War in Ukraine: situation report from WHO Ukraine country office. Issue No. 47, 10 March 2023

Issue No. 47 10 March 2023 09H30 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 19 080 271 (UNHCR) INJURED 13 620 (OHCHR) CONFLICT-RELATED DEATHS 8173 (OHCHR) WHO KEY FIGURESHIGHLIGHTS 2134 SUPPLIES PROCURED USD 240 MILLION FUNDING REQUESTED 192 HEALTH CLUSTER PARTNERS 11.1 MILLION TARGET POPULATION 833 VERIFIED ATTACKS ON HEALTH 1 162 NUMBER OF PERSONNEL DEPLOYED & REPURPOSED IN UKRAINE WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 1917 PATIENTS RECEIVED TRANSFER & MEDEVAC SUPPORT Source: ERCC NUMBER OF AMBULANCES DELIVERED Since 1 March 2022 59 NUMBER OF GENERATORS DELIVERED Since 1 March 2022 28 (WHO) (WHO) (WHO) (WHO)  In his statement “Ukraine 1 year on: this is not the time to let fatigue win”, Dr Hans Henri P. Kluge, WHO Regional Director for Europe, emphasized three urgent priorities: mental health, rehabilitation, and access to health services.  24 February 2023 marks one year since the escalation of the war in Ukraine and WHO has been working more actively than ever in Ukraine.  WHO has delivered essential medicines and supplies to areas close to the front line in Ukraine, reaching 118 000 people with key health interventions. Up to 12 interagency United Nations (UN) humanitarian convoys reached more than a dozen settlements in the Kharkiv, Donetsk and Zaporizhzhya regions with supplies, including interagency health kits, trauma supplies and medicines to treat noncommunicable diseases. We are here together with Ukraine. Together with Ukrainian doctors, nurses, authorities, civil society, all those putting in the work. We will survive this winter. We are ready for the seasons that follow. We are here for decades to come Dr Jarno Habicht, WHO Representative in Ukraine. ©WHO SITUATION UPDATE 2 WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 WAR IN UKRAINE Situation report from WHO Ukraine country office Leadership and coordination Issue No.47 10 March 2023 09H30 CET  On 2 March a Russian missile strike on a five-story building in Zaporizhzhya reportedly resulted in 13 deaths, including children. The UN Humanitarian Coordinator for Ukraine, Denise Brown, met with local authorities at the site, stressing that civilians and civilian infrastructure are protected under international humanitarian law and should never be targeted.  The security situation in the frontline town of Bakhmut in the eastern Donetsk region has deteriorated significantly, with sustained intense shelling. According to local authorities, access to the town remains limited. Of the 70 000 to 80 000 people who lived in Bakhmut before the war, only around 7000 remain.  Local authorities reported that the Russian forces repeatedly attacked the village of Kozache in the Kherson region, injuring more than 10 civilians. Two volunteers of a local nongovernmental organization (NGO) assisting with evacuation efforts in the village were also injured, as reported by partners on the ground.  UN Secretary-General Antonio Guterres visited Kyiv on Tuesday, hoping to firm up the deal struck between Ukraine and the Russian Federation last year to allow for the export of grain from both countries. The agreement, negotiated and implemented by UN and Turkey, must be renewed by 18 March, as global food prices soar, putting humanitarian aid efforts around the world at particular risk.  The WHO Representative (WR) in Ukraine continued high-level engagement with the MoH, authorities and partners in Kyiv, as well as briefings with donors and media.  WHO 2023 Emergency Appeal: Ukraine & Refugee-Receiving Countries: For period January - December 2023, the appeal details WHO’s resource needs for Ukraine and refugee-receiving countries that are estimated at US$ 240 million: US$ 160 million for the health response in Ukraine and US$ 80 million for addressing the healthcare needs of Ukrainian refugees in refugee-receiving countries.  On 7 March WHO/Europe, together with the WHO Country Office in Ukraine and the Ministry of Health of Ukraine are hosting a public event highlighting people’s rehabilitation needs, disability inclusion and the use of assistive technology in the context of the health response to the ongoing war. The high-level event will address the work of WHO related to law, policy and service provision in the context of war, WHO's rehabilitation, assistive technology and disability inclusion strategy, as well as our collaborations with organizations and key ministries.  The IM, along with United Nations (UN) partners in Dnipropetrovsk, supported the Humanitarian Operations Planning Cell in planning next week’s convoys to support the frontline response in high-risk areas in east Ukraine. 3WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 WAR IN UKRAINE Situation report from WHO Ukraine country office 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: 8 173 civilians killed; 13 620 civilians injured. As of 6 March, 138 killed (69 men, 40 women, 1 girl, as well as 28 adults whose sex is not yet known); 451 injured (155 men, 95 women, 11 boys, 9 girls, as well as 181 adults whose sex is not yes known).  