It’s working against the clock, says Christian Katzener, managing director of the German section of Doctors Without Borders (MSF). They were prepared, managed to fill camps in Odessa and in the now surrounded Mariupol, for example, and to supply hospitals with medical material such as bandages, surgery kits, medicines and anesthetics. You don’t just have to think about the war wounded, but also about the chronically ill who are dependent on insulin, for example. The MSF team also brought a large transport to the Ukrainian capital of Kyiv, including a kind of pop-up operating table that can be set up quickly anywhere. But how does it work to get life-saving goods to where people need them?
With a lot of logistics, askatzer explains. And MSF has four decades of conflict experience. MSF has three large warehouses in Europe, in Amsterdam, Ostend and Bordeaux, where duty-paid supplies are waiting to be dispatched immediately. From there, they strategically distributed the material by truck when the worst became apparent, in Poland, Romania, Bulgaria, Slovakia and Moldova. Some transports went directly to Lviv, where warehouses were rented. The western Ukrainian city is the major hub, and the World Health Organization (WHO) also handles relief supplies there.
A fast machine is running at Doctors Without Borders, they have even sent mobile clinics. All of this is happening, says Christian Katzener, in consultation with the Ukrainian authorities, but not directly with the military. It is then estimated how great the need is where, “nothing should be wasted”. It helps that MSF has been active in Ukraine, in the east, for years, for example in the care of HIV patients. And a network of local medical professionals informed MSF. Even the big WHO does it like this: With local organizations and the Ministry of Health, deliveries are calculated on the basis of local data, risk analyzes and transport capacities.
One of the iconic images of the war in Ukraine – an injured pregnant woman is brought out of a shelled maternity hospital in Mariupol. She did not survive, and other people were also killed.
(Photo: Evgeniy Maloletka/dpa)
Meanwhile, OCHA, the UN agency for humanitarian affairs, is looking for ways to bring further aid and create escape routes. Amanda Pitt, on the Ukraine mission for OCHA, describes it Süddeutsche Zeitung So: You are working with the defense ministries of Russia and Ukraine to establish a humanitarian notification system. Both sides of such agreements need to be informed at the same time to get safe routes, with constant communication about schedules and movement of trucks and people. “We’re open to all possibilities,” said Pitt.
In Mariupol there is a lack of everything
However, the UN was not involved in setting up previously announced humanitarian corridors. Hardly any actually came about, which is why nothing can be delivered. One of the desperate messages from Mariupol, for example, is that not only is there a lack of food and water, but that medication and medical supplies have also been used up. In Isjum, for example, it should be the same.
According to Katzener, around 100 employees work for MSF in the Ukraine: doctors, nurses and logisticians. In Lviv, Mariupol, Zhytomyr or Sieverodonetsk. Also in Kyiv, where they are supposed to stay. Of course, the safety of her people and the patients comes first, which is currently restricting the possibility of movement. The colleagues in Russia, sayskatzer, would inform the Ministry of Defense in Moscow about the whereabouts of the MSF people. He doesn’t know if that protects her.
There are still ways to Kyiv. With the large delivery from MSF there on Sunday two weeks ago, sayskatzer, it was a great help that the Ukrainian railways offered to transport the material. That saved time, and a lot fits in freight wagons. The material arrived in Lviv on Saturday, they loaded it onto the train at night, and the next afternoon they were able to receive 40 cubic meters of life-saving items in the capital.
Material is one thing, but you also have to be able to use it. That’s why MSF, says Christian Katzener, did “dry runs” in hospitals in Kyiv and other cities — how to do it mass casuals, situations in which a large number of injured people suddenly arrive. Which rooms are suitable, where is what, who is doing what, and yes, also what are the criteria for triage when deciding who should be treated first, when it no longer makes sense. Surgeons, usually specializing in a narrow area, are instructed to operate on gunshot wounds. As many as possible should also be able to perform Caesarean sections, which has proven to be important everywhere.
The WHO brought 36 tons to Lviv
The WHO also reports that medical material is running out in some places. She, too, tried to make provisions, with huge amounts. On March 5, they brought 36 tons to Lviv for further distribution. Three days later, ten tons went to seven regions via Kyiv. On March 12, the WHO had ten tons of medical material and medicines transported to Kharkiv, Sumy, Dnipro, Cherson, Mariupol, Mykolaiv, Zhytomyr, Zaporizhia and Cherkassy. Each delivery should last for 150 injured and 15,000 other patients over three months. In addition to the usual material, the WHO names oxygen and oxygen equipment, material for blood transfusions, power generators, defibrillators, monitors.
But hospitals are not only cut off, they are being fired upon by Russian units, contrary to the laws of war. According to Ukrainian information, more than 100 clinics have already been damaged, some destroyed. Not only that, the Ukrainian General Staff announced on Wednesday that in Makiivka, a town of 350,000 people near Donetsk, “the situation in local hospitals is catastrophic, they are unable to provide medical care to civilians due to a lack of qualified medical personnel”.
The risk of epidemics is growing
The WHO, together with the Ukrainian authorities, is trying to get an overview of the overall health situation with the help of clusters and 3D maps. In this way, it should be discovered as quickly as possible if an epidemic breaks out – another concern of the experts, including at Doctors Without Borders. OCHA warns that the fight against tuberculosis must continue. Clean water is no longer available in Mariupol and other cities. People drink rainwater, melt snow, use water from heating systems when they are in need. Boiling is often not possible.
This entails risks, diarrheal diseases, in the worst case cholera. This was pointed out by Kate White, emergency coordinator at MSF. It is known from an outbreak in 2011 that the cholera bacterium is present in the region. And Christiankatzer points out that not only contaminated water is dangerous, but also a lack of it – children in particular are at risk of dehydration as well as weakened people. This is life threatening. Children in particular could also develop pneumonia from the cold. War, that hasn’t changed, doesn’t just kill at the front.