The war in Ukraine is life-changing for a myriad of reasons. We are living through history. Many of us just beginning to enter college or navigating our way through high school have become so accustomed to these declarations that we do not blink twice. After the COVID-19 pandemic, there is no "normal" and we have to adapt on a daily basis to what the next major event is. At this point, it would not be so out of the ordinary to be told that there is an alien invasion that will occur in the next year. We have faced so much strife that these abnormalities are not abnormal, especially with the past year being filled with more death and loss than ever imaginable.
In Ukraine, though, death has not simply been a result of the bullets and bombs of those engaged in combat, but instead, innocent citizens are facing the repercussions. Yes, the data comes from over a month ago on March 2, but the UN claims that 136 civilians had died at the time— a catastrophic number. Many of them are fighting a war that they are not even sure how began, with many being the same age as or even younger than myself. However, some deaths have been a result of the wider implications of conflict on public health based on the definition of war.
Image: Russian troops have left death and destruction behind in Ukraine with warfare raging on. Cars are completely burned-out and homes are entirely destroyed, even flattening tanks in the wake of the war. The warfare is so ravaging that the top turret of the tank was even crushed and
War: The Battle Beyond The Field
Wars are complex health emergencies. We generally think of infrastructure collapsing in terms of governmental and civil disarray, but what about the children, mothers, and the disabled who were already disadvantaged before? Previously, Ukraine had over 3 million people that needed humanitarian aid because of the eight-year-long conflict, but those individuals never received the complete assistance to be entirely recovered. There are hundreds of thousands of refugees in Ukraine after the war, especially those in need of medical oxygen supplies.
“Beyond hospitals, primary care, screening, and immunization programmes will have been disrupted. This means that people with chronic diseases such as diabetes or heart failure may not get optimal treatment— if any at all” (Lee, Ukraine: War has an impact on people’s health beyond bullets and bombs). What about individuals with undiagnosed diseases such as precancerous cells, or who are in need of testing for genetic disorders? With the lack of screening programs, cancers, amongst other diseases, maybe missed or diagnosed too late, increasing the death rate even more than just as a result of combat.
Image: After the constant air raids, many families have lost their homes and livelihoods, fearing for their lives. The safest option is to travel to a shelter where the necessities are provided and many are in subway stations. In cities like Kyiv, families are living in these shelters on mattresses with small children losing their homes and livelihood.
The Infinite Pandemic
What about contagious viruses? Although COVID-19 seems to be something of the past, it still ravages and destroys individuals and their families, especially those that are elderly. In a time of war, the risk of infectious diseases or viruses spreading increases because there is a lack of a supply of clean water and sanitation. Obtaining COVID-19 boosters may be compromised, so variants that may have less of an impact on the population could potentially have a greater impact on an area such as Ukraine in which the vaccine rate is reduced in comparison to other nations. For instance, with the Syrian conflict, there was a lack of polio vaccines, which resulted in an outbreak of polio in 2017.
In particular, Ukrainians are forced to seek shelter in crowded trains, bomb shelters, and refugee processing facilities, which are locations where COVID-19 can be transmitted rapidly. When Russia invaded Ukraine on February 24, the number of COVID-19 cases in the country had declined from the beginning of February, when Omicron peaked with over 37,000 cases each day. This was at a time in which testing was easy to obtain, but obviously, due to other priorities during wartime, there is a low vaccination rate of approximately 36%, and with the aforementioned lack of testing obtainable, the number of citizens that claim to have the virus is lower than would hypothetically be inferred.
However, even if individuals were to test positive for COVID-19 in Ukraine, they would have little to no medical facilities to seek care from. Based on the WHO’s Surveillance System for Attacks on Health Care, 73 attacks occurred on Ukrainian health care facilities between the beginning of the war and March 28. There are innocent patients who are facing repercussions, as, unfortunately, three were killed in a Russian airstrike on a maternity and children’s hospital in Mariupol, Ukraine. On top of this, “some 17 people were also injured, including staff and patients, local officials said” (Ukraine war: Three dead as maternity hospital hit by Russian airstrike). The ramifications occurred during a ceasefire with Russia, causing colossal damage beyond injuring the patients at the hospital with burned buildings, obliterated cars, and a gigantic crater outside the hospital. This war is killing innocent people, but beyond that, what about mental health?
Image: The week of March 7, three people, including a child, were killed after a Russian strike on a maternity and children's hospital in Mariupol. Approximately 17 others were also injured. The strike caused colossal damage, as it was clearly an attack on vulnerable civilians of Ukraine.
The Impact of War on Children
PTSD (Post-traumatic Stress Disorder) is often characteristic of soldiers in combat but is also a condition that ravages the innocent citizens of Ukraine, especially children. There is a routine for these children, as they have to think about the potential of combat reaching their homes. The different outcomes and potentials race through their minds, as there is a protocol that has to be followed to ensure their safety.
“When you hear a shot, you run to the basement, hide, and wait for the explosion. You need to survive while you run to the basement. And then you need to survive in the basement” (UNICEF, Ukraine conflict affecting children’s mental health: UNICEF).
Beyond PTSD, children are even developing diabetes as a result of this conflict-related stress, with blood sugar levels peaking throughout the day. Families are feeling the strain, as parents must brave a strong face, although their physical and psychological well-being are deteriorating, as well. Is it best to shade one’s children from the events that are happening around them, or is telling the truth to one’s children part of adapting to living through history?
Image: Ukrainians are forced to flee their homes for their own safety. Men aged 18 and above must remain to fight for their country, while women and children are able to flee the wreckage that was once their homeland. Families are often separated, and the adoption processes are currently unknown for children in Ukraine.
The challenge now is understanding the ramifications of every decision and prioritizing safety over all else. Safety is surviving the impacts of destruction and fighting for the rights that every citizen of Ukraine deserves. The ability to live life in peace with guarantees of healthcare and safety is clearly a basic human right; however, in times of crisis, essentials become desires, and living in the current moment means coping with the current moment. Health needs to be a priority and, regardless of the circumstances occurring, children need to be protected. Safety is a question, but every country should do its very best to help in this effort for the success of the future.
Below is a donation organization (The United Nations World Food Programme) that collects funds to assist people with food accessibility who are affected by the conflict in Ukraine and other nations: