（英文）行业资料 WHOs response to the Ukraine crisis- annual report,2022

WHO’sresponsetothe

Ukrainecrisis

Annualreport,2022

2

Documentnumber:WHO/EURO:2023-5897-45662-68308

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Coverphoto:©WHO/SimonMóricz-Sabján

AmotherfromeasternUkrainewithherdaughterataregistrationcentreattheHungarian-Ukrainianborder,Beregsurány,08March,2022

3

WHO’SRESPONSETOTHEUKRAINECRISIS

ANNUALREPORT,2022

Contents

Foreword

4

WHO’sresponseinUkraine

8

Specificobjective1:Accesstoemergency

andcriticalmedicalcareisstrengthened

9

Specificobjective2:Infectiousdiseases

arepreventedandrespondedto

13

Specificobjective3:Emergencyhealth

informationandsurveillanceforevidence-

baseddecision-makinginhealthare

reinforced

14

Specificobjective4:Effectivecoordination

ofhumanitarianinterventionsinthe

healthsectorisensured

15

WHO’sresponseinrefugee-receiving

andhostingcountries

17

Bulgaria

19

Czechia

21

Hungary

23

Poland

25

RepublicofMoldova

29

Romania

32

Slovakia

34

Ensuringaneffectiveand

saferesponse

36

Fundingandpartnershipsoverview

38

Acronyms

EMS

EMT

EMTCC

IDP

IEHK

MHPSS

MoH

NCD

NCDK

NGO

PRSEAH

PSEA

RCCE

RDT

SEA

SOP

TESK

TWG

emergencymedicalservicesemergencymedicalteamEMTcoordinationcentreinternallydisplacedpersons

interagencyemergencyhealthkit

mentalhealthandpsychosocialsupport

ministryofhealthnoncommunicablediseaseNCDkit

nongovernmentorganization

preventingandrespondingtosexualexploitation,abuse,andharassment

protectionagainstsexualexploitationandabuse

riskcommunicationand

communityengagement

rapiddiagnostictest

sexualexploitationandabusestandardoperatingproceduretraumaemergencysurgerykittechnicalworkinggroup

4

Foreword

DearPartners,

Since24February2022,thewarinUkrainehascausedwidespreadsufferingtoitspeopleandseriousdamagetothecountry’sinfrastructure.

Attacksonthecountry’shealthsystemanditspowernetworkthreatenpeople,compromisetheprovisionofhealthcare,andcomplicatethedistributionofessentialmedicinesandequipment.

Delaysandinterruptionstotreatmenthavebeenaffectingmillionsofpeople,exacerbatingwar-relatedtraumaanddiseasebothwithinandbeyondthecountry’sborders.Attheendof2022,morethansixmillionpeoplelivinginUkrainewerethoughttobeinternallydisplaced,whiletheEuropeanRegionnowhostsalmosteightmillionUkrainianrefugees.

ThescaleoftheemergencyinUkraineandtheresponseitdemandsisgreaterthananythingseenintheEuropeanRegionfordecades.Despiteintensepressure,thehealthsystemisstillfunctioning,andemergencysupportisavitallifeline.

WHOistheUNsystem’sleadhealthcoordinator,itsresponseextendingthroughoutUkraine,facilitatingthedeliveryofhealthservicesin-country,aswellasintherefugee-receivingandhostingcountriesprofiledinthisreport.

WorkingwiththeUkrainianMinistryofHealthandmorethan190healthclusterpartnerstoovercomemassivedisruptionandunprecedentedsupply-chainchallenges,WHOseekstohelpmaintainhealthcareandgettreatmenttopeopleinhard-to-reachandregainedareas.Insomeregainedareas,WHOhasjoinedhumanitarianconvoyswithin72hours,todelivermuch-neededmedicines,equipmentandsupporttofirstaidworkersasquicklyaspossible.

Theresponsetoouremergencyappealshasmeantthatover8.4millionpeopleindesperateneedwithinUkraineitselfhavebeenabletoaccesshealthcare,receivetreatmentandgetthemedicines,vaccinesandtherapytheyurgentlyrequire.WHOisonlyabletodeliveratthislevelbecauseofourresourcepartners,andthespecificimpactofthedonationswehavereceivedisoutlinedinthefollowingpages.

Ensuringthehealthandwell-beingofallpeoplehasbeenatthecoreofWHO’smandateandcommitmentsfor75yearsnow.Withyourassistancewewillcontinuetobepresentwhereweareneededmost,andworktirelesslytoprotectpeoplefromharm,minimizemorbidityandlaythefoundationsforrecovery.

EffortstorebuildandresumethejourneytowardsbetterhealthinUkrainearealreadyunderwaybutwilltakesignificanttimeamidthisprotractedcrisis.AllofusatWHOsincerelyhopethatalongthewaywecancontinuetocountonyourlife-savingsupportforthepeopleofUkraine.

HansHenriP.Kluge

RegionalDirector

WHORegionalOfficeforEurope

©WHO

7April,2022-WHO/EuropePressBriefingfromLvivUkraine-RegionalDirector’sstatement

5

©WHO

7April2022:Kharkiv,Ukraine.Theplaygroundisemptyandsilent,nolongerasafeplaceforchildrentolaughandplay.

TheUkrainecrisishashighlightedseveralimportantlessonsintermsofpublichealth,includingthefollowing:

Healthisessentialforrecovery;itiscriticaltomaintainessentialhealthservicesinwar-

affectedareasintheshortterm,andequally

1chuacltils-rion.

2iitn,li,se

Coordinationofsectoralresponseinvolvingallhumanitariananddevelopmentpartnersiscritical

tosuccessfulassessment,planning,

needsoftheaffectedpopulation.

3tapDiyleoy,

tofuturedisastersorhealthemergencies.Fortimelimitedstopgapmeasures,theinternationalEMTnetworkcanalsoprovideurgentsupport.

EmergencyMedicalTeams(EMT)meet

urgentlife-savinghealthneedsofaffected

4shocksincludingthoseinvolvingrefugee

Strengtheningnationalhealthsystemsshouldbeapriorityforcountry

preparednesstopromoteresilienceto

influx;thisensurescontinuityofservicesevenascapacityisbuilttorespondtoemergingneeds.

arcilenaihacdsahl

Supportforinternallydisplaced

disadvantaged;equally,financialprotectionshouldbeensuredforhostpopulationstopromotesocialcohesionandhealthforall.

6

“

©WHO

WHOfieldofficersvisitanimmunizationcenterintheRivneOblastinUkraine.

includingWHO,tosupportthosemostimpactedbythedevastatingwarinUkraine.WHOhasbeenastrongallyandpartnerinsafeguardinghealthcareinUkraine,andwehavebeenworkingcloselywithWHOtoensurethattherighttohealthcareisrespectedandprotected.WecontinuetoplaceourtrustinWHOtominimizedisruptionstothedeliveryofhealthcareservicesandensuresafeaccess.

MichaelKöhler

DeputyDirector-General,

W“ehavebeenworkingcloselywithourpartners

T“hepeopleofUkrainehavebeenunderrelentlesspressure

andtremendousstress.Mentalhealthissuesareemerging,thesewillbeoneofthemostdevastatingandlonger-lastingconsequencesofthewar.Despitethechallenges,wewillcontinuetostandtogetherinunityanddefiance.Wewillcontinuetohelpeachotherandfortifyourcommunitytoovercomethisgreataggressionandtragedy.TogetherwithWHOandotherpartners,wewillensurementalhealthsupportforourpeople.Togetherwewillpersevere.

OlenaZelenska

FirstLadyofUkraine

©WHO/OlhaIzhyk

ElderlypatientsshelterinthebasementofNovovolynskHospital,westernUkraine.

