War in Ukraine: situation report from WHO Country Office in Ukraine: issue No. 75, 30 May 2024

EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 1Page Issue No. 75 30 May 2024 17H00 CET WHO Country Office in Ukraine - WHO ERF GRADE 3 WHO distributions and prepositioning of kits in Kharkiv oblast Kharkiv oblast is a key region in northeastern Ukraine, covering 31.4 thousand square kilometres (5.2% of Ukraine’s total area) with a pre-invasion population of 2.7 million. It shares borders with Luhansk, Donetsk, Dnipropetrovsk, Poltava, and Sumy oblasts, and has a significant border stretch with the Russian Federation. Since the full-scale invasion in 2022, the region has been heavily affected by missile attacks, putting a strain on the health-care system and posing a threat to public health. As of November 2022, about one third of the region was liberated, with approximately 2% still not under government control. Around 800 000 people have left the oblast, while many internally displaced persons have sought refuge there. People continue to leave areas of intense hostilities. As of 22 May, the International Organization for Migration estimated that over 17 300 people had been displaced from the most affected communities of Derhachi, Lyptsi, Staryi Saltiv, Tsyrkuny, Vovchansk, and Zolochiv in the past two weeks, with 45 600 people EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 2Page remaining. In the first four months of 2024, Kharkiv oblast received 22.4 metric tonnes (22 400 kg) of critical medical supplies valued at US$ 467 000, benefiting an estimated 55 583 people. The WHO Kharkiv store currently holds 2.5 metric tonnes (2500 kg) of medical supplies for rapid deployment, valued at US$ 10 000. In the coming weeks, an additional 202 medical kits will be sent to Kharkiv. These kits contain essential supplies for emergency medical aid, trauma care, noncommunicable diseases, paediatric care, and severe acute malnutrition. Efforts are ongoing to meet the needs of displaced and non-displaced persons in Kharkiv oblast. The Health Cluster and WHO have been collaborating with local health authorities and partners to address the needs of those affected by the conflict. As of 28 May, six health partners have provided primary health-care services to 1021 people (including 183 children) with primary health-care and mental health and psychosocial support services at the Kharkiv City Transit Centre. Coordination has also focused on meeting the needs of specific vulnerable groups, including people over 60 years of age and people living with disabilities, in collaboration with the Protection Cluster. Partners continue regular planning based on a schedule established by the Health Cluster to serve accessible non-displaced populations in the region. © WHO © WHO EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 3Page • Between February and May 2024, 10 basic emergency care (BEC) training sessions were conducted in Kyiv, Odesa, Lviv, Ternopil, Poltava, and Vinnytsya. They were hosted at medical universities to ensure sustained training opportunities, one each in Lviv and Ternopil, followed by a BEC training of trainers. Over 150 participants were trained, with a selection of over 40 potential instructors identified. Additionally, five master trainers were certified, finalizing the trainer pathway. These BEC training sessions are part of an international initiative designed for medical professionals who have completed clinical training and provide emergency care within hospitals and at pre-hospital stages. The BEC course aims to equip physicians with a systematic approach to critically ill patients’ initial assessment and treatment. Participants are trained to assess patient conditions using the ABCDE system, identify and apply key treatments and procedures for life-threatening conditions, and determine the appropriate next steps for patient care. Basic emergency care training sessions © WHO EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 4Page A crucial aspect of the training is developing a team of local BEC trainers in Ukraine. With the support of WHO, several internationally accredited trainers are assisting Ukrainian candidates in completing the necessary steps to become accredited BEC master trainers. To attain master trainer status, candidates must first complete the BEC course. Subsequently, they must conduct three BEC courses, with one session being supervised by an internationally accredited facilitator. Upon fulfilling these requirements, candidates can obtain certification and begin instructing others. The BEC course is a collaborative endeavour undertaken by WHO, the International Committee of the Red Cross, and the International Federation for Emergency Medicine. © WHO Implementation of the European Trauma Course WHO is working with the Ministry of Health of Ukraine to lead the implementation of the European Trauma Course (ETC). This course was developed in collaboration with the European Resuscitation Council, the European Society of Anaesthesiology and Intensive Care, the European Society for Trauma and Emergency Surgery, and the European Society for Emergency Medicine. The ETC is a specialized hospital-based training programme designed for experienced physicians and registered non-medical health professionals actively involved in the direct emergency care of patients with significant trauma. EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 5Page This state-of-the-art trauma care training programme focuses on developing technical (specialized) and non-technical (personal) teamwork skills. It is currently the only internationally accredited comprehensive trauma course created to instruct physicians and allied health professionals in delivering collaborative care within multidisciplinary teams, all working towards the common goal of providing the best possible patient care. To ensure the long-term sustainability of the ETC in Ukraine and to reduce dependence on external/international instructors, efforts are under way to establish a group of national/local Ukrainian ETC trainers. Consequently, WHO organized a national rollout of four courses in May 2024. This enabled Ukrainian candidates with instructor potential to complete all necessary steps to become accredited ETC trainers. Out of the 96 participants in the four cohorts, around 8–12 participants from the initial course will advance to full accreditation, which includes completing three ETC courses as trainees. Additionally, approximately 36 participants will progress through various stages towards instructor accreditation. The ETC is designed for specialists who provide emergency medical care at the hospital stage. The expected participant breakdown for this series of courses is as follows: 25% emergency medicine doctors, 25% orthopaedic traumatologists and