November 23rd, Donetsk region, Ukraine: The long-running conflict in eastern Ukraine has continued since 2014. Many have left the villages and towns near the fighting but some people are still living here. A lot of them are older people. There is a high incidence of chronic diseases such as asthma, diabetes and heart disease. Yet people often find it difficult to access healthcare. In some villages, volunteers supported by Médecins Sans Frontières (MSF) are providing transport and health information to help people get the medical care they need.
“There was before and after. Groceries became unavailable abruptly. Medical services became unavailable. The kindergarten and school shut down. Everything [changed] in the blink of an eye,” says volunteer Valentyna Naumovychm, who works with MSF.
“[Now] the village is dying out. Mostly the elderly remain. Those who could leave, left."
"Those who could leave, left"
[Valentyna naumovychm][msf volunteer]
Village is dying out
"There were 500 people here, 300 households. Now there are 136 people and 75 households.” Those who stayed behind, she adds, never forget about the conflict:
“We are constantly reminded of it.”
Crucial lifeline
Volunteers like Valentyna provide a crucial lifeline for people living in villages close to the conflict.
Incidents of shelling and shooting happen almost every day in some of these areas.
Around many villages, landmines remain a serious threat.
Partly as a result of these risks, transport systems remain disrupted and many services are simply not available.
Services unavailable
This often includes medical services.
Volunteer Hennadiy Shapovalov says, “Prices in our pharmacy are a little bloated. We are located farther from the ‘civilisation’, near the contact line, [so] not all suppliers agree to come here.”
In a nearby village, local volunteer Oksana Kovalenko says, “There is a doctor in our area but the outpatient clinic is five kilometres away."
"Busses stopped coming here. How can these elderly people get to see a doctor?”
“When we started the project,” says MSF activity manager, Anastasiia Zhydkova, “we found that we have needs and we have services, but no connection between the needs and the services.”
MSF also heard about local people who were using their own resources to help people in their villages. Some of them would bring clean drinking water to elderly residents, others organised recreational activities.
Programme to be expanded
One person set up a laundry service in a village where households didn’t have running water.
MSF began collaborating with local volunteers in 2020 to form village health teams (VHTs) who could provide health information, transport patients to clinics and hospitals, and collect and deliver prescription medications.
The programme soon expanded to include other villages.
Struggle to reach medical care
Volunteer Oleksander Serheyev explains how it works:
“We hung up an announcement saying, ‘A health team is working. We can provide some services, such as driving you to a family doctor."
"Or in case a doctor refers you there, driving you to hospital.’
"Generally, we drive and assist those who don’t have their own vehicles."
After a visit to a family doctor where they receive a prescription, we drive them to a pharmacy.”
He adds, “In these villages, we are all like relatives.”
“In these villages, we are all like relatives.”
[volunteer][oleksander serheyev]
In the space of just three months between July and September 2021, these volunteers provided more than 500 trips to doctors’ visits, medical tests and hospitals for people who would otherwise have struggled to reach the medical care they needed.
During the same period, almost 800 prescriptions were filled and life-saving medication delivered to 270 patients.
“People can’t afford to go to hospital. If I didn’t have this ancient car, I wouldn’t be able to get to hospital either!” says volunteer Tetiana Karadzeli.
Community-led solutions
With a little support from MSF, health team volunteers are able to provide transport services, along with accurate, up-to-date health information, free of charge to vulnerable people in their communities.
MSF has worked in Ukraine since 1999, working on HIV/AIDS, TB in prisons, hepatitis C and providing direct medical and humanitarian assistance to people affect by the conflict in eastern Ukraine.
In Donetsk region, MSF works with volunteers to support community-led solutions to improve healthcare access, as well as working on mental health.
MSF provides training and support for doctors and nurses in 4 ambulatories [health centres] and 11 FAPs [village health points].
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