Ukraine Health Crisis

All contents Copyright 2022-2023 William F. Pewen

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Irpin Hospital Ward


This page provides limited updates and observations as I work with colleagues to assist in the ongoing health crisis in Ukraine arising from the Russian invasion. I am particularly focused on helping to prevent and mitigate infectious disease outbreaks. Posts here are be limited, due to both time and security constraints. I hope to be able to produce a longer account later.

In war, the toll of disease often equals or even exceed combat casualties. Russia’s destruction of cities and infrastructure, targeting of health facilities, and displacement of approximately one in four Ukrainians from their homes – all these have contributed to epidemic disease risk. The outcome is already evident. In 2022, new tuberculosis cases increased by 59 percent – and it is likely many new infections were not detected in the chaos of war. Infections among the wounded are also too often resistant to many antibiotics as well. Infectious outbreaks may become more widespread, impairing Ukraine’s resilience and recovery, and even impacting its NATO and EU partners.

A multiyear effort is needed to strengthen response by bolstering diagnostic and therapeutic capacity, and improving prevention by reducing an immunization deficit which impacts millions of children. Such as effort requires approximately $98 million dollars to accomplish. That is funding that governments and philanthropies can readily provide, and the cost of a four year effort represents just 2/10ths of 1% of the total US civil assistance provided thus far. As some have said, about the cost of a fighter jet.

A number of documents, slides, and media reports can be viewed here

Like many others I have largely self-financed my efforts. I am thankful for those who have contributed to defray a bit of that expense. If you are looking to know more or help with either funds or medical equipment or supplies, email me at I am working with 501(c)(3) organizations in both the U.S. and Ukraine which are serving diverse needs for medical aid. These include those with long-established reputations, such as the Ukrainian Medical Association of North America, Cleveland Maidan Association, and the Christian Medical Association (in Lviv).

Posts – Most recent first

October 9 – Ohio Public Broadcasting
In an interview with Stephen Langel for Ohio Public Broadcasting, Senator Sherrod Brown (D-OH) stated his commitment to addressing health threats in Ukraine:

“There will be substantial humanitarian aid,” Brown said. “We will meet these needs and make sure that these humanitarian issues, especially child vaccinations, are met.”

September 21 – NPR Broadcast, “Here and Now”
Following a CNN report that polling demonstrated that Americans are roughly split on extending further aid to Ukraine, I’ve been working to gain funding of limited and specific U.S. humanitarian assistance to avert infectious disease outbreaks – a goal which should have broad support. However, in the current political climate, it is uncertain whether Congress will avoid a government shutdown, much less provide needed assistance to Ukraine. We can avert additional health crises, as we described on NPR’s ‘Here and Now‘. Unfortunately, the reporter’s Q&A on what could be done to avert epidemic disease was cut. It would certainly have given a more positive outlook!

August 25 – Ohio Public Broadcasting
This week Ideastream reported both on-line and radio broadcasts on the efforts of Ukrainian organizations which are providing critical donations of critical medical supplies to health care facilities in Ukraine. I was pleased to join Dr. Taras Mahlay to describe the critical threat of epidemics in wartime, and how infectious disease could threaten its NATO and EU partners, while also impairing Ukraine’s recovery. The need for modest U.S. assistance to support response and prevention efforts is indisputable.

August 11 – Press Interviews and Informing Congress
I’ve been engaged in both congressional and media education the past few weeks. One thing I appreciate more than ever is how so many issues are interconnected. I just did a Bloomberg Media interview on the issues of drug safety and shortages, and noted that we now face the bizarre situation of a global immunization “catch-up” campaign in the midst of critical vaccine shortages. Ukraine got both left out of a WHO list of priority nations, and still needs funding to ensure future vaccine deliveries. This remains a blind spot for too many government leaders.

This week I was pleased to join Dr. Taras Mahlay as we were interviewed on Sound of Ideas to discuss both immediate needs for medical response and longer term outbreak prevention in Ukraine.

July 13 – Inconvenient truths regarding infection
In recent months, I’ve been describing how war has underscored Ukraine’s needs to both respond to, and prevent infectious disease. That has particularly focused on how in the year following Russia’s February 2022 expanded invasion of Ukraine some infections have escalated, needs for response have increased, and immunization rates have suffered. While governments have recognized the essential need to improve immunization, inadequate resources been provided.

Dr. Kevin Kavanagh kindly posted a recent presentation I was pleased to make to HealthWatch USA. This concise 23 minute video provides a description of the impact of this war on infectious disease, and strategies to mitigate epidemic threats – particularly by bolstering immunization among millions of children who have not yet been protected by vaccination.

June 22 Ukraine Recovery Conference (London)
At the Ukraine Recovery Conference, the immense cost of rebuilding is discussed. With an estimate exceeding $750 billion, spending on health system investment appears to comprise significantly less than 1%.

March 10 – 2022 Retrospective
Like some others, my time in blogging and fundraising is miniscule. In recent months I’ve focused on immunization deficits. The most severe appear to be in the 5.2 million children under 14 in whom nearly half of immunizations were missed. In some years, a scheduled vaccination was completed in less than 1 in 5 children. This leaves millions at risk. There is growing recognition among Ukraine and U.S. governments, as well as UN agencies of the risk, and efforts to reduce it are underway. That is progress.

As I recently authored an account of work in 2022 for an editor in California, I am providing that here in an effort to catch up on things a bit, and give more of you a brief view of the situation in Ukraine.

September 4 – Irpin and Bucha (Kyiv Suburbs)
I joined media representatives for a survey of impacts in these communities. The clear and overwhelming targeting of civilians is obvious. Russians destroyed health facilities, housing, schools, and infrastructure. Such targeting causes both immediate, and longer term casualties from health effects.

