People wait for a doctor's consultation in front of the old building functioning as a primary health care facility in Synykha village, Ukraine. Halyna, 70, cries. She has heart disease but it is almost impossible for her to visit a doctor. "The polyclinic is 30 km away, the bus runs only once a day but even in town there is no cardiologist to consult with. I cannot afford medicines. We have not received proper health care for more than 2 years since the conflict started. Without the support provided by the mobile team, I cannot imagine how I would survive."
Mobile clinics are the only source of health care for many displaced people in Ukraine
Halyna's situation is not uncommon. To address the needs of the population affected by the conflict and internally displaced persons (IDPs), WHO has established mobile emergency primary health units (MEPUs) in 6 regions in eastern Ukraine.
A team consisting of nurses, a doctor and a driver collect vital data and offer services for child health, nutrition, communicable and noncommunicable diseases, maternal and newborn health, mental health and hygiene. Valentyna, a doctor from the Kupyansk mobile unit, says cardiovascular diseases are especially common among affected populations and people often don't have access to the essential medicines required for treatment or prevention. WHO purchased and supplied the medications used.
Some of the mobile clinics visit and help people near conflict lines, where the security situation remains tenuous and existing health facilities have been destroyed or do not function anymore. The care provided by the mobile clinics also reaches collective centres for IDPs. If these people are not registered to reside in the territories where the centre is located, then the MEPUs may be their only access to health care.
WHO and partners finance mobile clinics' services
Health Cluster partners, such as the Ukrainian Red Cross and the Hippocrates Greek Medical Foundation, run these MEPUs. The European Union Humanitarian Aid and Civil Protection department, the United Kingdom Department for International Development, the United Nations Central Emergency Response Fund, and the governments of Canada, Estonia, Israel and Finland provide funding.
"We supported WHO and its partners to provide mobile outreach clinics to the most isolated communities in the conflict-affected areas of eastern Ukraine. The approach has proven to be very effective and has had huge buy-in from the local health authorities," says Fergus Thomas, Humanitarian Advisor to the British Embassy to Ukraine. "In particular, this system has made some impressive inroads into providing not only primary health care but in helping people to access psychiatric assistance through the mobile mental health teams."
Four mobile mental health teams help affected Ukrainians overcome post-traumatic disorders
Artema village, near the conflict line, was bombed more than a year ago. Though there is no shelling now, people remain dismayed and scared. "We live in constant fear that war could come back to our village. I cannot sleep at night," says Raisa, 57. Quality mental health services are needed for conflict-affected communities.
In line with the MEPUs approach, WHO established four mobile mental health teams operating within the Ukrainian health system in four regions of the country. The project aims not only to improve access to specialist mental health services, but also to enhance capacity within the existing system. This community-based mental health care could be scaled up over time to become part of the wider mental health reform process in Ukraine.
"Four clinics are not nearly enough to support more than 1 million people in need," says Patricia Kormoss, Emergency Coordinator of the WHO Country Office in Ukraine. "We plan to increase the number of mobile mental health teams in operation as part of efforts to address the psychological problems people face as a result of the humanitarian crisis."