ThehumantollandimpactofthewaronthepopulationofUkrainehasbeendevastating.Deathandsufferingofcivilians,ravagedurbanandruralareas,andtotallossoflivelihoodsformillions.Thewarhasresultedinmorethan21millionpeopleinneedofhumanitarianassistance–includingfood,water,shelterandhealthcareservices.TheUNinUkrainecontinuesourworktoensurethathealthservicesremainavailableinUkraineandthatlife-savingmedicalsuppliescontinuetoreachthosewhoneedthemthemost.

DeniseBrown

UNResidentCoordinatorin

Ukraine

DGECHO

©WHO/UkaBorregaard

Przemyslhospital,Polishborder–March2022

7

“Russia’swaronUkrainehasseverelyimpactedthelivesandsafety

ofcivilians.Theglobalcommunitymustworktogethertoalleviatethesufferingofthemostvulnerable,includingtheUkrainianelderly,womenandchildrenwhohavesufferedduetothiswar.WecontinuetoworkinclosecoordinationwithWHOtodelivermuch-neededhumanitarianassistanceandensurehealthcareservicesremainavailabletorefugeesaffectedbytheUkrainiancrisis.Healthcareisafundamentalhumanright,andweremainsteadfastinourcommitmenttopreservingthisright,andtotheUkrainianpeople.”

©WHO/AnnePellichero

PeoplefromKharkivcomeeverydaytogivebloodtoensurethereisafunctioningbloodbank.

“

JulietaVallsNoyes

AssistantSecretaryofStatefortheUSBureauofPopulation,Refugees,andMigration

©WHO/MartaSoszynska

Ukraine:Ukrainianspreparetoleavetheircountry,Lvivtrainstation-March2022

ThewarinUkrainehashadaheavytollonmy

peopleandonessentialservicesincludinghealth

care.Healthisafundamentalhumanrightnotleast

intimesofwar,andwemustsafeguardit.Health

careservices,healthworkersandpatientsarenot

atargetandmustallbeprotectedfromharm.With

thankstoWHO,wehavebeenabletoensurethat

healthservicesremainfunctionalandthatlife-

savingmedicalsuppliescontinuetobeavailable

andreachthemostvulnerableinourcommunities.

ViktorLiashko

MinisterofHealth

Ukraine

©WHOUkraine:ImmunizationCentre,RivneOblast.

WHO’SRESPONSEINUKRAINE

©WHO/MartaSoszynska

On9March2022,peoplerushtogetontrainsatthestationinLviv,Ukraine.

WHO’sresponseinUkraine

SavinglivesisthepriorityofWHO’sresponseinUkraine.WHOworkstoensuretime-critical,life-savingassistance,non-discriminatoryaccesstoemergencyandessentialhealthservicesandprioritydiseasepreventionprogrammes,andlayingthefoundationforlonger-termhealthsystemsrecoveryandstrengthening.

FourspecificobjectiveshavebeendefinedforWHO’sresponseinUkraine:

Specificobjective1:Accesstoemergencyandcriticalmedicalcareisstrengthened

Specificobjective2:Infectiousdiseasesarepreventedandrespondedto

Specificobjective3:Emergencyhealthinformationandsurveillanceforevidence-baseddecision-makinginhealtharereinforced

Specificobjective4:Effectivecoordinationofhumanitarianinterventionsinthehealthsectorisensured

©WHO/AndreiKrepkih

WHODirector-GeneralDrTedrosAdhanomGebreyesusinfrontofadestroyedPrimaryHealthCarecentre/COVID-19VaccinationSitenearMakarivDistrictHospital,Ukraineon07May2022.

8

9

1

Specificobjective1

Accesstoemergencyandcriticalmedicalcareisstrengthened

WHOANDPARTNERACHIEVEMENTS

Emergencyandcriticalhealthcare

WHOsupported26EmergencyMedicalTeams(EMTs)inUkraine,thatsupportedemergencyandprimaryhealthcare,inpatientandspecialistsurgicalcareandrehabilitation,patienttransferandMedevacassistance.EMTsprovided18744consultationsinnineoblasts.