surgeons, and 25% anaesthesiologists or resuscitation specialists. © WHO © WHO EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 6Page 128 7 800 000 3 800 000 5 900 000 Attacks on Health Care reported by WHO SSA tool People in need People targeted by Health Cluster partners Internally displaced persons (IDPs) KEY FIGURES Key humanitarian numbers EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 7Page The Risk Communication and Community Engagement (RCCE) team printed and distributed public health advisory materials in evacuation areas in April and May. In Donetsk oblast, the distribution efforts included packages of leaflets covering cholera, botulism, intestinal infections, hepatitis A, and rabies, with 2000 pieces of each type. They also distributed packages of posters highlighting hepatitis A, cholera, and rabies, comprising 100 pieces of each type. In addition, new frequently asked questions messages, which include links to services, were created in partnership with the Accountability to Affected Populations (AAP), Camp Coordination and Camp Management Technical Working Group (TWG), and the Ministry of Health. These messages will be shared with partners. Two RCCE TWG meetings were held during this time to streamline RCCE efforts and provide technical support to the Ministry of Health. The TWG welcomed the AAP TWG chair to promote collaboration in overlapping areas in the coming months. Additionally, WHO organized a webinar on radiation safety awareness in partnership with the National Research Center for Radiation Medicine to mark the Chernobyl Disaster Remembrance Day. Partners were invited to participate under the auspices of the TWG and Health Cluster. Furthermore, 11 prefabricated structures in Kharkiv and two in Mykolayiv were supplied with leaflet packages, each containing 1000 pieces per classification and two posters per classification. Distribution of public health advisory materials covering various gastrointestinal diseases © WHO © WHO EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 8Page Health Cluster raises awareness among health partners on reporting attacks on health care In the past two years, the military operations in Ukraine have moved to the eastern and southern parts of the country. This shift has allowed for a more focused response to affected communities. However, challenges have arisen due to limited access and communication in these regions, caused by increased insecurity from recent clashes. This hinders the timely reporting of attacks, including those on health care, from front- line areas. Gathering accurate information on these attacks is crucial for advocacy, especially considering that violence and obstruction to health-care access are standard in front-line regions. These challenges not only obstruct civilians’ access to services, but also endanger the safety of health-care workers. © Health Cluster. Attacks on Health Care team, Galyna Gorodetska, and Sergyi Artykutsa, introducing the Dnipropetrovsk Workshop session to health partners, 17 May 2024. To collect information about previously unreported incidents and improve future reporting and awareness, the WHO-led Health Cluster in Ukraine arranged a workshop on attacks on health care. The workshop, which took place in Dnipropetrovsk on 17 May and Odesa on 24 May, brought together 42 participants from 23 partner organizations. The event focused on partners in regions that frequently experience such attacks while planning and carrying out activities supporting the Ministry of Health. The workshop included presentations and group work covering various topics related to attacks on health care, such as the historical context, a human rights perspective on health, the WHO system for verifying attacks on health care (WHO SSA), definitions of related terminology, strategies for protection and mitigation, and steps to improve incident reporting. EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 9Page © Health Cluster. Health Cluster partners International Medical Corps and International NGO Safety Organisation presented the results from group discussions on protection and mitigation measures during the Dnipropetrovsk workshop on 17 May 2024. During the group work and brainstorming sessions, participants shared information, exchanged past experiences, and discussed best practices. They also confirmed their commitment to strengthening collaboration. In Dnipropetrovsk, 22 representatives from 15 partner organizations attended, while in Odesa, 20 representatives from 11 partner organizations participated in the exercise. After the workshop, key information is collected, and partners’ inputs are monitored to update the SSA platform. The escalation of conflict in Ukraine since February 2022 has had devastating consequences for health-care facilities, workers, and patients across the country. As of 27 May, there have been 1808 verified attacks on health care, resulting in the deaths of 142 people and injuries to 340 others. These acts of violence continue to endanger the lives and well-being of health-care workers and patients. During the Seventy-seventh World Health Assembly held in Geneva, Switzerland, from 27 May to 1 June 2024, Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, emphasized a critical message: “Attacking or militarizing health care is a violation of international humanitarian law”. This underscores the importance of safeguarding health-care facilities and personnel during conflicts and crises. Attacking health care impedes achieving the highest attainable standard of health for all people, as a fundamental right, and the ideal on which WHO was founded 76 years ago: “All for Health, Health for All.” WHO uses a thorough process through its Health Cluster team, involving various sources of information, field verification, and collaboration with partners. By addressing gaps in reporting and promoting cooperation, WHO, through the Health Cluster, works to enhance protection for health-care facilities, staff, and patients in Ukraine. To strengthen advocacy efforts, the WHO-led Health Cluster will continue to work with partners to verify reported incidents and update the SSA platform. EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 10Page KEY FIGURES Key operational numbers Health Facilities reached Interagency convoys conducted Supplies distributed People provided with supplies 155 1 12.5 MT 79 164 620 12 379 MT 1 974 062 Week 20 and 21 Week 20 and 21 Week 20 and 21 Week 20 and 21 Overall Overall Overall Overall EMERGENCY SITUATION REPORT WHO COUNTRY OFFICE IN UKRAINE Issue No. 75 11Page Contact us Visit website Email us WHO Representative Incident Manager Health Emergencies Lead Document number: WHO/EURO:2024-5319-45083-74681 © World Health Organization 2024. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license