The instability of life in Ukraine, combined with the constant stress caused by the war, is giving rise to an alarming trend: people are seeking medical help too late. Such delayed consultations often lead to patients developing complications that could have been avoided with timely treatment.
Over the course of several months, many patients, particularly elderly people, who had sought routine consultations with Médecins Sans Frontières teams, eventually required hospitalisation. Chronic conditions requiring ongoing monitoring had been deteriorating unnoticed until they developed into medical emergencies.
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Vira, a 64-year-old woman from the Mykolaiv region, is one of them. Due to the constant shelling of her hometown by Russian forces, she moved to another settlement further away from the front line in the Mykolaiv region.
“My flat was destroyed, as were my daughter’s and son’s flats,” says Vira. “That’s why we moved. But it’s dangerous here too. A farm was hit recently. Many cows were killed. I was terrified. I started feeling weak, and my vision began to blur,” she continues. “As I couldn’t find a GP in the town where I live, I went straight to the hospital.”
After being examined by a doctor from Médecins Sans Frontières, Vera, who suffers from diabetes, was quickly admitted to one of the hospital’s inpatient wards.
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Like her, more than 3,200 patients treated by Médecins Sans Frontières teams since the start of the year in hospitals near the front line have been admitted to hospital to stabilise their chronic conditions. This represents over 75 per cent of all patients examined by Médecins Sans Frontières during their initial consultation. The most common diagnoses are hypertension, diabetes and coronary heart disease.
Mobile clinics operating in transit centres for displaced people and remote communities near the front line report the same trend. In some cases, patients arrive in such a serious condition that an ambulance must be called to provide emergency care.
“People live under constant stress, experiencing the effects of shelling, power cuts and uncertainty on a daily basis,” says Robin Meldrum, programme coordinator for Médecins Sans Frontières in Ukraine. “As a result, people often fail to notice the worsening of serious chronic conditions. Conditions that could be managed become life-threatening.”
Among the patients treated by Médecins Sans Frontières teams, there are many elderly people suffering from complications of conditions such as high blood pressure, diabetes and asthma, which have arisen as a result of interrupted outpatient treatment. For example, in Kherson, the average age of patients admitted to the intensive care unit we support is 63.
“By the time people see a doctor, they are often already in a critical condition — and sometimes it is too late,” says Meldram.
Access to healthcare remains a serious problem in some regions of Ukraine. Since the start of the full-scale invasion by Russian forces in February 2022, many local medical facilities have been damaged or destroyed, medical staff have left, and pharmacies are often closed. To see a doctor, people have to travel long distances — sometimes 20, 30 or even up to 100 kilometres — along damaged roads and under the constant threat of drone strikes. Public transport is virtually non-existent.
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Disruptions to healthcare provision are also affecting patients with tuberculosis and other infectious diseases. Many of them are forced to travel long distances to receive treatment, and limited access to diagnostic services means that cases may go undetected, obscuring the true scale of the need.
To address these gaps, Médecins Sans Frontières supports hospitals near the front line and runs mobile clinics in the Donetsk, Dnipropetrovsk, Kherson, Mykolaiv and Zaporizhzhia regions.
“We are trying to reach the communities where access to healthcare is most limited,” says Katsa Brennemann, MSF’s health manager in Ukraine. “However, due to the danger – in particular attacks on civilian infrastructure, railway stations and passenger buses – people are afraid to leave their homes.”
“Humanitarian workers are also operating under constant threat; we have had to suspend operations in dozens of locations near the front line due to rocket and drone attacks,” says Brennemann.
Teams from Médecins Sans Frontières are doing everything they can to ensure at least a basic level of medical care in areas that are physically dangerous for people to reach, by conducting remote consultations. In such cases, a volunteer from the local community, who has been trained by Médecins Sans Frontières, takes vital signs and assists in communicating with the patient, whilst the consultation takes place via a video call with a doctor from the organisation.
As the war continues, ensuring access to basic healthcare involves not only treating urgent conditions but also preventing them. Without timely medical care, chronic conditions that can be managed will continue to escalate into life-threatening conditions, imperceptibly worsening the health of those who are already facing extreme hardship.
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