War in Ukraine: situation report from WHO Ukraine country office. Issue No. 53, 31 May 2023

Issue No. 53 31 May 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 21 924 285 (UNHCR) INJURED 19 324 (OHCHR) CONFLICT-RELATED DEATHS 4688 (OHCHR) WHO KEY FIGURESHIGHLIGHTS 2353 SUPPLIES PROCURED USD 240 MILLION FUNDING REQUESTED 196 HEALTH CLUSTER PARTNERS * 11.1 MILLION TARGET POPULATION 973 VERIFIED ATTACKS ON HEALTH 1 91 NUMBER OF PERSONNEL DEPLOYED & REPURPOSED IN UKRAINE WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 2158 PATIENTS RECEIVED TRANSFER & MEDEVAC SUPPORT Source: ERCC NUMBER OF AMBULANCES DELIVERED Since 1 March 2022 94 NUMBER OF GENERATORS DELIVERED Since 1 March 2022 166 (WHO) (WHO) (WHO) (WHO) (WHO) *details on Health cluster section ▪ A health-care facility in the city of Dnipropetrovsk was hit in a missile strike on 26 May. The WHO team in Dnipropetrovsk, along with local authorities and partners (Médecins Sans Frontières Belgium, Médecins Sans Frontières Switzerland, Direct Relief, Ukrainian Red Cross and International Committee of the Red Cross) assessed urgent needs and provided the necessary support within hours of the attack. According to the final update provided on 26 May, 31 people were injured in the attack, of whom two died and 16 were hospitalized. Eight health-care workers were among the wounded, as WHO strongly condemned any form of violence against health-care facilities or medical professionals. ▪ On 24 May the 76th World Health Assembly (WHA) discussed and approved the resolution on Ukraine. During the WHA the report on the implementation of resolution WHA 75.11, which focuses on WHO’s support for the humanitarian and emergency health response in Ukraine last year was discussed and published. ©WHO/ Sameh Kirollos SITUATION UPDATE 2 WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 53 31 May 2023 17H00 CET 1. More than 20 drones were destroyed in overnight air attacks launched by the Russian forces on Kyiv on Tuesday, 30 May. Serhiy Popko, head of Kyiv’s military administration, stated that this was the third attack on the city within 24 hours. 2. At least one person was killed and 15 were injured in the Russian forces’ missile strike on a clinic in the eastern Ukrainian city of Dnipropetrovsk on 26 May. 3. On 24 May two people were killed and 17 were injured as a result of shelling. ➢ In the Chernihiv region, there were four attacks in a day, with a total of 40 explosions recorded. ➢ In the Sumy region, the Khotin hromada was targeted in overnight shelling with mortar and grenade launchers. No casualties or destruction were reported. ➢ In Zaporizhzhya, 102 attacks were recorded, including three air strikes, seven unmanned aerial vehicle attacks and 92 artillery strikes. ➢ Attacks carried out in the Dnipropetrovsk region, Nikopol, Marhanets and Myriv communities resulted in no injuries but did damage a hotel and six houses as well as a gas pipeline, and completely destroyed four buildings. ➢ In the Kharkiv region, rescuers and firefighters worked around the clock in emergency response efforts in the Velykyi Burluk community and Plosky in the Kupiansk district. ➢ In the Luhansk region, the Russian forces attacked Stelmakhivka, Nevske and Bilohorivka with artillery and mortar. They also continue to use civilian medical facilities for their own purposes. The Central District Hospital in Bilovodsk is overcrowded with wounded Russian soldiers. ➢ In the Donetsk region, 24 attacks were carried out, with 10 settlements shelled. As a result, 11 people, including one child, were injured. The damaged infrastructure included 25 residential buildings, railway tracks, a cultural centre, and a school. ➢ In the Mykolayiv region, the town of Ochakiv was under shelling, which resulted in one person injured, along with damage to gas lines, power lines and internet infrastructure. ➢ In the Kherson region, 64 attacks were carried out, including 11 on the city of Kherson alone. One person was killed and two were injured in the attacks. 4. As a result of shelling in the Kherson region, a hospital, an agricultural enterprise and residential buildings were damaged. Health service delivery 26 May On 26 May WHO joined the humanitarian interagency convoy to the Siversk in the Donetsk region, where it delivered medical supplies for the treatment of noncommunicable diseases and primary medical equipment (blood glucose meter, tonometer, otoscope, etc.) to help 1300 community residents. Supplies include noncommunicable disease kits and interagency emergency health kits. Financial support was provided by the Federal Foreign Office of Germany, the Directorate-General for Neighbourhood and Enlargement Negotiations (DG NEAR) and the United States Agency for International Development (USAID). ©WHO 3WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 HEALTH INFORMATION Conflict-related health information ▪ From 