However, it has proven its sustainability and continues to work, in parallel to the strategy of post -war recovery. What Ukrainian doctors and patients who receive from international partners need about the situation in the frontal and recently deocal regions, as well as the threat of a new wave of morbidity at the COVID-19, which has already risen in Europe, NB, the NV asked the most. Habihta, Head of the World Health Organization (WHO) Office in Ukraine.
- What are the key needs of the Ukrainian health care system today and what does WHO do to help satisfy them? - Due to the Russian invasion, the health care system of Ukraine was extraordinary. Medical workers who do huge work in very difficult conditions, patients who receive help in shelters, give birth to children, as well as millions of Ukrainians who move the country-all this is a real stress test for the system.
It is also worth mentioning a large number of residents of occupied medical care areas. Five months ago, no one could imagine that. The WHO representation in Ukraine supports the humanitarian response [to the situation in Ukraine] and cooperates with the Ministry of Health (MOH) and the authorities. Our team works in Kiev, Lviv, Poltava, Dnipro and Vinnitsa, and another office in Odessa is being prepared for opening.
Our support varies from providing medicines to the organization of trainings for medical staff. In the most general calculation, we have already sent 860 tons of medicines to Ukraine - including traumatological kits, medicines, electrical generators and ambulances - and half of this volume was distributed to the establishments that most need them.
We also conducted first aid trainings in mass lesions and additionally - for chemical attacks for more than 2 thousand health workers in several regions of Ukraine - mainly eastern and southern. Over the next months, we will continue to teach and share WHO recommendations.
According to our observations, if in the first months after February 24, the most popular assistance for injuries and medicines for its provision and for surgery, then in recent months the need for rehabilitation and polychronic care - that is, available medicines for cardiovascular disease, diabetes etc. Together with [Minister of Health] Viktor Lyashko and Lady Elena Zelensk, we also support mental health initiatives throughout Ukraine.
For example, we conduct [Self-Help Plus) self-help training in the WHO And we do not forget that Kovid is still near. Moreover, the number of cases in Ukraine is increasing - as well as throughout Europe. Finally, what I consider to be unique in Ukraine: despite the ongoing war and a very loaded health care system, there is a lot of reflecting on restoration and rebuilding.
In this area, WHO, together with partners, works to preserve optimism in such unprecedented time and to determine the principles of building and restoration of health care system in such a way as to continue the reforms that began in 2016. We have defined five basic principles that we must follow for successful recovery. First, the system should be more flexible-this is what we have understood in the last five months.
Secondly, it should be more human-centered, as Ukrainians have a lot to improve the health care system. Third, it is fair-to provide financial protection, because we do not want to remove every second hryvnia from their own pocket. Fourth, the system should be more effective and, in the first way, more accountable to get rid of corruption.
- Do you have access to the occupied territories to supply medicines or provide medical services? Do you help the cities that are firing the most? - Initially, we had access to many such places - Kharkiv, Sumy, Kherson. In recent months, this has become more difficult. But just a few days ago, we had the opportunity, together with several UN agencies, including the World Food Program, to deliver medicines to Kramatorsk and surrounding areas.
I have to admit that it is very difficult to deliver humanitarian aid. We ask for the provision of humanitarian corridors, and in the meantime we prepare kits for the treatment of wounds, injuries and emergency surgery, other medicines in Dnipro, Poltava, Odessa - to give them civilian [in the occupied territories].
- If we talk about military medicine, how well do Ukrainian doctors cope with complex polytraumas, in your opinion? And what help in this area does WHO provide? - Our organization does not specialize in military injuries as such and does not work directly with military doctors. We are engaged in humanitarian assistance. But, having communicated with many doctors who have gained experience in Ukraine since 2014, I know that Ukrainian medical institutions are knowing such assistance.
- Do you think that residents of frontline areas have sufficient access to medical services? - According to the reports and according to my assessment of the situation in the south and east of Ukraine, there are more medicines, as well as operating equipment - all necessary for the treatment of injuries and burns, amputations.