According to the United Nations High Commissioner for Refugees, as of 7 March over 19 million borer crossings from Ukraine to neighbouring countries, of whom just over 10 million and over 2.3 million crossed the border to Poland and Hungary, respectively. Issue No.47 10 March 2023 09H30 CET COVID-19 and other communicable diseases  In the week of 24 February–2 March, the average daily number of new COVID-19 cases was 1822, an increase from 1399 per day in the previous week. The seven-day average daily polymerase chain reaction (PCR) tests performed increased to 5413 from 5353 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 fatal case of the fulminant form of meningococcal infection in an 11-year-old boy was reported in the Zvenyhorodka raion in the Cherkasy oblast. Preventive anti-epidemic measures were carried out to stop further spread. More information is available here.  Parotitis cases continue to be reported in the Cherkasy oblast, with two children aged nine and 14 and one adult reportedly ill. The children were not vaccinated against mumps. More information is available here.  A rotavirus outbreak was detected in the Lviv Lyceum No. 81 named after Petro Sahaidachnyi. Five schoolchildren of different ages were hospitalized at the Lviv Oblast Infectious Diseases Hospital. For more information, click here. WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 4 Surveillance WAR IN UKRAINE Situation report from WHO Ukraine country office 7-day average testing data as per 9 February Issue No.47 10 March 2023 09H30 CET Test Positivity rate (PCR) in private and state labs Trend in new cases WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 5 WAR IN UKRAINE Situation report from WHO Ukraine country office UKRAINE COUNTRY OFFICE ACTIONS Issue No.47 10 March 2023 09H30 CET • The WHO Country Office in Ukraine, in collaboration with national and regional health authorities, is using data collection and monitoring tools to assess health-care resources and service availability to inform critical health-care interventions in areas impacted by the war. • The Health Resources and Services Availability Monitoring System (HeRAMS) involves gathering information on the functionality of health facilities, damages incurred, basic amenities and service availability across various domains, including trauma and general services, child health and nutrition, communicable diseases, sexual and reproductive health, maternal and newborn care, noncommunicable diseases, and mental health and psychosocial support. Health Information Chemical, Biological, Radiological, and Nuclear (CBRN)  Thirty clinicians from the MoH- identified referral hospitals for chemical injuries in the Rivne and Khmelnytsky oblasts completed a two-day practical course on management, exposure assessment and medical response to a radiation emergency. ©WHO ©WHO WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 6 WAR IN UKRAINE Situation report from WHO Ukraine country office UKRAINE COUNTRY OFFICE ACTIONS Issue No.47 10 March 2023 09H30 CET  The Referrals map has been updated and now includes data from Health and Protection Clusters, Child Protection and Gender-Based Violence Subclusters, and MHPSS TWG. More than 120 organizations are represented. The updated map will help to improve coordination of organizations providing MHPSS services and ensure a better understanding of gaps.  From January to February, 90 trainers completed the Self-Help Plus stress management course, most of them from partner organizations of the Stress Management Task Team. The trainers will scale the knowledge by training facilitators to conduct group stress management sessions. Training of trainers will enhance the capacity to provide psychological support to people affected by adversity. Mental Health and Psychosocial Support (MHPSS)  An assessment of urgent needs of emergency laboratories in affected territories (Zaporizhzhya, Dnipropetrovsk, Mykolayiv, Kherson) is ongoing. To date, the needs from 24 laboratories in the Kherson oblast have been processed, which included provision of more than 40 items, such as equipment, reagents, and consumables.  The WHO CO continues to support poliomyelitis (polio) activities in Ukraine. Large procurement in support of wastewater surveillance for polio was initiated for five Oblast Centers for Disease Control and the UPHC. The equipment, reagents, and consumables will strengthen testing capacities for isolation and safe handling of the virus. National laboratories Lab webinars conducted in 2022–2023  One hundred and sixty SARS-CoV-2 samples collected in January and February were sequenced and analysed at the UPHC. The following variants were identified: BA.2.10.1, BA.2.3.20, BA.2.75, BA.2.75.5, BA.5.2.20, BA.5.2.28, BA.5.2.3, BA.5, BA.5.1.37, BA.5.1, BA.5.1.2, BA.5.1.3, BA.5.2, BA.5.2.1, BA.5.2.61, BE.1.1, BF.14, BN.1.2, BF.7, BN.1.3, BN.1.3.1, BN.3.1, BQ.1, BQ.1.1, BQ.1.1.46, BQ.1.1.18, BQ.1.10, BQ.1.2, BQ.1.5, BR.2, CH.1.1, CV.1, XBB.1, XBB.1.1, XBB.1.5, XBB.1.9, and XBB.2. One hundred and fifty-five genome sequences of SARS-CoV-2 samples were uploaded to the GISAID database.  