Russia’s unilateral decision to invade Ukraine had the effect of setting in motion a series of crises that affected everyone.

Russia’s war in Ukraine has triggered a number of interrelated crises. Within Ukraine itself have been countless military and civilian deaths, forced migration, but globally, the war has led to a food crisis, and reduced donor funding for other health-related issues. Within Ukraine, the government is working tirelessly to address its population’s health needs, particularly in mental health. With the assistance of Olena Zelenska, the country’s first lady, she is leading efforts to collaborate with local, regional, and global organizations to tackle the crisis. This effort includes additional training for mental health professionals, dedicated hotlines, and a program to train primary care physicians in identifying and providing basic mental health support.

One pressing mental health emergency highlighted by Ulana Nadia Suprun, Ukraine’s former acting Minister of Healthcare, is the assistance needed for victims of sexual assault committed by Russian soldiers. While it is challenging to determine the exact number of victims, documenting these cases is crucial to identify individuals requiring support, even if many are reluctant to relive the trauma. Suprun emphasizes that despite claims that politics do not affect healthcare or global health, it is now evident that the conflict instigated by Russia has had far-reaching consequences that goes beyond the battlefield.

According to The Lancet, the war has had both immediate and long-term impacts on public health. People either die or sustain injuries due to violence or develop health issues stemming from the traumatic experiences of war and limited access to adequate medical care. Despite the best efforts of Ukrainians, the quality of healthcare and service delivery has deteriorated in some areas affected by the war, as reported by the World Health Organization and other non-governmental organizations. Numerous regions lack electricity and running water, while hospitals in eastern Ukraine can only provide a fraction of the necessary care, forcing patients to travel long distances or forego seeking treatment. Ukraine’s Ministry of Health has observed a significant decline in routine immunization rates since the invasion.

Clinical neurologist Sarah Moore emphasizes that gender plays a substantial role in how war affects health. Women often bear the long-term consequences of war on their health, despite men being more likely to die or sustain injuries in battle. Access to obstetric care and family planning services becomes more challenging, compromising the safety of childbirth. Violent conflicts also increase the risk of rape for women, with rape and sexual assault frequently used as weapons of war. These acts cause physical and psychological harm to women.

In Russia, a mandatory state health insurance scheme provides free healthcare for all citizens. Still, the public healthcare system faces widespread criticisms due to insufficient government funding, outdated medical equipment, and low wages for healthcare workers. Consequently, many expatriates in Russia choose private medical care, which is widely available. Some public facilities have started offering private services to individuals with insurance in recent years, and certain private providers also offer public healthcare services.

Researchers have found evidence of deliberate attacks on Ukraine’s healthcare system among over 700 attacks recorded between February 24 and December 31, 2022. The attacks inflicted significant damage, including 218 hospitals and clinics destroyed or damaged, 65 ambulances targeted, 181 other health infrastructure sites (pharmacies, blood banks, dental clinics) attacked, and 86 assaults on healthcare personnel, resulting in the deaths of 62 healthcare workers and injuries to 52. Approximately one in ten hospitals in Ukraine has directly suffered damage from these attacks, with the most devastation occurring in the eastern provinces of Kharkiv, Donetsk, Luhansk, and Kherson. Many medical professionals have also faced threats, imprisonment, captivity, and forced labor during Russia’s occupation of eastern Ukraine.

Western countries have provided billions of dollars in support to Ukraine since the full-scale invasion by Russia in February 2022. Allied forces have also trained tens of thousands of Ukrainian soldiers over the years. Currently, additional jets, tanks, and armored vehicles are being delivered, and NATO’s Ukraine fund offers immediate assistance, improving the situation on the battlefield. Ukraine rightfully belongs to the NATO and Euro-Atlantic families, and hopefully, this can be achieved.

The conflict shows no signs of ending. Researchers, bureaucrats, academics, world leaders, and professionals across various fields are attempting to predict the aftermath of this war, but uncertainty looms regarding the potential use of tactical nuclear weapons by Russia. The impact extends beyond the healthcare system, with infrastructure, the economy, finance, and other systems shattered. The consequences of this invasion affect individuals worldwide, not just in Russia and Ukraine. Both Moscow and Kyiv appear unprepared to negotiate, creating a prolonged state of uncertainty on the world stage.