Since we have already certified hundreds of attacks on the Ukrainian health care system, including those that have led to the death of medical workers and civilians, we understand that such a need always exists - especially where fighting is ongoing.
This issue is invariably in the focus of our attention: we make sure that in the regions where hostilities continue, the WHO teams or united humanitarian convoy, which would send medicines as close as possible to the front line and assist the health workers there. - In the destroyed and captured occupiers of cities, people run the risk of getting cholera and disinfectant, on the front - on the tetanus, which is called trenches.
Are there any risks that there will be an epidemic of these diseases in Ukraine? To what extent is the country ready to treat these diseases? And how can they be warned? - It is important that in war, Ukraine has a working health care system. Our task is to evaluate the risks and provide support where it is needed. Together with hundreds of partners, WHO assesses the public health system in sections of infectious diseases, non -infectious diseases and the risks of epidemics.
Since April, we have calculated that a number of flares have high risks [turn into an epidemic]. In particular, we have to treat cholera carefully - especially now, in the summer. Realizing that there is a risk, we began to pay much attention to information. In the last few weeks, we, together with health authorities, have made a lot to increase the population about cholera and other diseases that can be infected through water and food.
In particular, more than 300,000 information leaflets were distributed, social networks and other channels were used, and as a result, more than 12 million Ukrainians were covered with their information campaign. We also prepared more than 5,000 cholera diagnostic tests in Ukraine to be able to use them, consulting safe water, water and sanitary systems, and organized a number of trainings for epidemiologists.
- Do you think vaccines in Ukraine? And did the level of planned vaccination among adults and children have changed since the war? - We were convinced that Ukraine is provided with vaccines in the coming months. But together with health authorities, we continue to look for gaps, evaluate what the situation will be at the end of the year and in 2023, and where we can help. We also follow the presence of vaccines in the deoculated territories - in the Kyiv, Chernihiv, Sumy regions.
And we strive to make sure that in the western regions where many temporarily displaced Ukrainians live, vaccines are in excess. At present, more than 6 million Ukrainians have temporarily or constantly changed their place of residence. As for the overall level of vaccination, I have to admit that it has fallen. Therefore, it is important that people take care of their vaccinations on their own. For example, measles: each adult should have at least one dose, each child - at least two.
If you are in the process of moving and know that they have not received these vaccinations, contact your family doctor, the medical center, health authorities. The same goes for diphtheria: children should receive three doses, and in adulthood, revaccination should be performed every ten years. For the prevention of pertussis, children need three doses, and adults have two revaccination plus a booster. I would also recommend vaccination against seasonal influenza.
We see that many people are now catching up with COVID-19 vaccinations, and we notice informational campaigns on the streets on vaccination. Now, when the incidence is going uphill both in Europe and in Ukraine, it is important to make sure that people enjoy a booster dose, and those who have not yet done the first two vaccinations are doing so.
- Do you have statistics on the number of Ukrainians who have received a third dose of the KOVid vaccine? And will the need and be possible to make another - fourth? - We still collect such statistics. I know that as of February 24, almost 40% of adults have been vaccinated with KOVid, and in some cities, such as Kyiv and Lviv, vaccines were over 60%. But, of course, in the first two months of the vaccination war they began to do less.
Many vaccination centers were closed and some survived the attacks and were destroyed. Therefore, in some cities and villages, they had to create new centers and deliver vaccines there. By the way, I would like to assure that with the support of WHO, the global initiative of Covax and other partners Ukraine will continue to be provided with vaccines.
Last week, the European Technical Advisory Group, which advises vaccination against Covid-19, suggested that the second booster vaccination with moderate or severe immunodeficiency and chronic diseases. There are vaccines for these categories in Ukraine. However, when thinking about the booster doses, it should be remembered that by February 24, many elderly Ukrainians have not been vaccinated at all.