A new standard operating procedure was developed, describing the reporting and management of laboratory safety-related accidents, incidents, and emergencies.  A two-day workshop titled "Operating a 3-Diff automated haematology analyser" was held at the Central City Hospital of the Rivne City Council. The training targeted 31 laboratory clinicians, including physicians, biologists, and technicians. WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 7 WAR IN UKRAINE Situation report from WHO Ukraine country office Operational Support and Logistics - OSL  As of 27 February, 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$ 67.85 million and a total weight of over 2937 metric tonnes. They included Trauma and Emergency Surgery Kits (TESK) 2019, WHO trauma bags, Interagency Emergency Health Kits (IEHKs) and other items.  Between 20 and 27 February medical supplies and equipment with a total value exceeding US$ 1.75 million and a total weight of more than 113 metric tonnes were delivered to 21 oblasts across Ukraine. They included IEHKs, trauma/surgery supplies (TESK 2019, surgical instruments etc.), intercity bus, 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 Trauma backpack kit WHO emergency 7809 3915 678 163 1102 8394 617 413 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 Issue No.47 10 March 2023 09H30 CET WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 8 WAR IN UKRAINE Situation report from WHO Ukraine country office UKRAINE COUNTRY OFFICE ACTIONS Health Cluster / Partner updates Issue No. 47 10 March 2023 09H30 CET  On 15 February Health Cluster Ukraine launched ActivityInfo, which will serve as the sole platform for Partners to report their activities against the HRP 2023 objectives. To familiarize partners with reporting via APM (Activity Planning Module) and RMM (Response Monitoring Module) on the ActivityInfo platform, the Health Cluster continued to facilitate ActivityInfo Clinics.  Since its launch on 15 April, the Health Requests, Planning and Response tool (HRPR) has been revised and upgraded and 573 requests have been logged overall, with the most recent requests logged in the Kharkiv, Donetsk and Zaporizhzhya oblasts.  To foster Kharkiv oblast-specific coordination of Partner activities, the Health Cluster established the Kharkiv Subnational Health Cluster in February 2023. The first Kharkiv Subnational Cluster coordination meeting was held on 23 February: Partners discussed planned activities, Partner updates in retaken areas in the oblast, NGO co-coordination of the Kharkiv hub, and received a volunteer-based organization Mission Kharkiv to present the organization’s activities in delivering life-saving medication and anti-cancer medicine to people in need in Kharkiv. The Kharkiv Subnational Cluster meetings will continue to be held on a biweekly basis, in both English and Ukrainian (simultaneous interpretation). On 1 March the Health Cluster held its National Coordination Meeting, during which:  WHO gave a presentation on Prevention of Sexual Exploitation and Abuse (PSEA) to review the core basics in PSEA and to raise awareness of the referral pathways and reporting channels available in Ukraine. Following the meeting, WHO shared an expression of interest for members of the Health Cluster interested in participating in future trainings on PSEAH:  HelpAge International presented the key findings of the “I’ve lost the life I knew”: Older people’s experiences of the Ukraine war and their inclusion in the humanitarian response. The HelpAge research finds that the majority of older people, particularly those over 70, older women, and older people with disabilities, cannot afford to meet their basic needs, including food, medicine, hygiene items, utilities, and health care. The situation has become more acute as the war continues. The share of older people who said they had to save on food increased from 23% in February 2022 to 35% in December 2022. Seventy-eight per cent of the respondents report being unable to afford necessary medicines and assistive products. For more information, click here. WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 9 WAR IN UKRAINE Situation report from WHO Ukraine country office Issue No.47 10 March 2023 09H30 CET Communications From 20 February to 5 March, WHO Ukraine country office published 37 Twitter posts, 17 Facebook posts and 14 Instagram posts, which received a total of 1 209 333 impressions on Twitter and on 43 134 Facebook page, covering topics such as: videos about deliveries; vaccination