24 February to date, the Office of the UN High Commissioner for Human Rights (OHCHR) recorded: 4 688 civilians killed; 19 324 civilians injured. From 1 to 21 May 2023, 133 killed (76 men, 38 women, 4 boys, 1 girl, as well as 14 adults whose sex is not yet known); 466 injured (182 men, 116 women, 15 boys, 7 girls, as well as 146 adults whose sex is not yet known). ▪ According to the United Nations High Commissioner for Refugees, as of 23 May over 21.7 million border crossings from Ukraine to neighbouring countries were registered, of whom just over 11.7 million and over 2.7 million crossed the border to Poland and Hungary, respectively. WAR IN UKRAINE Situation report from the WHO Ukraine country office ATTACKS ON HEALTH Verified reports of attacks (1 January 2022 to date) For further information, click here. Leadership and coordination Issue No. 53 31 May 2023 17H00 CET ▪ The WHO Representative (WR) continued high-level engagement with the MoH, authorities, donors and partners in Kyiv. ▪ The WR and the Incident Manager (IM) held meeting with auditor team that will be on mission in Ukraine until 2 June. ▪ The WR is attending 76th World Health Assembly and Executive Board at WHO headquarters. ▪ The IM, along with UN partners in Dnipropetrovsk, supported the Humanitarian Operations Planning Cell in planning the delivery of interagency humanitarian aid coordinated by OCHA. WHO) has verified the 1000th attack on the health system in Ukraine since the full-scale invasion of the Russian Federation in February 2022 - the largest number of attacks the WHO has ever registered in any humanitarian emergency. The data once again highlights the complex and dangerous conditions of the country's health system and challenges in the delivery of both routine and emergency medical services. The attacks hinder access to medical care for tens of thousands of people, increasing the risk of disease and death. These attacks threaten the safety and well-being of health workers and undermine assistance to people living near conflict zones, […] Attacks on medical facilities are a violation of international humanitarian law. They are depriving people of the help they need and have long-term consequences. Dr. Jarno Habicht WHO Representative in Ukraine WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 4 Operational Support and Logistics - OSL ▪ As of 28th May, 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$ 79.64 million and a total weight of over 3277 metric tonnes. They included Trauma and Emergency Surgery Kits (TESK) 2019, WHO trauma bags, Interagency Emergency Health Kits (IEHKs) and other items. ▪ Between 22-28 May 2023 medical supplies and equipment with a total value exceeding US$ 360 thousands and a total weight of more than 3 metric tonnes were delivered to 12 oblasts across Ukraine. They included IEHKs, trauma/surgery supplies (TESK 2019, surgical instruments etc.), personnel protective equipment, medication). UKRAINE COUNTRY OFFICE ACTIONS TESK IEHK PED-SAM WHO CTT NCD WHO Trauma 1st aid kit WHO Emergency Trauma backpack complete 10 129 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. 53 31 May 2023 17H00 CET WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 5 UKRAINE COUNTRY OFFICE ACTIONS Health Cluster / Partner updates WAR IN UKRAINE Situation report from the WHO Ukraine country office As of May 2023, there are 78 active members in the humanitarian health response (asso-ciates and observers not included, as at the time of the release, the partner list is being updated). As of 30 April 2023, 74 of the reporting Health Cluster partners have reached 2 799 130 people in 1439 settlements across 24 oblasts. 620 individual health facilities have been supported in 2023 by Health Cluster partners. For more information, please see the OCHA Ukraine Humanitarian Response Dashboard 2023. ▪ The UN Office for the Coordination of Humanitarian Affairs (OCHA) shared different scenarios for facilitating the development of preparedness measures in response to the needs of people affected by any potential escalation in the southern, eastern and northeastern part of the country. Subnational Health Cluster coordinators in Dnipropetrovsk and Odesa are looking at the response capacity, organizing and coordinating with Cluster Partners, and meeting with oblast health departments and regional centers for disaster medicine to finalize preparedness plans. ▪ On 17 May, the Health Cluster held a National Coordination Meeting during which: ➢ The Health Cluster presented and discussed the first quarter (Q1) analysis of the health humanitarian response progress in 2023 against the Humanitarian Response Plan 2023 targets. ➢ The Health Cluster provided an overview of the procedure for the development of preparedness measures for a potential escalation. The planning and organization of the contingency plan will continue at sub-national levels, in