War in Ukraine: situation report from WHO Ukraine country office. Issue No.4, 4 May 2022

BY THE NUMBERS (since 24 February): AFFECTED 18 M LEFT UKRAINE 5 563 959 (UNHCR) INJURED 3 316 (OHCHR) CONFLICT-RELATED DEATHS 3 153 (OHCHR) WHO KEY FIGURESHIGHLIGHTS By 24 February 2022 383 METRIC TONNES SUPPLIES DELIVERED USD 45 MILLION FUNDING REQUESTED 106 HEALTH CLUSTER PARTNERS 6 MILLION TARGET POPULATION 1 630 TOTAL NUMBER OF HOSPITALS 186 VERIFIED ATTACKS ON HEALTH WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 Issue No. 4 4 May 2022 19H00 CET WAR IN UKRAINE Situation report from WHO Ukraine country office 1 132 NUMBER OF PERSONNEL DEPLOYED & REPORPOSED IN UKRAINE ▪ The WHO Regional Office for Europe (WR) is deploying a team to Kyiv, for the first time since the start of the war, which will meet with staff members in the WHO Country Office (CO). WR will be visiting recently liberated areas in the Kyiv oblast and holding several high-level in-person meetings with government counterparts, speaking with members of the national and international press corps, and handing over WHO donations. ▪ Planning for the Director-General’s upcoming mission to Ukraine is under way and involves preparations for site visits, high-level government meetings and a staff meeting. A team led by an Incident Manager with a Health Operations Pillar Lead and the WHO Health Emergency Officer, who provided support for Mariupol before the war, has embarked on a mission to Zaporizhzhya, together with the UN Family and partners. It assessed the preparedness of the hospitals and reception centres in the region to care for evacuees and replenished the needed medical supplies from the WHO warehouse in Dnipropetrovsk. The mission will continue assessing and addressing the needs of frontline hospitals in Kharkiv oblast, before returning to Lviv via Kyiv. ©WHO/Ukraine SITUATION UPDATE WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 2 ▪ Approximately 100 civilians were evacuated from Mariupol in the Donetsk oblast on 1 May. The thousands still in the city are in dire need of basic supplies. For more information click here. ▪ The Ministry of Health (MoH) and the European Commission continue to arrange evacuation flights for Ukrainians from combat zones. Adults and children with severe injuries, burns and illnesses in need of specialized and urgent medical care are being evacuated. Previous evacuees were transported from Dnipropetrovsk to Lviv by a specialized medical train, before continuing to Poland’s Rzeszów Airport. The patients were later transported to Italy for further treatment at the Bologna Trauma Centre. ▪ On 30 April Ukraine received 23 ambulances from countries such as Finland, Israel, the United Arab Emirates, the United Kingdom, and the United States. The ambulances will be sent to regions heavily impacted by the conflict. For more information click here. WAR IN UKRAINE Situation report from WHO Ukraine country office Leadership & Coordination Leadership ▪ Regular high-level engagement with the MoH and other government counterparts. ▪ A team led by an Incident Manager travelled to Zaporizhzhya to jointly coordinate the evacuation of civilians from Mariupol. The team delivered medical supplies to a local hospital in the region and is closely working with the UN team on the ground. ▪ The Deputy Incident Manager and the Operations Support and Logistics Lead are setting the Hub Office in Dnipropetrovsk, intended to support frontline health needs. Issue No. 4 4 May 2022 19H00 CET HEALTH INFORMATION Conflict-related health information ▪ As of 2 May 2022, the Office of the UN High Commissioner for Human Rights (OHCHR) recorded: • 3153 civilians killed (1115 men, 722 women, 71 girls, and 83 boys, as well as 72 children and 1 090 adults whose sex is yet unknown); and • 3316 civilians injured (395 men, 324 women, 69 girls, and 80 boys, as well as 170 children and 2278 adults whose sex is yet unknown) ▪ According to the United Nations High Commissioner for Refugees, as of 1 May 2022 more than 5.5 million Ukrainians crossed the border to neighbouring countries, of whom just over 3 million and 0.8 million crossed the border to Poland and Romania, respectively. . HEALTH INFORMATION WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 3 WAR IN UKRAINE Situation report from WHO Ukraine country office COVID-19 and other communicable diseases ▪ The average seven-day number of polymerase chain reaction tests performed decreased from 42 460 to 1422 (1565 in the previous report). ▪ As of 2 May, the average number of new COVID-19 cases was 625 per day during the last seven days, compared