of IDPs; trainings on stress management; handover of 59 vaccination buses; media briefing on global health issues with Dr Tedros Adhanom Ghebreyesus; interview of Dr Jarno Habicht to the Japan media; interview of Dr Hans Kluge to different media; videos devoted to the one year of war and WHO response; the work of occupational therapist in WHO’s supported rehabilitation hospital; WHO health emergency appeal for Ukraine; information about health data; stories of Ukrainians during the war as refugees; video story on rehabilitation about the doctor and the patient in Okhmatdyt hospital in Kyiv; deliveries of 12 convoys to the frontline reaching 100 000 people; announcement for healthcare workers to participate in online mhGAP training course; WHO’s collecting data with HeRAMS instrument; launch of the Nursing Leadership Group and start of conducting a series of practical seminars for nurses across Ukraine; health attacks; World Hearing Day 2023; WHO’s support of the work of national emergency medical teams providing urgent medical care in Ukraine’s frontlines. Production: Deliveries of medicines and supplies through the humanitarian convoys • Facebook UKR, Twitter UKR, Instagram UKR One year of war and WHO’s support • Facebook UKR, Twitter ENG, Instagram UKR, Facebook UKR, Twitter ENG Story on rehabilitation about the doctor and the patient in Okhmatdyt hospital in Kyiv • Facebook UKR, Twitter ENG, Instagram UKR Signing of a memorandum between WHO, MOH and partners on cooperation in the field of mental health • Facebook UKR Emergency medical teams providing urgent medical care in Ukraine’s frontlines with WHO support • Facebook UKR, Twitter ENG, Instagram UKR  The Health Cluster presented the Cash and Voucher Assistance for Health in Ukraine Framework at the 01 March 2023 national meeting. CVA response options were presented to participants to vote on and discuss. Results of the vote and partner feedback will be used to further refine the framework and approach. Together with World Food Programme (WFP), partner REACH launched a Multi-Sector Needs Assessment (MSNA) to provide an overview of the humanitarian situation in Ukraine, establish a baseline for future assessments, and confirm calculations underpinning the 2023 Humanitarian Needs Overview. For more information, please see the published MNSA 2022 Bulletin here. The MNSA health sector findings will be presented to Health Cluster partners by REACH on 13 March. Health Cluster / Partner updates UKRAINE COUNTRY OFFICE ACTIONS WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 10 WAR IN UKRAINE Situation report from WHO Ukraine country office Communications Issue No. 47 10 March 2023 09H30 CET Media: • Interview on mental health for Axios (United States) with Alisa Ladyk-Bryzghalova, WHO Ukraine mental health programme lead • Interview for NHK (Japan) with WHO Representative Jarno Habicht • News: “More than 100 000 people reached with key health interventions at Ukraine’s front lines”: • News: “Using data to provide more specialized health care in Ukraine” Social listening 1. The following rumours are being monitored and evaluated: • Negative discussions regarding a report by the WHO Regional Office for Europe that approximately 10 million Ukrainians may be suffering from mental disorders, both moderate and severe. In August 2022 the MoH predicted that 15 million Ukrainians would suffer from mental disorders after the war ends. • A growing problem with availability of medicines or medicine shortages due to the destruction of large distributors' warehouses through shelling and inability to pay suppliers. Medicine prices increased by 18% in January–October 2022 and by 27.1% in November 2022. • A case of rabies reported in the Kyiv region. 2. Risks related to post-traumatic stress disorder • Increase in unauthorized use of small grenades by civilians • Metro suicide cases 3. COVID-19 discussion is being revived with a new wave of rumours related to vaccine side effects and related social media posts • Unfounded claims of “turbo cancer” caused by COVID-19 vaccines • Cases of the “Kraken” COVID-19 subvariant reported in the Zakarpattya, Ternopil, Sumy, Odesa, Lviv and Cherkasy regions 4. War-related disease searches are being monitored. UKRAINE COUNTRY OFFICE ACTIONS e-Learning Platform OpenWHO.org: Free online courses in Ukrainian supporting health emergency response Total number of Ukrainian language courses 24 Total number of enrolments in Ukrainian courses 6167 Total number of certificates issued in Ukrainian courses 2236 Total number of digital badges issued in Ukrainian courses 489 WHO UKRAINE COUNTRY OFFICE WHO ERF GRADE 3 11 WAR IN UKRAINE Situation report from WHO Ukraine country office 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. Issue No. 47 10 March 2023 09H30 CET Document number: WHO/EURO:2023-5319-45083-68629 © World Health Organization 2023. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license.