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In frontline Ukraine, global pandemic puts people at unimaginable risk

In their policy paper, Vostok SOS asked Ukraine’s Ministry of Reintegration of the Temporarily Occupied Territories to monitor the provision of medical facilities along the contact line as well as the situation for staffing, medicine, medical equipment and protection equipment. This programme should also monitor access to health services for citizens residing in settlements along the demarcation line.

“The entry/exit points should be closed,” Rieutsky says, with obvious dismay in his voice. He’s referring to the checkpoints that regulate movement between Ukrainian-controlled territory and non-governmental controlled territory. “In order to prevent the worst from happening, we need to restrict the mobility of people as much as possible.”

Rieutsky’s distress likely concerns the state of the healthcare system in the non-governmental controlled territories. It’s been damaged in the six years of protracted conflict and, subsequently, by economic blockades and international sanctions. Healthcare infrastructure has been disrupted by its complete disconnection from medical supply chains in governmental-controlled territory. This has caused a continuous shortage of medicine, equipment and staff, as quite a few specialists have left because of the war.

In mid-March, almost at the same time as the Ukrainian government, the de-facto authorities of non-government controlled territories proclaimed “high alert” regimes. This implied that the “border” between the two so-called “Donetsk People’s Republic” and “Luhansk People’s Republic” was closed, medical staff were deployed at the entry/exit point and checkpoints in order to identify people with relevant symptoms, such as high fever, and to send them to the relevant infection hospital. The de-facto authorities have started cooperating with UN agencies to ensure provision of necessary Covid-19 material and equipment, but the concern that the restricted access to the regions increases a massive outbreak remains.

The first Covid-19 case in non-governmental controlled Luhansk was announced on 28 March. But as of 29 March “they are still not keeping the quarantine and not cancelling mass events, or clubs,” says Pavel Lisyansky, representative of Ukraine’s human rights ombudsman in Donetsk and Luhansk regions. “Judging from this and their media environment, you could get the impression that they are not afraid of the virus at all.”

The main reason to hide the pandemic outbreak in the non-governmental controlled territory is to avoid public panic and a rush towards the border with Russia. As soon as people are aware of the pandemic risks, Lisyansky explains, they might demand proper medical treatment which the grim medical infrastructure in these regions cannot provide.

Tests taken in non-government controlled Luhansk are taken to the bordering Russian region of Rostov. The city of Donetsk has a laboratory capable of running the tests but it seems highly questionable whether it will be capable of dealing with an influx of tests from several hundreds of patients as soon as the pandemic unfolds. The Eastern Human Rights Group reports that hundreds of people have already been hospitalised with suspected pneumonia in non-governmental controlled territory. Meanwhile, Russia, which normally controls each and every political step in the region, is absorbed with its own pandemic outburst. “This is why the curators in the Kremlin have decided to maintain silence on this topic in these regions,” Lisyansky explains.

When it comes to hospitals under Ukrainian control, Lisyansky is more optimistic. The NGO he founded, the Eastern Human Rights Group, is in touch with hospitals in the region and aware that many of them lack equipment and relevant material. Yet help from Kyiv is coming, he says, with funds and masks allocated to various local hospitals. Due to their exposure to regular shooting, hospitals in frontline cities like Svitlodarsk have established strong ties with international organisations and NGOs. Now the doctors working in Svitlodarsk are doing their best to prepare for the pandemic. “In the course of six years of war, people have developed the skills to survive in extreme situations,” Lisyansky says.

On 18 March, my colleague and I were released from hospital in Kostiantynivka before we received our results. Forty eight hours after our hospitalisation, medical staff received an order to free the beds for patients suffering from more severe symptoms. They did not know when our results would be available, but promised to inform us via phone. Because we were among the first suspected cases in Sloviansk, local media followed our treatment closely. When we returned to town, the information that our tests were negative went viral over social media – two days before we received confirmation by phone from the hospital. Will the medical systems in Ukraine’s conflict-affected regions be able to adapt quickly enough to contain the outburst of the crisis? The fact that no one knows remains the greatest cause of anxiety.

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