Attachments
1. EXECUTIVE SUMMARY
1. After February 24, 2022, there was a notable decline in the populations of Donetska, Kharkivska, and Khersonska oblasts. These areas have become major hosts for IDPs, with up to 30% of the population being IDPs as of February 2024, largely due to ongoing intra-regional displacement. Concurrently, these oblasts have been subject to temporary occupations, intense combat operations, and frequent shelling, prompting the evacuation of residents, particularly children. Consequently, there has been a significant decrease in the proportion of minors and a notable increase in the elderly population, comprising roughly one-third to half of all residents, the majority of whom are over 60 years old. Survey data indicates that in addition to pensioners, many families include individuals with chronic illnesses requiring continuous care, people with disabilities, individuals affected by shelling or occupation, and those with mental and behavioral disorders, thereby exacerbating the vulnerability of families amid wartime.
2. In addition to these socio-demographic shifts, the full-scale Russian war against Ukraine has inflicted damages upon residential buildings, medical infrastructure, and the environment, posing severe threats to the health and lives of residents. However, survey findings suggest that participants often lack a comprehensive understanding of the risks associated with explosive ordnance (EO). Even when there is a need for additional information on related topics, it is not prioritized, despite significant contact between participants or residents and EO. This oversight has, in some instances, led to fatal consequences due to unsafe practices and ignorance of EO risks.
3. Despite efforts to restore damaged healthcare facilities (HCFs) by February 2024, access to healthcare for hromada residents remains limited, and in some cases, entirely unavailable. The unmet need for medical assistance and medications persists in most hromadas due to various factors such as the absence of local HCFs, transportation challenges hindering access to nearby facilities, ongoing shelling, or financial constraints impeding the affordability of services. Existing medical requests are not always highly specialized and could be addressed at the primary HCF level or through appropriate referrals to secondary ones. Given these challenges, the establishment of mobile teams emerges as a potential solution, offering primary healthcare services with provisions for transportation to HCFs for secondary or specialized care when necessary.
4. A critical issue is the financial situation of the participants, as many struggle to cover daily needs. Following increased unemployment and worsening financial circumstances after February 24, 2022, various social benefits, targeted assistance from governmental or international organizations, and financial aid from friends or relatives have become primary income sources for surveyed participants. Despite a significant portion receiving financial assistance over the past year, the need for it remains a priority as of February 2024. Currently, only in isolated cases can existing hromada resources meet this need, highlighting the necessity for humanitarian project interventions. Financial aid recipients have been able to address diverse needs, from purchasing medications to acquiring construction materials for housing restoration, making cash assistance the most optimal means of meeting hromada needs. However, further investigation is required regarding the extent, frequency, and criteria for distributing such assistance.
5. Another urgent need among surveyed hromadas is for personal hygiene items and household chemicals, which existing hromada resources cannot adequately supply. Clothing, footwear, and household appliances and items are also in demand but are largely inaccessible within the hromadas. Access to these goods is further hindered by participants’ limited financial resources, and can be covered by distribution of NFI or cash assistance by humanitarian projects.
6. Among all forms of aid, food assistance is most prominent – nearly all surveyed participants received food packages over the past year, and as of February 2024, the available opportunities for distribution largely surpass the demand. However, feedback on the quality of these packages has been mixed; participants often note the monotony of contents, lacking variety such as 6 vegetables and fruits. Some participants appreciated receiving seeds and chickens or expressed a desire for such assistance, although it wasn’t included in the survey. Introducing these types of aid could address the short-term need for fresh produce and poultry, reducing the necessity to spend financial resources on them. Additionally, in the long term, it could contribute to agricultural recovery and provide residents with income-generating opportunities by selling surplus produce or poultry.
7. In all analyzed hromadas, with the exception of one, there are no internationally-led humanitarian assistance projects, including programming to address GBV issues. Efforts to prevent and respond to such cases are mainly handled by social services and departments of city or rural councils. Instances of domestic or gender-based violence are sporadically reported, possibly due to mistrust of the police or social services, as well as fear of condemnation, publicity, and potential retaliation after reporting. GBV is not widely recognized among residents, as many respondents couldn’t provide definitive answers to survey questions on the topic and only occasionally reported known cases in their hromadas. Assistance for women affected by violence is either unavailable or service availability is unknown to residents. However, medical, psychological, legal assistance, and shelter services could be beneficial. Mobile teams could integrate psychological and legal assistance alongside medical aid. Given the regional context and residents’ reluctance to discuss domestic and gender-based violence, specialists providing services to potential survivors must possess sufficient skills and qualifications.