Former WHO Emergencies Head Volunteers on the Ukraine Border: ‘Needs are Immense’
NATAN Worldwide Disaster Relief organization volunteers, including Dr Dorit Nitzan
Former WHO/Europan Emergencies Director Dorit Nitzan (centre), now a front-line volunteer on the Polish-Ukraine border.

The Ukrainian refugees are crossing the border with only their coats on their backs. The women are holding their children’s hands. The children’s eyes are wide and their jaws clenched in fear.

“They come here exhausted and cold,” said Dr Dorit Nitzan, former Health Emergencies Coordinator for the World Health Organization´s European region.

Nitzan only retired from WHO within the last two months and already she has returned to the field.  But this time she is not a visiting high-level official to a humanitarian crisis zone, but a front-line volunteer sleeping on a mattress in a mall with hundreds of other refugees.

Nitzan is part of a team of first responders offering critical medical care to Ukranian refugees just inside the Polish-Ukranian border – after having finally managed to flee to safety from war torn communities in Ukraine.

According to the latest United Nations High Commissioner for Refugees (UNHCR), more than two million people, the vast majority of whom are women and children, have left Ukraine since 24 February, the day that the war started.

“The needs are immense, and we are doing our best in a small clinic,” Nitzan said this week on a call with Health Policy Watch – a call that was interrupted more than once by a sick person in need of care or an emergency.

Nitzan arrived in Poland last week with a delegation of physicians, nurses and social workers affilated with the all-volunteer NATAN Worldwide Disaster Relief organization, an Israeli-based network. Working closely with the Red Cross of Poland, the US-based Operation Blessing, the Mexican CADENA and WHO, Nitzan’s team has taken over a shopping mall in Medica, where it is serving some 3000 refugees.

Nitzan said they are expected to stay in the field for at least two months, with volunteers rotating in and out of the country every couple of weeks. The volunteers sleep on mattresses in the mall just like the refugees.

“We live with the people,” Nitzan said. “We aim to be wherever we are needed for as long as we are needed.”

Although Nitzan recently left WHO after reaching the mandatory retirement age of 65, she told Health Policy Watch that she still feels a part of the organization.

Secured a top job – then left for a war zone

Nitzan had only just returned to her home country in Israel and secured a top job at Ben-Gurion University, when the war broke out. She felt particularly compelled to respond – having also served in Ukraine on behalf of WHO from 2012 to 2016. That was during the last period of major conflict in which Russia occupied Crimea, and then supported the establishment of two pro-Russian breakaway enclaves in eastern Ukraine.

“I know Ukraine and I know the Ukrainians,” she said. “We were hoping Ukraine was marching towards a better future and this is a big slap. It really hurts me. It is extremely hard to see.”

A paediatrician, Nizan has been helping the refugee children. “I loved my job in the high chair and at the table, but here, with kids around me, I love it – I feel fulfilled,” she told Health Policy Watch.

A NATAN volunteer assists a Ukrainian refugee child at a clinic in Poland.
A NATAN volunteer assists a Ukrainian refugee child at a clinic in Poland.

More supplies are on the way

Nitzan has been in touch with the Polish branch of WHO, and through NATAN continues to stay abreast of WHO’s efforts in the region.

WHO Europe’s regional director, Dr Hans Kluge, told a press briefing on Tuesday that WHO was working to ensure the safe passage of critical medical supplies into Ukraine.

“Lifesaving essential medicines, such as oxygen and insulin, personal protective equipment, surgical supplies, anesthetics, and safe blood products, are in short supply,” Kluge said. “So far, two shipments totalling 76 tonnes of trauma and emergency health supplies, as well as freezers, refrigerators, ice packs and cool boxes are in transit in Ukraine. We have further shipments of 500 oxygen concentrators and more supplies are on their way.”

WHO is also supplying infrastructure and support to border countries and the clinics that have opened up in them, like the one in which Nitzan is operating. Kluge said that expert WHO teams have been sent to Hungary, Poland, the Republic of Moldova and Romania.

“We are working with UNHCR and coordinating closely with the relevant governments, local authorities and partners to assess the needs of incoming refugees upon entry at the border, build health system capacity to accommodate large numbers of refugees and ensure access to services,” he noted.

Next week, a meeting is planned on refugee and migrant health in Turkey where current events will be addressed by health ministers, representatives of refugee and migrant groups, partner organizations and the WHO African and Eastern Mediterranean regions.

“Continuity of care for those with long-term health needs is a major challenge because broken supply lines are affecting the treatment of conditions such as diabetes and hypertension, as well as for cancer,” Kluge said. “According to [the United Nations Population Fund] UNFPA, an estimated 80,000 women will give birth in the next three months without access to critical maternal care. Re-establishing and maintaining vaccination programs and continuing treatment for people living with TB and HIV, are priorities, as is the provision of mental health services.”

Nitzan explained that WHO also serves as a watchdog for attacks on healthcare and health workforce during the work, “which is not permitted at any time. Any attack we need to report,” she added.

To date, according to Kluge, there have been 16 confirmed reports of attacks on health facilities in Ukraine. However, on Wednesday, a Russian attack on a large maternity and children´s hospital in the beseiged city of Mariupol left at least 17 people injured, Ukranian authorities said.  WHO said it was aware of the reports and investigating that latest incident.

The day after: conflict, COVID-19 sap ‘ability to cope’

Nitzan said that while the doctors and other medical staff are now working in emergency mode, she worries for the day after the war. With so many refugees fleeing to other parts of Europe, there will be a “brain drain” in Ukraine.

“The strongest people left,” she said. “The people left behind will be the sick, the elderly and poor.”

And it will cost the country and the world a steep price to rebuild Ukraine, which could detract from other global health priorities, though she was not specific.

Dr Dorit Nitzan with a partner volunteer at the NATAN Worldwide Disaster Relief organization healthcare clinic in Medica.
Dr Dorit Nitzan (right) with another volunteer from the NATAN Worldwide Disaster Relief organization.

Over the last six or seven years, WHO worked closely with Ukraine to improve its health system, including offering universal health coverage and improving hospital care. The country had stocked medicine warehouses and was more prepared than expected, she said.

“The conflict, together with COVID, has left Ukraine with no ability to cope,” Nitzan said. “The margins are so thin, and everything is so fragile.

“I am afraid that whatever was achieved from 2015 until now and so much more will have to be rebuilt.”

Image Credits: NATAN Worldwide Disaster Relief organization, NATAN Worldwide Disaster Relief organization .

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