to 24 629 as of February 24. ▪ During the reporting week, 25 of the 35 sentinel sites from 10 of the 12 regions submitted weekly Influenza Like Illness (ILI), and Severe Acute Respiratory Infections (SARI),A syndromic surveillance data. No data were received from the Zaporizhzhya and Kharkiv oblasts. Surveillance Issue No. 4 4 May 2022 19H00 CET ▪ Tetanus and diphtheria vaccination coverage among children under 16 years old in Dnipropetrovsk is very low, which could potentially worsen the epidemiological situation in the region. For more information click here. ▪ In the Zakarpattya oblast 534 cases of infectious diseases (excluding influenza and Acute Respiratory Infections - ARI) have been detected since beginning of the year, which represents a 36% increase over the same period of last year. For more information click here HEALTH INFORMATION WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 4 WAR IN UKRAINE Situation report from WHO Ukraine country office Emergency Medical Teams Data submitted by EMTs b/n March 12 – April 30 Issue No. 4 4 May 2022 19H00 CET Needs Assessment ▪ WHO, together with Premise, a crowdsourcing organization, conducted a household health needs assessment based on crowd-sourced data. Of the 1495 households who responded to the survey, 30% have sought health-care services. Of those, 33% reported having problems accessing services, while 33% had difficulty accessing routine medication. Among the respondents who sought out health-care services, 39% cited the security situation as the main barrier to access, while 23% reported that no health-care services were available in their area. ▪ The same study shows that the top three medications that households are having difficulty accessing are pain medicine, medicine for cardiovascular diseases and medicine for hypertension – respectively, for 46%, 40% and 39% of households who tried to obtain the medications. 126 daily reports and 7550 consultations WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 5 WAR IN UKRAINE Situation report from WHO Ukraine country office ATTACKS ON HEALTH Verified reports of attacks (as of 3 May 2022) For further information, click here. Distribution of HF attacked by Oblast and extent of damage 95 out of 149 attacked HFs matched by name and location ▪ Communication in Luhansk oblast is severly damaged. A water crisis has affected all government- controlled cities in the oblast. The city of Mykolaiv has not had access to running water since 12 April. ▪ As of 1 May, there are approximately 328 000 internally displaced persons (IDPs) registered in the Lviv oblast. ▪ One outbreak of acute gastrointestinal disease (five cases) at a local refugee facility was reported in the Lviv oblast. All the cases are linked to food consumption. Local media monitoring Issue No. 4 4 May 2022 19H00 CET Data submitted by EMTs b/n March 12 – April 30 Oblasts # of HFs Attacked Average # of patient visits per month per facility Kharkiv 28 72 183 Kyiv 17 15 194 Donetsk 13 29 618 Luhansk 11 30 673 Zhytomyr 9 36 452 Mykolaiv 7 17 572 Chernihiv 5 21 528 Zaporizhzhia 5 8 045 Sumy 3 3 612 Vinnytsia 2 2 444 Kherson 1 2 567 In total 101 240 188 WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 6 UKRAINE COUNTRY OFFICE ACTIONS Health operations Health Cluster/Partner updates: ▪ The Ukraine Health Cluster released its April Update to the Public Health Situation Analysis for Ukraine on 29 April. It can be viewed here. ▪ The Health Cluster’s mission to Dnipropetrovsk took place on 26–29 April with the objective of better understanding how the national Health Cluster can support eastern Ukraine, gaining a clearer picture of subnational coordination needs, and discussing needs, gaps, challenges and bottlenecks. ▪ The Ukraine Health Cluster held a national meeting for partners on 27 April, which was attended by more than 110 participants. ▪ On 29 April the Assessment and Analysis Technical Working Group held its first meeting, attended by 18 participants. ▪ Health Cluster rapid needs assessments took place on 18–22 April at household and community/shelter level. The assessments were conducted in the form of interviews by six partners (five international nongovernmental organizations (NGOs) and one national NGO) across 11 oblasts. WAR IN UKRAINE Situation report from WHO Ukraine country office Issue No. 4 4 May 2022 19H00 CET UKRAINE COUNTRY OFFICE ACTIONS WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 7 Operational Support and Logistics WAR IN UKRAINE Situation report from WHO Ukraine country office Issue No. 4 4 May 2022 19H00 CET Distributed by type, shipped, In pipeline Items