.2 million crossed the border to Poland and Hungary, respectively. WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 50 19 April 2023 17H00 CET WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 4 Operational Support and Logistics - OSL ▪ As of 16th April, WHO received in its warehouses in the city of Kyiv, in the Kyiv oblast and in Lviv medical supplies with a value of over US$ 74.46 million and a total weight of over 3184 metric tonnes. They included Trauma and Emergency Surgery Kits (TESK) 2019, WHO trauma bags, Interagency Emergency Health Kits (IEHKs) and other items. ▪ Between 10-16 April 2023 medical supplies and equipment with a total value exceeding US$ 2234 thousands and a total weight of more than 31 metric tonnes were delivered to 19 oblasts across Ukraine. They included IEHKs, trauma/surgery supplies (TESK 2019, surgical instruments etc.), refrigerators, medication and office supplies. UKRAINE COUNTRY OFFICE ACTIONS TESK IEHK PED-SAM WHO CTT NCD WHO Trauma 1st aid kit WHO Emergency Trauma backpack complete 9699 4366 678 163 1381 8194 1110 The number of WHO modules delivered to Ukraine from 1 March 2022 to date Open in Power BI Ukraine Dashboard Data as of 02/03/23 14:22 WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 50 19 April 2023 17H00 CET WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 5 Health service delivery UKRAINE COUNTRY OFFICE ACTIONS WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 50 19 April 2023 17H00 CET On 13th April, WHO took part in the interagency humanitarian aid delivery to Dnipro. The donated items were mainly laboratory equipment to Mechahniko Hospital. Prior to that, donations and aid were delivered to Stephnohirsk at Zaporizhzhia region on 12th April, and four hospital at Zaporizhzhia city on 10th April. ©WHO WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 6 UKRAINE COUNTRY OFFICE ACTIONS Health Cluster / Partner updates WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 50 19 April 2023 17H00 CET ▪ The Health Cluster held its National Coordination Meeting on 13 April. The highlights of the meeting are presented below. ▪ Natalia Husak, Head of the National Health Service of Ukraine (NHSU), gave a presentation outlining the key trends implemented at primary health-care level by the NHSU, in collaboration with its national and international partners, and further elaborated the NHSU’s primary health-care plans for 2023– 2024 resulting from consultations, deliberations and agreements reached with NHSU’s partners. Many of the plans had been discussed at the primary health-care conference held by the MoH of Ukraine, the NHSU and WHO on 28–29 March 2023. ▪ The Health Cluster presented a preview of the upcoming ActivityInfo dashboard, developed to display Partners’ activities in line with the Humanitarian Response Plan 2023 objectives set to reach 7.8 million people in need of humanitarian health assistance in 2023. ▪ Since its launch on 15 April 2022, the Health Requests, Planning and Response tool has been revised and upgraded to improve the quality and processing of the information collected and to facilitate a higher coverage rate of requests. Overall, since its launch in April 2022, 736 supply requests have been processed overall, with the most recent requests logged for the Zakarpattya, Kharkiv and Zaporizhzhya oblasts in the past two months. WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 7 Communications UKRAINE COUNTRY OFFICE ACTIONS WAR IN UKRAINE Situation report from the WHO Ukraine country office Social media ▪ The Health Cluster held its National Coordination Meeting on 13 April. The highlights of the meeting are presented below. ▪ Natalia Husak, Head of the National Health Service of Ukraine (NHSU), gave a presentation outlining the key trends implemented at primary health-care level by the NHSU, in collaboration with its national and international partners, and further elaborated the NHSU’s primary health-care plans for 2023–2024 resulting from consultations, deliberations and agreements reached with NHSU’s partners. Many of the plans had been discussed at the primary health-care conference held by the MoH of Ukraine, the NHSU and WHO on 28–29 March 2023. ▪ The Health Cluster presented a preview of the upcoming ActivityInfo dashboard, developed to display Partners’ activities in line with the Humanitarian Response Plan 2023 objectives set to reach 7.8 million people in need of humanitarian health assistance in 2023. ▪ Since its launch on 15 April 2022, the Health Requests, Planning and Response tool has been revised and upgraded to improve the quality and processing of the information collected and to facilitate a higher coverage rate of requests. Overall, since its launch in April 2022, 736 supply requests have been processed overall, with the most recent requests logged for the Zakarpattya, Kharkiv and Zaporizhzhya oblasts in the past two months. Media: The following news stories were published on the WHO/Europe website: ▪ Strengthening infectious disease control in Ukraine ▪ Overcoming barriers to accessing rehabilitation in Ukraine amidst conflict ▪ Public health and immunization efforts in Ukraine bolstered by WHO amid the war ▪ WHO-supported emergency medical teams help thousands in Ukraine’s regained regions Issue No. 50 19 April 2023 17H00 CET The following two interviews were published in the media: ▪ op-ed by Jarno Habicht, WHO Representative in Ukraine, on the United Nations in Ukraine website. ENG, UKR. ▪ interview with Jarno Habicht for Japan’s NHK media about health