TheUkraineministryofhealth(MoH)withthesupportfromWHOestablishedthreehealthhubsinwesternUkrainetosupporttheemergencymedicalservices(EMS)medicalevacuationsandensurethesafepassageofpatientsfromeasttowest,includingthosewithcancer,fortreatmentoutsideUkraine.

Morethan1600patients,includingthoserequiringspecialistcareforinjuriessustaineddirectlyfromthewar,andotherhealthissueshavebeensupportedwithMedevactovariousEuropeanUnion(EU)hospitalsthroughcoordinationwithMoHandclosecooperationwiththeEuropeanCommission’sDirectorate-GeneralforHealthandFoodSafety(DGSANTE)andtheEuropeanCivilProtectionandHumanitarianAidOperations(DGECHO).WHOprovidedtechnicalsupportonrepatriation,coordination,andharmonizationacrosscountries.

Morethan13700consultationsinsevenoblastswereprovidedby27MobileHealthUnitssupportedbyWHO.Oftheseconsultations,73%wereNCD-related.

WithindaysofterritoriesbeingregainedbytheUkrainiangovernment,WHOjoinedpartnerstodelivercriticallyneededmedicines,suppliesandequipmenttoallowhealthfacilitiestoresumedeliveringhealthservices.InKherson,WHOjoinedthehumanitarianconvoy72hoursaftertheGovernmentofUkraineregainedcontrolofthecity,deliveringmedicinesforacityhealthcentretotreatmorethan1000patients;thiswasthefirstopportunityforaidworkerstoenterKhersonwithhumanitarianaidsinceRussianforcestookcontrolofthecityinearlyMarch2022.

1.EuropeanCommission.7December2022.Ukraine:ECHODailyMapof06December2022[website](https://erccportal.jrc.ec.europa.eu/ECHO-Products/Maps#/maps/4315,accessed27February2023).

AssisttheEmergencyMedicalServices(EMS)indeliveringemergencymedicalcaretotheconflict-affectedpopulation,includingwounded/trauma-affectedindividualsandthosewithsevereCOVID-19andnoncommunicablediseases(NCDs),prioritizingvulnerablegroups,e.g.,personswithdisabilities,olderpersonsandchildren.

Highlights

18744

EMTconsultations

13708

MobileHealthUnitconsultations

38000

interventionsfortraumaandemergencysurgeryenabledwithTESK

1900000

peoplecoveredforbasiccarebydistributedIEHK

5570000

peoplecoveredforNCDhealthneedsbydistributedNCDK

23000

consultationsonmentalhealthandpsychosocialsupportservicessupportedbyWHO

16351

healthevacuationssuccessfullycompletedwithWHOsupport

10

©WHO

WHOfieldofficeinUkrainetraineddoctors,nursesandfirstrespondersfromUkraine

formasscasualtyincidents,inLviv.

WHOlaunchedthefirstroundofHealthResourcesandServicesAvailabilityMonitoringSystem(HeRAMS)toassessavailableessentialhealthresourcesandservices.Thereare1590facilitiesreportingin10OblastswhereHeRAMSisoperational,andtheoutcomesareusedbydecision-makersatthecountry,regionalandgloballeveltosupportthecurrentresponseandrecoveryofthehealthsystem.

Traumaandrehabilitation

WHOdevelopedarehabilitationstrategytostrengthenrehabilitationandaccesstoassistivedevicesthroughoutthetraumapathway.Thiswascoupledwithcapacity-buildingandcoachingforhealthcareworkersincludingphysiotherapistsandoccupationaltherapists,anddistributionofrehabilitationsupplies.

Specializedrehabilitationequipmentwasdeployedalongwithconsumablesandassistivetechnologies,aspartofbuildingup20-bedin-patientrehabilitationdepartmentsinmulti-profilehospitalstoensure

coverageofbothacuteandsubacuterehabilitation.

