War in Ukraine: the impacts on child health

[摘要] The Russian invasion of Ukraine has triggered an enormous humanitarian crisis that has inflicted, and continues to inflict, deep and enduring harms on human health. One of the groups most heavily affected, including the greatest impacts on health and wellbeing, is children.Prior to the outbreak of war, child health in Ukraine was heavily burdened by concerning rates of infant mortality, low provision of routine vaccinations, and high prevalence of infectious diseases including multidrug-resistant tuberculosis.1 As such, the country’s over-stretched and under reform health system, which is officially state funded yet considerably supplemented by out-of-pocket payments,2 was poorly positioned to respond to the additional burdens of child health created by the war.SEPARATED FAMILIES Russian aggression has so far triggered over 13 million Ukrainians to flee their homes, including 5.4 million refugees who now reside in neighbouring European countries to the west of Ukraine,3 and 7.7 million internally displaced people who have left their homes but remain in Ukraine.4 The majority of these migrants are women and children, because the imposition of martial law on 24 February 2022, in preparation for potential military conscription, prohibits male citizens aged 18 to 60 years from leaving the country. As such, tens of thousands of families have been separated, and many children migrate unaccompanied, as parents remain at home to preserve the household income and dispatch their children westward towards areas of safety.5Before escaping Russian hostilities, many children are forced to shelter for extended periods in crowded, cold, and unventilated spaces that are patently unfit for human habitation. Consequently, they now suffer from infections, infestations, and musculoskeletal disorders, as well as a significant burden of acute illness, uncontrolled chronic disease, poor sanitation and hygiene, dehydration and malnutrition, psychological injury, and mental health deterioration. After managing to escape to safer locations, hundreds of thousands of children now reside in temporary evacuee centres fashioned from repurposed schools, nurseries, and gymnasiums. Conditions in these facilities are often cramped and unheated, creating optimal conditions for transmission of respiratory infections in groups of children with poor initial health.

[学科分类] 卫生学