Therefore, we must pay attention to the elderly and those who have chronic diseases - to make the first and second doses. Moreover, autumn is approaching and we see an increase in the incidence level in Europe. - Can you name the numbers about increasing the incidence of coronavirus in Ukraine? - We see that the incidence rate is growing, but not in all areas. [The number of confirmed cases in Ukraine after February 24 began to decline sharply and from 191.
6 thousand cases per week on February 14-20 fell to 905 cases on July 4-10; However, in the interval by July 17, the indicator increased to 1. 4 thousand - data provided by WHO representation in Ukraine after the interview. ] However, we must remember that the morbidity has changed now, as testing tactics have changed: not everyone is doing tests. - In your previous interview, you said that one of the functions of WHO in Ukraine is monitoring attacks on health care facilities.
Do you have data on the amount of destroyed and damaged hospitals? And does your organization support efforts to restore them now when the war is ongoing? - Indeed, one of the Tasks of WHO is to monitor, check and report all attacks on the health care system. We have recorded more than 400 such cases. Among them are attacks on primary care centers, hospitals, fast.
At the same time, visiting some medical facilities in Irpen and Bucha, I am very optimistic, because I see how quickly the authorities restore water supply, patients with patients' medical records and access to [database] EHealth. We, for our part, assist with mobile medical teams and medicines until health care facilities have not yet resumed their work. Such teams consist of Ukrainian doctors who work on weekends and who we financially support.
A few months ago, I watched the work of the mobile medical team in Gostomel and I was glad to see how 50 patients came to the family doctor on Saturday and received their medicines, because at that time the pharmacy did not work yet. In the last five months, I have understood well: there are many intelligent and very bold doctors and nurses in Ukraine. And our task is to maintain them so that they can do their work.
As for recovery in a broader context, the WHO task is to collect all partners together with the Ministry of Health and make sure that we have a common vision of a more intelligent, green and effective health care system for people. Therefore, since April, we are discussing how to make sure that after reconstruction, the health sector will become even better: more intelligent, digitalized, appropriate requirements of European integration. Medical institutions may be different.
And here it is important to remember the five principles I mentioned at the beginning of the conversation. - While it is summer, but autumn and winter are approaching. This is the season when logistics is complicated and people are more likely to get sick. How do you plan to make sure that Ukraine is provided with medicines, equipment and staff for the cold season? What are you doing for this? - Currently, the United Nations is developing a Winterization Strategy.
And this is much more complicated than just health care. It is necessary to take care of energy supply and fuel, shelter, food, and health. What the Ukrainian Ministry of Health asked in our organization is to supplement what the state provides. The first priority is that Ukraine has working pharmacies and hospitals, available medicines, working doctors.
WHO as a humanitarian response should make sure that the country has reserve stocks of all necessary for the treatment of injuries and injuries, as well as drugs for chronic diseases. After all, the war is ongoing, we see daily attacks, including civilian infrastructure. We also study whether Ukraine needs more cancer treatment, as well as vaccines in vaccines by the end of this year and in 2023.
- Finally, I will ask you to remember what struck you the most in the last five months in Ukraine? - I have to admit, there were many impressions. Having worked in Ukraine for almost four years, on the one hand I am a diplomat, but on the other - I feel at home in Ukraine. I saw doctors, colleagues who did their work in incredible circumstances. I know many Ukrainians - and among them every five member of our own team - who lost their property, home or even relatives.
There are many emotions that I have to digest and that will stay with me for the rest of my life. Usually these are very sad emotions. But there are others. For example, when traveling in the Kiev region, I saw people who returned, planting potatoes and flowers, cleaning gardens. Talking to them, I realized why they needed the primary care center - because then they feel safety. I realized how important the cornerstone is a health care system for a sense of security.
I was also amazed by the resilience of Ukrainians. We have resumed all the work we did with the authorities before the beginning of the war. Ukrainians look into the future and continue to work on vaccination and other health issues. Often recovery begins when missiles are not flying, but in Ukraine it is not. Ukrainians say that we cannot wait until tomorrow, we must make the garden in order and to be provided services. And everyone makes efforts to move forward.
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