received and distributed One Pheumatic Frame Module Tent (covers 60m2) purchased under the funds of Department of Foreign Affaris, Trade, and Development (DFATD) Canada has been donated to the Ukranian State Emergency in Kyivska oblast. Photo credit: WHO ©WHO/Ukraine UKRAINE COUNTRY OFFICE ACTIONS WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 8 Vaccine-preventable diseases and immunization (VPI) WAR IN UKRAINE Situation report from WHO Ukraine country office Photo & caption ▪ The standard operating procedures on outreach vaccination in IDP settings, developed by WHO CO, were approved by the MoH. Ten oblasts (Cherkasy, Chernivtsi, Ivano-Frankivsk, Kirovohrad, Lviv, Rivne, Ternopil, Vinnytsya, Volyn, and Zakarpattya) have been designated for implementation with technical operational and logistic support from WHO. Implementation has begun in the Rivne and Lviv oblasts. ▪ Since 29 April the WHO CO has restored joint WHO and Centre for Public Health of the MoH of Ukraine (UPHC) remote supportive supervision activities for oblasts on vaccine-preventable disease surveillance and immunization, focused on diphtheria, measles, rubella, tetanus, pertussis, mumps and COVID-19. The first webinar for WHO and UPHC regional trainers was completed, with more webinars scheduled for 3–11 May 2022. ▪ Technical meetings were held by the WHO VPI team and the Centers for Disease Control and Prevention in the Lviv and Rivne oblasts to plan outreach vaccination activities and required support for the entire Q2 2022. ▪ The WHO CO adapted Immunization Academy (IA) video materials for Ukraine. They were published on the IA website at the end of April. ▪ On 28 April WHO attended a joint MoH, UPHC and WHO virtual briefing to launch European Immunization Week 2022 in Ukraine. The participants highlighted risks related to diphtheria, measles and poliomyelitis, and shared simple actions required from the general population to help prevent diseases and related mortality, as well as reduce burden on the health system. Further details can be found here (in Ukrainian only). Issue No. 4 4 May 2022 19H00 CET Communications ▪ As part of World Immunization Week, WHO stressed the importance of scaling up routine vaccination, even during conflict, with a press release, a UN Geneva Palais press briefing from a vaccination centre in the Rivne oblast, and Twitter and Facebook posts. All yielded strong media coverage. ▪ Global Citizen, an advocacy platform, interviewed Yevgenii Grechukha, a Technical Officer working on immunization, about the difficulties and importance of strengthening vaccinati n coverage. Read the interview here. ▪ Photo and video coverage of a field visit related to World Immunization Week was used to create a package of interviews, photographs, and B-roll footage in English and Ukrainian. See the package here. ▪ WHO Representative, Jarno Habicht, habichtj@who.int ▪ WCO Incident Manager, Dorit Nitzan, nitzankaluskid@who.int ▪ WCO WHE Lead, Guillaume Simonian, simoniang@who.int WHO Ukraine Contacts WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 9 WAR IN UKRAINE Situation report from WHO Ukraine country office Key links and useful resources ▪ Emergency Medical Teams (EMT) For updated EMT network activities, click here. ▪ Online courses & knowledge-transfer platform For updated interactive, web-based, online courses, click here. ▪ WHO Publications and Technical Guidance For updated WHO Publications and Technical Guidance on technological hazards and health risks in Ukraine, click here. 16 courses available in Ukrainian to strengthen health emergency response WHO offers 16 open online courses in Ukrainian on key health emergency topics through a dedicated Ukraine learning channel on OpenWHO.org. The courses have more than 3000 enrolments and have been developed by the WHO Country Office in Ukraine with the involvement of national medical and public health experts. The main purpose of the Ukraine learning channel is to provide easy access to up-to-date online courses in Ukraine’s national language, targeting health care workers, public health professionals, laboratory experts and other specialists working in different levels of the health systems in Ukraine. Courses address topics such as emergency operations centres, COVID-19 surveillance, medical device sterilization and simulation exercises. Additional courses are being translated and adjusted to the Ukraine context for the current crisis. Issue No. 4 4 May 2022 19H00 CET Document number: WHO/EURO:2022-5319-45083-64443 © World Health Organization 2022. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license.