Irpin hospital strike
Patient room at Irpin
One of a multitude of cars stacked together which have been struck by automatic weapons
Irpin building facade
Destroyed housing in Irpin
Many remain displaced from damaged homes and are now living in crowded conditions
Destroyed university buildings in Irpin
Directly across the street, munitions ripped through steel and brick
Destroyed school in Irpin
Munition impacts next door to Irpin school
Bucha Shopping Center (west end)
Bucha Shopping Center (east end)
Fragments of Russian weapon which struck shopping center

July 7Expat perspectives up close

I was perusing my laptop where I had been making some quick impressions of life in this war. As I have had phone and teleconference calls, within two weeks here I noted an increasing dissonance between seeing a conflict through a media filter, versus “on the ground”. The key one, is the 24/7 presence…and living with those who are suffering. The dissonance and the huge time zone shift, can make for frustration. Most days I feel an imperative that is difficult to impart to those stateside.

Some impressions…..

Meeting a Ukrainian mother in Budapest traveling to the Balkans with her son to find work…she had to leave her husband behind…and she wants to feed me from a meager bag of food she is carrying

A raucous Ukrainian family group in the compartment next to ours, the women finding joy in life…talking and laughing into the late night hours on the night train to the Polish-Ukrainian border.

A rail compartment companion whose bilingual skills were as limited as mine…but still we manage to understand each other.

The reaction during a border check as 49 returning Ukrainians aboard a bus realize an American is riding with them to Ukraine

Seeing a family reunion in Lviv train station…dog included

Air raids…lots of sirens…but people carry on anyway

Getting dinner in Lviv with young people who are convinced the world will get better

Suddenly realizing you have a curfew…and you are not 16

Meeting a soldier still wearing dressings on a war injury…and others without limbs.

Sharing a room with a medic who is recovering and woman who may never, after she lost home and loved ones

Riding a train with a soldier who is terribly sick, but resolute.

Walking streets your grandfather did as a young man.

Amazed that without many road connections, nor air service, somehow the store shelves are mostly stocked.

The bizarre feeling that one is living an updated version of WWI or WWII, as the war becomes one of trenches, artillery, and rockets.

Having to explain that no, I can’t hop a plane, there is no Amazon delivery, my banking services are almost nil, my health insurance doesn’t work here, and though things are a little difficult…this is nothing like the Donbas.

The chaos of struggling to remember your meager college Russian and finding that as it comes back…now you need to switch to Ukrainian

Thinking you just heard a plane overhead, and realizing if you actually did, you might want to duck…

Finding that ice cream and coffee stands are ubiquitous in Kyiv

Experiencing checkpoints reminiscent of the cold war…because now it’s a hot one

The kind woman in my hotel who must make a relatively meager wage, but brings in waffles with cherry topping to feed us breakfast

Finding the best-selling mens wear may now be cammo

Playing MacGyver a lot..improvising

Becoming blaise about sandbags and automatic weapons

Seeing the joy in the face of a babushka when you tell about your grandparents origins here

Feeling tired most of the time as you’re up at 630, but then often up till 2 am because you’re talking to some people half way around the world

Being light years closer than watching a broadcast news clip, being continually connected to the subjects of the story in a way that is so totally different.   

Americans are here for a lot of reasons.  One of them relates to the simple fact that one must “pay it forward”, because most of us are the product of ancestors who did just as Ukrainians are doing now.  And you realize that could be their gift to us – helping to rekindle a stronger sense of community.    

July 6

The “New Normal” here involves more than COVID. On the metro…in between short vignettes on Ukrainian history, and some ads…I saw a public safety message…one we shouldn’t have to be providing:


Mine Safety
What you need to know how to do!

Bypass projectiles that don’t explode…they are ready to explode at any moment
Don’t pick up found items that may be disguised explosive devices
..approach an explosive object
..move it or pick it up
..disassemble, throw, beat on it
..make a campfire nearby
..bring it home

July 5

At the Ukraine Recovery Conference, the immense cost of rebuilding is discussed. Regardless of how this burden is borne, Ukraine cannot move forward without health security. Ensuring that now will reduce the cost of recovery and save lives.

Earlier Ukraine Scenes

I’ve pulled just a few scenes to give one a picture of Ukraine (largely scenes in and near Lviv and Kyiv). I generally avoid the tragic photos, though I meet many who traumatized or injured…and one must also recognize that photos and depictions of colleagues and work can present security issues. Thus I filter a great deal at this time. This is not only a humanitarian crisis…it is also wartime.

Countryside approaching Lviv
Reunion with family and pets in Lviv
My lodging in Lviv was in shared quarters with a medic and a refugee from Kharkiv

Lviv sentiment on Putin’s invasion effort

Family time with children on a Sunday in Lviv
Throughout the country are memorials to those lost in this war
Kyiv is a magnificent city – the people, culture, architecture, and scenery.
Kyiv is in a “New Normal” state – business reduced somewhat, air raids, etc…but persevering.
Maidan Square (almost curfew!)

Barriers are distributed throughout Kyiv…Bucha is just minutes away.
“The development of a people can be judged by how it treats animals”
…and Ukrainians exhibit that.
Signage that children were in this car didn’t deter Russian attackers

Remnants of a Russian tank on St Michael’s Square
Many foreign volunteers (flags of the nations of those who have served)
War creates some incredible contrasts
No rubles wanted here….
A too common sight is of those bandaged and struggling with the wounds of war…and of funerals.
Amidst crowds and conflict in a resolute nation, a dog just lies down and takes a nap.