Bridging Healthcare Gaps for Ukrainian Refugees: Urgent Needs and Long Term Solutions
By Nicole Downar
This post is part of a series in diverse mediums focusing on the theme “How do we envision equity in global health?”. These submissions are by McGill students who were part of the course, Fundamentals of Global Health, in Fall 2023.
The ongoing conflict in Ukraine, beginning on February 24th 2022, has resulted in a significant humanitarian crisis of monumental proportions. Escaping the dreadful circumstances of armed conflict, a substantial number of Ukrainians, primarily women and children, are seeking sanctuary in adjacent nations such as Poland and Slovakia. Nevertheless, this surge has exerted an immense burden on the already delicate healthcare infrastructures of these host nations, emphasizing the pressing necessity for inclusive and equitable healthcare provisions.
Reports from the United Nations High Commissioner for Refugees (UNHCR), the World Health Organization (WHO), and various non-governmental organizations (NGOs) offer supporting proof for the concerning state of affairs. The ongoing Ukrainian refugee crisis has exacerbated existing vulnerabilities within the healthcare systems of the countries hosting these refugees. Moreover, these healthcare systems are encountering supplementary difficulties due to the compounding impacts of the COVID-19 pandemic and preexisting scarcities of healthcare workers [4]. The healthcare concerns faced by refugees incorporate a broad range of issues, including the management of chronic diseases and the urgent mental health concerns arising from the traumatic experience of displacement. Furthermore, there are significant concerns about the potential spread of communicable diseases including Tuberculosis and HIV, as well as the persisting challenges posed by the ongoing COVID-19 pandemic [4].
The ethical and legal necessity to deal with these matters is of utmost importance, with some rights and responsibilities being prioritized. The 1951 Geneva Convention serves as a crucial foundation for protecting the healthcare rights of refugees [4]. A recent Polish law provides retroactive assistance to Ukrainian citizens affected by the conflict. Nevertheless, the effective execution of these legal rights and ethical responsibilities faces numerous difficulties, especially with language obstacles, vaccination coverage, and shortages of medical personnel [4].
Furthermore, the significant obstacles faced by refugees in terms of language and culture pose considerable challenges to their ability to access essential medical services. Proposed solutions have suggested the utilization of healthcare professionals as interpreters and the translation of medical documents, yet the implementation of these measures remains inadequate [4].
Prompt and efficient emergency medical care is crucial in addressing acute health risks. However, it is equally essential to establish a long-term and sustainable strategy. By formulating appropriate policies, allocating necessary resources, and fostering collaboration with international organizations, host countries can effectively meet the ongoing healthcare needs of refugees [4].
The appeal made by The Lancet to halt violence, safeguard health facilities, and establish governance that is sensitive to migration serves as a resounding call for prompt action [3]. The necessity of ensuring the essential availability of medications, particularly for long-term illnesses, provision of mental health care services (particularly for children), and the assimilation of Ukrainian healthcare professionals into the healthcare systems of host countries are urgent matters that require immediate attention [3].
Furthermore, the presence of shortcomings in the healthcare system for individuals who have been displaced and are suffering from chronic diseases, along with the inadequate number of individuals receiving vaccinations in Ukraine, anticipate potential health dangers that are on the horizon. Immediate actions must be implemented to maintain the ongoing provision of medical care, mitigate the occurrence of epidemics, and prioritize the welfare of vulnerable populations, particularly pregnant women, children, and those with chronic conditions [3]. When such a strain on healthcare systems is palpable, Europe must prepare its health infrastructure, undertake comprehensive screenings, and ensure the provision of specialized care. Collaborative initiatives, such as the Network for the Improvement of Addiction Treatment (NIATx) model, could catalyze healthcare providers and stakeholders to overcome barriers in providing opioid agonist maintenance therapies for refugees, addressing their specific needs in the EU countries [2].
The path forward necessitates a concerted effort, integrating evidence-based approaches, safeguarding privacy in data collection, and actively engaging refugees in decision-making regarding their health data [1]. Advocating for inclusive healthcare policies, especially in times of armed conflict, stands as a pivotal bridge between knowledge and actionable policies that effectively deliver high quality healthcare, especially in times of conflict [1].
Europe is currently confronted with a critical juncture in addressing the healthcare requirements of Ukrainian refugees. This situation requires prompt intervention, sustained adjustments to existing policies, and cooperative initiatives to guarantee the protection of the right to fair healthcare for everyone, particularly those who are most vulnerable.
References
1. Bozorgmehr K, McKee M, Azzopardi-Muscat N, Bartovic J, Campos-Matos I, Gerganova TI, et al. Integration of migrant and refugee data in health information systems in Europe: advancing evidence, policy and practice. The Lancet Regional Health – Europe [Internet]. 2023 Nov 1 [cited 2023 Dec 4];34. Available from: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(23)00163-1/fulltext
2. Nikitin BM, Bromberg DJ, Madden LM, Stöver H, Teltzrow R, Altice FL. Leveraging existing provider networks in Europe to eliminate barriers to accessing opioid agonist maintenance therapies for Ukrainian refugees. PLOS Global Public Health. 2023 Jul 13;3(7):e0002168.
3. Ioffe Y, Abubakar I, Issa R, Spiegel P, Kumar BN. Meeting the health challenges of displaced populations from Ukraine. The Lancet. 2022 Mar 26;399(10331):1206–8.
4. Kolińska K, Paprocka-Lipińska A, Koliński M. The Ukrainian refugee crisis: its ethical aspects and the challenges for the Polish healthcare system – a descriptive review. European Journal of Translational and Clinical Medicine. 2023 May 2;6(1):79–86.