Delivered3900assistivetechnologiesproductsforwar-disabledpersons,includingwheelchairs,walkingframes,walkingsticksandshowerchairs,meetingtheneedsofover1200patients,primarilyinternallydisplacedpersons.

Distributedassistivetechnologykitswith4000essentialassistiveproductsto12traumahospitalstosupportacuterehabilitationfor2500patients.

Healthworkertraining

WHOprovidedtrainingto14nationalprehospitaltraumamanagementtrainersandreached

1254traineesinaseriesofwebinarsonclinicalmanagementandmedicalstaffsafetyinrelationtoChemical,Biological,RadiologicalandNuclearevents.Additionally,726EMSfirstrespondersandcliniciansfromreferralhospitalsin11oblastsweretrainedinchemicalprotection,decontaminationandtreatment.

providesassistiveproductsforthousandsofdisplaced

WHO

peopleinUkraine

WHOUkrainehasprovidedassistivetechnologykits(AT10kits)withessentialassistiveproductstohealthcarefacilitiesforthousandsofinternallydisplacedpersonsandotherpersonswithmobilityandself-careneedsresultingfromthewarinUkraine.

Upto4000assistiveproducts,whichincludecrutches,walkingsticks,walkingframes,wheelchairs,catheterkitsandotheritems,havebeenprovidedto12hospitalsinfiveregionsineasternUkraine.

Readthefullstory

here

11

Internationaltraumalifesupport(ITLS)trainingwasgivento72EMS,providingthemwithadvancedskillsintraumacare,andstrengtheningtraumacarecapacityinUkraine.Otherhealthworkersandserviceprovidersweretrainedonhospitalbloodtransfusionsinconflictsettings,onmanagementoftraumaticlimbinjuries,emergencynursingcare,andessentialburnscare.

WHOprovided1000healthcareworkerswithonlinetrainingsonthePENprotocol(PackageofEssentialNon-CommunicableDiseaseInterventions),diabetes,andcardiovasculardiseases.

Mentalhealthandpsychosocialsupport

TogetherwiththeFirstLadyofUkraineOlenaZelenska,WHOlaunchedandisimplementingthementalhealthandpsychosocialsupport(MHPSS)initiativetoaddresstheneedsofpeopleaffectedbythewarinUkraine,anddevelopedaroadmapthatsetsMHPSSpriorityactionsinsectorsincludinghealth,socialworkandeducation.

AframeworkforPrioritizedMultisectoralMentalHealthandPsychosocialActionsinUkrainewasdevelopedjointlywiththeMoHandtheMHPSSTechnicalWorkingGroup,andwithsupportfromtheInter-AgencyStandingCommittee(IASC)MHPSSReferenceGroup.

BasedonWHO’smhGAPinitiativeinUkraine,theMoHandtheNationalHealthServicesofUkraine(NHU)launchedanewservicepackageonprovisionofmentalhealthservicesinprimaryhealthcareasapartoftheStateProgrammeofMedicalGuarantees.

Twenty-sixCommunityMentalHealthTeams(CMHT)providinglong-termcareforpeoplewithsevere

mentalhealthconditionswereequippedwithskillsinthemanagementofstress-relatedmentalhealthconditionsthatareescalatedinthewarcontext.TheCMHTsprovided23000consultationsfromFebruary–

December2022.

Trainedmorethan179trainersfrom23oblastsofUkraineintheSelf-HelpPlus(SH+)coursetotrainprogrammefacilitatorsacrossUkraine.Thecourseaimsathelpingadultsexperiencingadversitieslearnhowtomanagestress.

Tomeetthecriticalneedsofpeoplewithmentaldisordersinmentalhealthfacilities,WHOprocuredmedicines,powergeneratorsandkitchenequipmentformentalhealthfacilitiesinUkraine.Thissupportenabledcontinuedsupportforpeoplewithdepression,epilepsy,andpsychosisduringthehumanitariancrisis.Overall,WHOreachedmorethan240000peopleinneedofMHPSSincludingatleast6400withseverementalhealthconditionsacrossUkraine.

