Despite a calming of the conflict in eastern Ukraine, thousands of people remain displaced from their homes or are living in dire conditions without access to basic healthcare.
Health workers have fled from hospitals, medical facilities have been damaged and destroyed, and there are critical shortages of medicines. Medical needs remain urgent on both sides of the frontline, for residents and displaced people.
Médecins sans Frontières/Doctors Without Borders (MSF) has expanded its medical activities to respond to the medical needs on both sides of the frontline.
Natalie Roberts, MSF emergency coordinator, is part of a team that is providing assistance to the people in Debaltseve, located halfway between Donestk and Luhansk.
Debaltseve has remained under rebel control, and heavy fighting continued here until 18 February – three days after the ceasefire came into force.
Here, Natalie describes the situation in Debaltseve.
The aftermath of conflict in Debaltseve
“The team that I’m working with reached Debaltseve in mid-February, three days after the fighting had stopped. There were still unexploded shells in the city.
Even when I arrived at the beginning of March, it was clear that heavy fighting had taken place very recently. Almost every window had blown out, walls had huge holes and most roofs had extensive damage.You couldn’t turn around without seeing a damaged building and you still can’t.
Today people are living in the same conditions. Most of them have left the basements and shelters where they took refuge during weeks of shelling, they moved back into their houses. But shelter remains the most significant issue.
Returning to a ruined city
At the height of conflict, most of the city’s 25,000 residents had fled, and around 5,000 were left behind. Now, more people are coming back every day.
Those who stayed had no choice or nowhere else to go. Some couldn’t leave because they were too old, disabled, or they just didn’t want to leave their homes.
Today the population has grown to 13,000. Some are coming home because they have nowhere else to go, but there is not a lot for them to come back to. And all of them, those who stayed as well as those who are coming back, are completely dependent on food aid.
The reconstruction of Debalsteve hasn’t started yet. People are still living in buildings with no heating and no water supply. People want to rebuild their homes, but there are no building materials, just plastic sheeting for the windows.
It is still cold, and it snowed 10 days ago. The communal heating system is not functional because the pipes were damaged by the weather and the fighting.
Electricity was reinstalled just in some locations. To get water, people have to walk to get it from wells and the water quality is appalling.
MSF’s ‘district nursing service’
When we first arrived, we started visiting people in their homes. We now have a phone number that people can call and a nurse or a doctor will drive out to see them, like a district nursing service.
Most of the population is elderly. And most of the treatment we are providing is for people with chronic medical conditions, like hypertension or arthritis, who have gone for months without treatment. The conditions they have been living in – the cold, the stress – have made their illnesses far worse.
I went to see one man suffering from arthritis, who was living in an apartment whose roof and walls had been badly damaged. It was incredibly cold, and without medication his arthritis had deteriorated to the point that he is now immobile.
Another of our patients is a double amputee who lost both his legs when he worked on the railways. He can no longer use his wheelchair because the wheels don’t work on the uneven ground.
MSF mobile clinics in Debaltseve
We also run a mobile clinic out of a van which moves around the town in different pre-advertised locations each day. We advertise where we’ll be, and treat about 60 people per visit, limiting the numbers so that people have enough time with the doctor.
Without any improvements to their living conditions, people with chronic illnesses will continue to get worse, despite the medical care we can provide.
I’ve met elderly people who say that they would just like to die. They don’t have depression; they just don’t want to be 80-years-old and living in a basement.
People are not sure what the future holds, and they don’t know what to do with themselves. It is almost as if the fighting went on for so long, people are afraid to have hope that it won’t start again.”
