GENEVA — As Ukraine enters a second winter of war, the World Health Organization warns that the country’s public health system will come under enormous stress as millions of civilians try to keep safe and warm during the long, brutally cold weather ahead.

“Since the Russian Federation’s invasion of Ukraine … we have seen the impacts on public health and the increase in disease burden,” said Jarno Habicht, WHO representative in Ukraine.

“So, even if the war would end today, the health needs of millions of people across Ukraine will increase,” he said, noting that children and the elderly “are suffering particularly and struggling as winter arrives amid ongoing fighting.”

Speaking to journalists Tuesday from Odesa, Habicht said he and Ukraine’s minister of health recently delivered critical equipment and medicines to Lyman, a city in eastern Ukraine on the frontline, “to ensure treatment can be available throughout the winter.”

“We heard constant shelling, and that is the reality for health care workers and patients,” he said.

10 million with mental health needs

The WHO has verified more than 1,400 attacks affecting health care since Russia invaded Ukraine on February 24, 2022, causing many civilian casualties and significantly disrupting the country’s health system.

“These attacks continue, providing the risks for the provision of health services,” said Habicht, noting that the fear of attack has put many people on edge.

“We have more than 10 million people in Ukraine with mental health needs,” he said.  “These can vary from anxiety to the other higher-level needs, for which it is necessary to turn to primary care and hospitals.”

He said that more than 55,000 primary health care workers have been trained to deal with mental health needs and that community mental health teams are available across different regions to provide care.

“These needs will be long-lasting and, particularly, the mental health needs will be here for many generations,” said Habicht, emphasizing that the war has been especially devastating for the country’s 7.5 million children.

“Since the beginning of the full-scale invasion, we have seen the impact the war has had on mental health, on nutrition, as well as on vaccinations,” he said. “So, we need to ensure that the comprehensive package is available. There, we have many partners, including UNICEF who [are] ensuring that there are outreach services to make sure that health care is available.”

“Potentially higher numbers of deaths”

WHO officials have reported that Ukraine suffers from low immunization rates for all vaccine-preventable diseases and, during the long winter ahead, will need to prepare for outbreaks of infectious disease along with difficulties arising from noncommunicable diseases, including cardiovascular disease, diabetes, cancer and chronic respiratory disease.

Habicht warned that “we will have potentially higher numbers of deaths because of the cold and freezing winter temperatures.”

The WHO estimates that 7.3 million people will need humanitarian support in 2024. Of that number, Habicht said, the WHO and partners aim to target 3.8 million of the most vulnerable.

He also said health care workers are bracing for a repeat of last year’s attacks by Russia on Ukraine’s power grid.

“We have witnessed an increase in the number of burns related to heating and new heating devices, as people need to find ways to have electricity and heating due to attacks on civilian infrastructure,” he said. “We need to talk about the increased burn needs due to the attacks with drones, and a number of civilians who have suffered as a result of them.”

In preparation for winter, Habicht said, many health care facilities have been installing generators and heating systems and providing a place where people can come to warm up, charge their phones and pass an anxiety-free moment.

On another positive note, he said Ukraine’s health system has been given a boost by the country’s recent progress toward accession to the European Union.

“With the potential that negotiations are moving forward, the potential is huge for the public health to ensure that, point for point, improving the public health system will improve also peoples’ health,” Habicht said.

“In that sense I am optimistic but also realistic that these changes will take time.”
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