World health officials warn the war in Ukraine is taking a heavy toll on the mental health condition of millions of people, requiring an urgent increase in mental health and psychological support.
“An estimated almost 10 million people may currently have a mental health condition, of whom about 4 million may have conditions which are moderate or severe,” said Hans Kluge, World Health Organization regional director for Europe.
Speaking in the Ukrainian city of Zhytomyr, Kluge said he met Thursday with first lady Olena Zelenska, who summed up the prevailing situation in the country by telling him that “everyone in society has to become a psychologist.”
Managing the critical situation, he said, “requires an all-government and all-society effort.”
Data and evidence gathered by Ukraine’s Ministry of Health and WHO in recent months show the major priorities and challenges that need to be addressed are mental health, rehabilitation, and community access to health services.
The latest estimate by the U.N.’s Office of the High Commissioner for Human Rights finds more than 7,000 civilians have been killed and nearly 12,000 injured since Russia invaded Ukraine nearly one year ago.
Kluge said rehabilitation of victims of the war must not be delayed but made available now.
“We are doubling the support on rehabilitation,” he said, “including treatment for war-related injuries, which are often horrific for adults and children alike.”
The latest WHO needs assessment survey finds that one in 10 people express difficulty in accessing medicine for various reasons, including damaged or destroyed pharmacies and the unavailability of supplies. One-third of those surveyed said they could not afford to pay for the medicine they need.
The survey also highlighted the need to pay more attention to the treatment of people with non-communicable diseases. Kluge noted that 44% of those surveyed said they had difficulty receiving care for chronic conditions.
“The most common were cardiovascular diseases, notably hypertension, but also diabetes and kidney disease, and then, of course, there is routine immunization that is weak,” he said.
The carpet bombing of Ukrainian cities, missile strikes and artillery fire by Russian forces has put much of Ukraine’s health care system out of commission.
In a media interview a few days ago, Ukraine’s minister of health, Viktor Liashko, said 1,218 health care institutions have been damaged, including 540 hospitals, 173 of which were completely destroyed.
Kluge said the WHO has verified nearly 780 attacks on health care services, calling it “unforgivable.” He said, “Any attack on any health and health care is clearly a breach of international humanitarian law.”
Speaking from Poltava Oblast, Jarno Habicht, WHO representative for Ukraine, said the health system was functional depending on the region. For example, in areas regained from Russia, such as Bucha, Irpin and Kharkiv, “access to health care is more difficult.”
“Primary health care centers, which have been attacked — more than 780 attacks —need to be rebuilt. These centers need water, these centers need electricity, these centers need health care workers to come back,” he said.
There were, however, hopeful signs of recovery, Habicht added, noting that 20% of health facilities have been rebuilt by charities and private-sector investments.
“So, that means that the health system is also healing itself,” he said.
The U.N. refugee agency estimates more than 8 million Ukrainians have fled to neighboring European countries as refugees, and an estimated 7 million are displaced inside Ukraine.
Habicht also said the WHO’s latest “health survey shows that the internally displaced people have more barriers to access to care” than those who have left the country.
Overall, he said, Ukraine’s health system is under stress but working, and in regained areas, rebuilding infrastructure and attracting more health care workers is critical.
As the war enters its second year, he said, “We need new specialists, we need to do faster training for nurses as well for the doctors.
“We need more mental health specialists … and physiotherapists to ensure that children have enough support that they can move around, they can go to school, and their life can go on.”
Kluge, who is on his fifth visit to Ukraine within the past year, noted the need for continued international humanitarian support. “Unfortunately, after what I saw, I cannot tell that the impact of the war on the health of the people in this country is going to diminish.
“I am very concerned it will in the coming months actually increase,” he said.