care in Ukraine Production: The following videos were adapted into Ukrainian and published on social media: 1. The main video to celebrate WHO’s 75th anniversary: Facebook UKR, Twitter ENG, Instagram UKR. 2. Video from Dr Tedros Adhanom Ghebreyesus for WHO’s 75th anniversary: Facebook UKR: Twitter ENG, Instagram UKR. 3. Video from Dr Hans Henri P. Kluge for WHO’s 75th anniversary: Facebook UKR, Twitter ENG, Instagram UKR. COVID-19 and other communicable diseases ▪ As of 13 April, the average daily number of new COVID-19 cases was 2371, a decrease from 2440 per day in the previous week. The seven-day average daily polymerase chain reaction (PCR) tests performed decreased to 3858 from 4244 in the previous week. A similar trend is observed with rapid diagnostic tests performed in laboratories and at primary health-care and hospital level. A comprehensive weekly COVID-19 dashboard can be found here. Surveillance from open-source intelligence ▪ A child of 8 months died of meningococcal meningitis in the Zaporizhzhia oblast. ▪ During the reporting period, a rubella case was reported in the Poltava oblast. ▪ As of week 14 of 2023, Poltava region has reported 31 AII cases, 20 chickenpox cases, 1 case of Lyme disease, salmonellosis case and rubella case ▪ According to communique by Lviv OCDC, an outbreak of Acute Intestinal Infection, AII, was reported in the city of Drohobych in Lviv oblast. A total of 10 children were affected, 7 children had positive samples for Proteus vulgaris 108, Proteus vulgaris 107, Proteus vulgaris 108, St. aureus WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 8 Surveillance 7-day average testing data as per 13 April Test Positivity rate (PCR) in private and state labs Trend in new cases WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 50 19 April 2023 17H00 CET WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 9 UKRAINE COUNTRY OFFICE ACTIONS National laboratories WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 50 19 April 2023 17H00 CET ▪ WHO supported the launch of the Illumina MiSeq next-generation sequencing platform at the Ukrainian Public Health Centre (UPHC), to be used for sequencing various respiratory pathogens. A workshop on testing the equipment, maintaining the platform, and data interpretation was organized and conducted at the UPHC together with an Illumina engineer. ▪ WHO provides support to laboratories located close to the war zone. The Mykolayiv water supply system was severely damaged due to bombing, which led to a in dramatic decrease in water quality with a very high concentration of salts and organics. WHO supports the enhancement of the water treatment system to enable proper functioning of the autoclaves and preventing potential leakage of the pathogens. ▪ WHO supported sequencing and analysis of 80 SARS-CoV-2 samples collected in March. The following variants were identified: BA.2, BA.2.10.1, BA.2.3, BA.2.3.21, BA.2.75, BA.5.1.12, BF.7, BN.1, BN.1.2.1, BN.1.3.1, BN.4, BQ.1.11, BQ.1.8, CH.1.1, CH.1.1.1, XBB, XBB.1, XBB.1.4, XBB.1.5, XBB.1.9, XBB.1.9.1, and XBB.2. Sixty-six SARS-CoV-2 genome sequences were uploaded to the GISAID database. ▪ WHO supported sequencing and analysis of 160 SARS-CoV-2 samples collected in March were performed. The following variants were identified: BA.2.3.20, BA.5.2.58, BA.5.2.6, BE.1.1, BF.7, BN.1, BN.1.3.1, BN.1.9, BN.3, BQ.1.1.37, BQ.1.1.45, BQ.1.10, BR.2.1, CH.1.1, XBB, XBB.1, XBB.1.1, XBB.1.4, XBB.1.5, XBB.1.5.12, XBB.1.5.15, XBB.1.5.33, XBB.1.9, XBB.1.9.1, XBB.1.9.2, XBF.7. 155 genome sequences of SARS-CoV-2 samples were uploaded to GISAID database. ▪ WHO supports the installation of and initial training on the VITEK 2 Compact 30 high- throughput microbiology analyser at the Zhytomyr Oblast Clinical Hospital named after Gerbachevsky. The analyser will significantly improve the quality of the results of microbiological research in determining the presence of infectious diseases or complications, and thereby prescribing the correct treatment to patients. ▪ WHO supported conducting two on-the-job training on library preparation and template preparation techniques for SARS-CoV-2 sequencing for new employee of the Laboratory of Molecular Tests of the UPHC. These trainings serve to improve the professional competence of laboratory personnel involved in performing next generation sequencing testing. e-Learning Platform OpenWHO.org: Free online courses in Ukrainian supporting health emergency response Total number of Ukrainian language courses 27 Total number of enrolments in Ukrainian courses 6820 Total number of certificates issued in Ukrainian courses 2630 Total number of digital badges issued in Ukrainian courses 566 WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 10 UKRAINE COUNTRY OFFICE ACTIONS ▪ WHO Representative Jarno Habicht, habichtj@who.int ▪ WCO Incident Manager Emanuele Bruni, brunie@who.int ▪ WCO WHE Lead Guillaume Simonian, simoniang@who.int WHO Ukraine Contacts Key links and useful resources ▪ Online courses and knowledge transfer platform For updated interactive, web-based, online courses, click here. ▪ Emergency medical teams (EMTs) For updated EMT network activities, click here. ▪ WHO publications and technical guidance For updated WHO publications and technical guidance on technological hazards and health risks in Ukraine, click here. WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 50 19 April 2023 17H00 CET Document number: WHO/EURO:2023-5319-45083-69056 © World Health Organization 2023. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license.