collaboration with health authorities and partners. ➢ OCHA presented the Humanitarian Operations Planning Cell (HOPC), the dedicated body for interagency coordination for areas where humanitarian needs are severe, including assessment, identification of priority areas for the rapid response and the operationalization of the first-line humanitarian response. The discussions were followed by an overview of delivering health items using inter-agency convoys by WHO. ➢ REACH presented the Multi-Sectoral Needs Assessment (MSNA), the MSNA research cycle and informed partners of the timeline for the MSNA round implemented in 2023. ▪ In response to a missile attack on a hospital in Dnipropetrovsk on 26 May, Health Cluster Partners provided on-site support to health authorities, psychological first aid for those affected, support in assessing urgent needs, and donations of medicines to support the health-care facilities to which patients were referred. As of 29 May, there have been 1004 attacks on health care in Ukraine since 24 February 2022. ▪ The Health Cluster released the Health Cluster Bulletin #2 March and April 2023, which includes an overview of the analysis of the health response progress monitoring (January – April 2023). For more information, please see here. ▪ Since its launch on 15 April 2022, the Health Requests, Planning and Response tool (HRPR) 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, in 2023, 388 supply requests have been processed, with the largest numbers logged for the Dnipropetrovksa, Cherkaska and Donetska oblasts over the past two months. Issue No. 53 31 May 2023 17H00 CET WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 6 Communications UKRAINE COUNTRY OFFICE ACTIONS WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 53 31 May 2023 17H00 CET Social media In the period from 22 May to 26 May, the WHO Country Office created 12 Twitter posts, 10 Facebook posts and 10 Instagram posts, which received a total of 24 860 impressions on Twitter and a Facebook page reach of 22 345 users, covering topics such as: mental health trainings for community mental health teams in Kyiv; the 76th World Health Assembly and documents and resolution on Ukraine; strengthening vaccination efforts in Ukraine by providing technical and material support to mobile medical teams, working in remote areas; training of trainers on the mhGAP programme; training on conducting supportive supervision for 25 staff of the newly established immunization units at regional centers for disease control and prevention from all regions of Ukraine; health attack on a hospital in Dnipropetrovsk; technical meeting on the concept of Capable Cancer Management Network; Poliovirus Outbreak Response Assessment in Ukraine; and vacancies. Media Two news items were published on the WHO/Europe website: ▪ New WHO initiative among efforts to protect the vulnerable from vaccine-preventable diseases in Ukraine; ▪ Roundtable dialogue on humanitarian support for persons with disabilities in Ukraine. Production One video was produced and published on social media: ▪ WHO continues to strengthen vaccination efforts in Ukraine by providing technical and material support to mobile medical teams working in remote areas to facilitate access to COVID-19 vaccines for the local population: Facebook UKR, Twitter ENG, Instagram UKR ©WHO COVID-19 and other communicable diseases WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 7 Surveillance WAR IN UKRAINE Situation report from the WHO Ukraine country office Issue No. 53 31 May 2023 17H00 CET Surveillance from open-source intelligence ▪ On May 8, a case of diphtheria was registered in the Kyiv city. (Per communique of Kyiv city CDC) ▪ During the reporting period, it was reported that six cases of Lyme disease have been reported in the Poltavska oblast. ▪ On May 9, quarantine restrictions have been imposed in the city of Boryslav in the Lvivska oblast extending to 5-kilometer radius due to the detection of rabies in a dog and a fox. (Per communique of Lviv OCDC). National level: cases, hospitalisations, ICU occupancy continue to decline, marking a sustained downward trend. Regional level: Cases are falling or plateauing at a low level in all oblasts. Variants: Omicron variant XBB is the dominant variant in Ukraine, with a clear growth advantage over both BA.2 and BA.5. Despite being more transmissible, WHO does not assess XBB to have additional public health risks compared to other Omicron variants. Last 7 days 16 May 22 May Trend Cases (7-day rolling average) 477 428 Hospitalisations (7-day rolling average) 254 244 ICU occupancy 1.7% 1.5% Deaths (7-day rolling average) 6 6 Last 21 days WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 8 UKRAINE COUNTRY OFFICE ACTIONS National laboratories WAR IN UKRAINE Situation report from the WHO Ukraine country office ▪ To strengthen the capacity of clinical laboratories