HealthSupplies

By2March2022,WHOhadestablishedalogisticshubandairbridgeofessentialsupplies.On14November2022,WHOwasonthefirsthumanitarianconvoyto

Kherson.

WHOsupplydistributionsystemhasincluded:.FivecharterflightsfromtheWHOstockcentrein

DubaitoWarsaw,PolandtransportingspecializedWHOkits,dieselgenerators,pharmaceuticalfridgesandfreezers,andequippedambulances.

.Fivelogisticshubs/warehousinglocationsin

anidAoGX(ivG1vivGOp?seenpdol\eve.

©WHO/AgataGrzybowska

UkrainianparamedicsfromEMS(EmergencyMedicalService)transportingseverelyill

patientsfromtheWhiteBustotheNorwegianMEDEVACaircraft,RzeszówAirport.

2.59ambulancesasofendJanuary2023.

12

ByDecember2022,WHOhadprocured2087metrictonnesofmedicalsuppliesforUkraine,ofwhich1360metrictonneshavereachedtheirintendeddestinations:723healthfacilitiesin24oblastsandthecityofKyiv.Thedeliveriescomprisetraumaandemergencysurgerykits,interagencyemergencyhealthkits,bloodtransfusionmaterials,essentialmedicinesandothercriticalsupplies,includingbodybags,ambulances,oxygenequipment,powergenerators,refrigeratorsandotherequipment.

DeliveredWHOkitsincluded:

•3422interagencyemergencyhealthkits(IEHK)

•7787traumaemergencysurgerykits(TESK)

•543noncommunicablediseaseskits(NCDK)

•2180majortraumabackpackkits

•160WHOcollection,testingandtransfusionkits(CTTKit)forsafebloodtransfusion

Inaddition,byDecember2022,WHOamongotheritemshaddistributed:

•592ambulancesandICUequipmentto11oblasts,enhancingemergencyresponsecapacityinvarioushealthfacilities

•64dieselgeneratorsto8oblaststomeettheenergyneedsofhospitalsandhealthfacilities

•3pressureswingabsorption(PSA)oxygengeneratorsforonsiteproductionofmedicaloxygen

•Liquidoxygentanks;oxygenstorageand

distributioncontainerswithcryogeniccylinderstomeetmedicaloxygenneedsinfacilities

•23mobileinflatabletentsfortheStateEmergencyServiceofUkraineandEmergencyMedicalServicesofUkraineinvolvedinemergencysearchandrescuemissionsforvictimsunderrubbleofdestroyedbuildings,aswellasprovidingbasicmedicalservicesintheliberatedterritories

•255externalfixatorsystemsforemergencyorthopaedicfixationofbonefractures

•13autopulseresuscitationsystems

•39portablepatientdefibrillationsystems

•550patientmonitors

•59portablepatientventilationsystems

•176BPAP(bilevelpositiveairwaypressure)ventilators.

BasedonWHO’scomprehensiveapproachandanestimationofthenumberofpossiblevictimsofwarinjuries,thesuppliestotheUkrainianhealthsystemareestimatedtohavethefollowingimpact:

•38000interventionsfortraumaandemergencysurgeryenabledwithTESK

•5570000peoplecoveredforNCDhealthneedswithNCDK

•1900000peoplecoveredforbasiccarethroughIEHK

•4000patientscoveredwiththecholerakits

•3500patientssupportedwithrehabilitationkits

MedicalsuppliesdistributedinUkrainebyOblast,07March–31December2022

By31December2022,WHOhadprocured2087metrictonnesofmedicalsuppliesforUkraine,ofwhich1360metrictonneshavereachedtheir

intendeddestinations:723healthfacilitiesin24oblasts,andthecityofKyiv.

ZAKARPARPATTIA

RIVNESKA

6.57MT

ZHYTOMYR

82.64MT

KYIV

224.31MT

LVIV

KHMELNITSKY

TERNOPIL

23.39MT

CHERNIVTI

44.23