“The reality is that the conditions we see in Ukraine are the worst possible ingredients for the amplification or spread of infectious disease,” Ryan said during a Wednesday media briefing on Ukraine, COVID-19 and other global health issues.

Refugees Carry Personal Items, Not Diseases

Ryan also said that if people in neighboring countries fear that refugees from Ukraine will trigger outbreaks of infectious diseases, they are mistaken.

“Let’s be very careful with our rhetoric,” he said. “This always arises that in some way, that people fleeing the horrors of war are going to bring stuff with them. But they’re not.“

For example, the refugees are not expected to raise COVID-19 numbers in Europe.

“Europe has plenty of COVID as it stands. The Ukrainian refugees are not going to change the dial on that,” Ryan said.

As an important line of defense, health check-ups, vaccinations, mental health support and other health services are provided at the entrances of neighboring

countries. WHO leaders say that health officials are also focusing on the needs of children and women, most of them from 2 million refugees so far.

Even more vulnerable than the refugees may be the people forced to stay behind. WHO stated that people unable to evacuate due to the conflict, including the elderly and people with chronic diseases who cannot get to their medications or regular treatments, remain at high risk.

Health Care Under Attack: The City of Mariupol

The WHO has confirmed 18 attacks in Ukraine, including hospitals, clinics and ambulances. The result was 10 deaths and 16 injuries among health care workers. News of a recent hospital bombing on Thursday also included a pediatric and maternity hospital in Mariupol.

The humanitarian situation in Mariupol is so bad that the Ukrainian city was bombed, aid could not enter and civilians could not leave safely. Kate White, an emergency manager for Doctors Without Borders/Médecins Sans Frontières (MSF) in Geneva, gave the following statement:

“In Mariupol, our teams report that many families do not have enough water, food and medicine. For small children this can be particularly dangerous. Unlike adults, their bodies cannot withstand wide fluctuations in food and water intake, and so they are at high risk of dehydration. Contaminated water can also cause diarrhea, which in turn can set in motion a vicious circle, with diarrhea leading to further dehydration. In extreme situations, this can also result in death.“

Poor water quality can lead to many diseases including skin infections and scabies. On top of this, people in Mariupol have to live in congested conditions without being able to follow basic health measures as they seek refuge from shells and explosions. This leads to respiratory tract infections and the spread of COVID-19.

Low and poor water supply can lead to outbreaks of infectious diseases, especially cholera. Mariupol witnessed an outbreak of cholera in 2011, so it is known that the bacteria that causes cholera are in that area.

The lack of fuel makes people to use wood for cooking in houses that are not built for this. So, the likelihood of fires is high, and people are at risk of incurring severe burns and suffering from respiratory illnesses. This could be a fatal blow.

Moreover, people are unable to move freely due to the intense war going on, which severely restricts their ability to seek health care. When the freedom of the people, their protection and their ability to receive timely health care are compromised, all of this goes against the laws of war, establishing the right of the public to receive protection and health care.

White said, “More broadly, eastern Ukraine has a high proportion of elderly people as a direct consequence of the eight-year conflict. Many young people fled when war broke out in 2014. Elderly people are the least mobile so more likely to stay on. Many have underlying health conditions including hypertension and diabetes. Even if we don’t see an immediate impact on elderly people, we know this will appear.“

She also said, “The war has disrupted community structures, which have been essential in supporting health care needs of elderly people. We had established a network of health volunteers who supported people to get timely diagnoses and treatment as well as help with getting medicines. Because of active fighting, many community health workers have left the region or are in hiding. So, this will only increase the sense of isolation among the elderly.“

“In Mariupol today, there is hardly any safe place and the sound of gunfire, shelling and aerial bombardment is ever present. Very often, mental health consequences take years to manifest but also require immediate assistance. We will have to deal with the mental health impact of this war on a massive scale for years.”

There are about 1,000 health facilities of different sizes — hospitals, clinics and other health care locations — either on the frontlines or within 10 km range. The hospital has low medical oxygen supplies too.

Ryan said that getting hospitals the needed supplies is essential, but hospitals also need power, clean water and fuel for generators to run.

“All of this infrastructure and engineering support is needed to keep your average hospital going in a normal situation. In the middle of a shooting war, it’s almost impossible,” he said.

“So, in effect, the health system is becoming engulfed in this conflict, engulfed in this crisis,” Ryan said. “We’ve seen now that some hospitals are being abandoned by the authorities because they simply cannot function, and there’s an attempt to move hospital equipment and move doctors and nurses around.“

Emergency medical teams are needed to relieve overworked, exhausted doctors, nurses and other providers. “They’re not getting time off, they’re not going home in the evening or on weekends, they’re not going on picnics,” Ryan said.

Therefore, “when we talk about attacks on health care, we’re not just talking about attacks on infrastructure. This is also … an attack on those health care workers, because they cannot maintain this effort for very long.“

“We are in awe and inspired by their efforts,” Ryan said. “But it cannot continue forever.“

Fears About Radiation Exposure

Considering the threat posed by radiation from the fragile state of nuclear reactors, a reporter asked if it was time for people in Ukraine to store iodine.

The WHO is a member of the International Atomic Energy Agency (IAEA) Emergency Preparedness and Response network. “We’ve worked on ensuring and monitoring for and any attacks or any damage to chemical installations as well as nuclear installations,” Ryan said. He also said that countries have already prepared plans in place since the Chernobyl accident took place in 1986.

“I’m sure they’re looking at those plans again,” he said. Ryan does not think it’s time for people to stockpile iodine for protection against radiation sickness. But governments are “well advised to ensure that the preparedness plans and their supply chains are in place should such a horrific eventuality occur.”

No Health Without Peace

Despite the WHO’s efforts on multiple fronts, “the only real situation to the solution is peace. WHO continues to call on the Russian Federation to commit to a peaceful resolution to this crisis,” said WHO Director-General Tedros Adhanom Ghebreyesus, PhD.

He told “Today I released a further US$3.5 million from WHO’s Contingency Fund for Emergencies (CFE) to purchase and deliver urgent medical supplies. This humanitarian health support is expected to rise following further needs assessments. This new support complements the trauma and medical supplies which we prepositioned in health facilities.“

WHO has for decades worked closely with health authorities across Ukraine. We have a deep knowledge of the capacities and needs of the country’s health system.

He also told, “We will continue to deliver care and support the people across Ukraine affected by this crisis.”

The health outlook in Ukraine will only worsen “unless we have a cease-fire,” Ryan agreed. “This is putting bandages on mortal wounds right now.“

Not only that is his wish but also it is our wish too. Make peace; not war.

Source: Medindia