and respond to needs in a timely manner, WHO conducts assessments of clinical diagnostic laboratories, regional and city infectious diseases hospitals, and other health-care facilities. Such assessments were carried out of 14 hospital clinical laboratories in the Chernivtsi oblast anti-tuberculosis dispensary, Communal non-profit enterprise Kelments multidisciplinary hospital, Communal non-commercial enterprise Hlyboke multidisciplinary hospital, Communal non-profit enterprise Novoselytsia Hospital of the Novoselytsia City Council, Communal non-profit enterprise Promin’ Health Centre, Communal non-profit enterprise Storozhynets Multidisciplinary Intensive Care Hospital, Regional communal non-profit enterprise Chernivtsi Oblast Children’s Clinical Hospital immunological laboratory, Municipal non-profit enterprise Chernivtsi Oblast Psychiatric Hospital, Municipal non-commercial enterprise Chernivtsi Oblast Clinical Hospital, Chernivtsi Oblast Perinatal Center, Regional non-profit enterprise Chernivtsi Oblast Hospital of War Veterans, and Municipal non-commercial enterprise Chernivtsi Oblast Clinical Cardiology Centre. ▪ WHO is committed to strengthening laboratory capacity in next-generation sequencing. On 15 May an assessment of the Dnipropetrovsk Oblast Center for Disease Control and Prevention (OCDC) was conducted for potential placement of a next-generation sequencing laboratory. ▪ Sequencing and analysis of 64 SARS-CoV-2 samples collected in April were performed and the following variants were identified: BN.1, BN.1.2.1, CH.1.1, EL.1, XBB.1, XBB.1.17.1, XBB.1.5, XBB.1.5.12, XBB.1.5.13, XBB.1.5.15, XBB.1.5.16, XBB.1.5.38, and XBB.1.9.1. Sixty-four genome sequences of SARS-CoV-2 samples were uploaded to the GISAID database. ▪ A five-day laboratory training on the Illumina MiSeq platform was completed at the Ukrainian Public Health Centre. Four specialists from the Virology Reference Laboratory gained the practical skills and theoretical knowledge to operate the Illumina Respiratory Virus Oligo Panel for sequencing the influenza virus and other respiratory viruses. ▪ WHO is working closely with the MoH of Ukraine to strengthen laboratory capacity in the area of next- generation sequencing. WHO has completed the procurement and delivery of reagents and consumables for the GeneStudio S5 sequencing system and the relevant documents were prepared and signed. ▪ WHO continues to work closely with Testmerstandart LLC (Zhytomyr) on the calibration and verification of the small laboratory equipment (incubators, centrifuges, manometers, pH meters, automatic pipettes, hygrometers, etc.). Calibration of laboratory equipment at the Zakarpattya OCDC, Vinnytsya OCDC, and Khmelnytsky OCDC was completed. Periodic (annual) calibration and verification of laboratory measuring equipment is a necessary stage in the quality control of laboratory tests. ▪ WHO assesses the basic quality and biosafety requirements of clinical and diagnostic laboratories using the WHO Laboratory Assessment Tool for laboratories implementing COVID-19 testing. An assessment of the PCR units in the three clinical laboratories in the city of Rivne was conducted on 22-24 May: the Clinical Diagnostic Laboratory (CDL) of the Rivne City Central Clinical Hospital, the CDL of the Oblast Information and Analytical Center for Medical Statistics (former Rivne Oblast AIDS centre), and the absence of some standard operating procedures (SOPs) were identified and relevant recommendations and sample SOPs were given. Issue No. 53 31 May 2023 17H00 CET WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 9 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 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 7193 Total number of certificates issued in Ukrainian courses 2884 Total number of digital badges issued in Ukrainian courses 602 Two new online courses are available in Ukrainian to support health workers’ response to measles outbreaks and infection prevention and control (IPC). The free courses were launched on OpenWHO.org’s Ukraine learning channel in collaboration with the WHO Country Office in Ukraine, for a total of 29 Ukrainian courses now available on the learning platform. In Ukraine, WHO provides systematic support to the Ministry of Health and the Center for Public Health in preventing the risk of measles outbreaks among the population, and the online measles course will provide health care workers with practical knowledge and skills. Online courses for measles outbreaks and infection prevention and control launched in Ukrainian The translation of the introductory IPC course is part of WHO comprehensive actions to strengthen national IPC and health care facility programmes in Ukraine. Issue No. 53 31 May 2023 17H00 CET Document number: WHO/EURO:2023-5319-45083-69618 © World Health Organization 2023. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license.