A letter from Ukraine: challenges for primary care

[摘要] Wars are complex and they lead to the breakdown of society, damage infrastructure, and have economic impacts. Although it is too early to tell what consequences will occur in the wake of the war in Ukraine, our healthcare system will likely take a huge hit.Primary care professionals have been on the frontlines of the Russian invasion, especially in eastern Ukraine, even continuing to work in primary care clinics.After the introduction of martial life, primary care doctors were transferred to working shifts on-call and provide remote counselling. All primary care clinics have on-call medical offices, where family physicians and specialist doctors provide necessary assistance. Primary care physicians also vaccinate against COVID-19, vaccine-preventable diseases, and perform necessary tests.Kharkiv and the Kharkiv region where I live and work were among the first areas attacked by Russia. From the first day of the war, Russian troops have been barbarically destroying civilian infrastructure and exterminating civilians in Kharkiv. Residential buildings, hospitals, schools, and universities are still continually under air-strikes and bombing.HEALTH CARE AND MEDICINES The whole process of family physicians’ work in Kharkiv and the Kharkiv region has been reformatted in the name of security.Consequently, our family doctors consult with their patients online or by phone. Those requiring a personal appointment attend by prior arrangement and are separated by allotted timescales so there are as few people as possible in the building at one time. Medical staff who do not have appointments in the offices can stay in touch with patients, advising them through Viber cameras, and other messaging or communication channels. Military logistics have been created. In one direction medicines and humanitarian supplies go from the west of the country to the east. In the opposite direction there are patients being transported with serious diseases who have subsequently lost the opportunity to receive the necessary treatment due to the hostilities. Significant assistance is provided by international partners supplying humanitarian goods (such as medicines), which are immediately redistributed to health facilities with the most critical need. There are separately formed packages of medicines, which — if and when humanitarian corridors open — are transferred to those territories where transportation by conventional logistics routes is impeded by Russian forces.

[学科分类] 卫生学