He is working against the clock, says Christian Katzener, director general of the German section of Médecins Sans Frontières (MSF). They were prepared, they managed to fill camps in Odessa and in the now besieged Mariupol, for example, and provide hospitals with medical supplies such as bandages, surgery kits, medicines and anesthetics. We must not only think of the war wounded, but also of the chronically ill who depend on insulin, for example. The MSF team also brought a large transport to the Ukrainian capital of kyiv, which included a kind of pop-up operating table that can be quickly set up anywhere. But how does it work to get life-saving products to where people need them?

With a lot of logistics, explains askatzer. And MSF has four decades of experience in conflict. MSF has three large warehouses in Europe, in Amsterdam, Ostend and Bordeaux, where duty-paid supplies are waiting to be shipped immediately. From there, they strategically distributed the material by truck when the worst hit, in Poland, Romania, Bulgaria, Slovakia and Moldova. Some transports went directly to Lviv, where warehouses were rented. The western Ukrainian city is the main hub, and the World Health Organization (WHO) also manages relief supplies there.

A fast machine is working at Doctors Without Borders, they have even sent mobile clinics. All this is happening, says Christian Katzener, in consultation with the Ukrainian authorities, but not directly with the military. It is then estimated how great the need is where, “nothing should be wasted”. It helps that MSF has been active in Ukraine, in the east, for years, for example, caring for HIV patients. And a network of local medical professionals informed MSF. Even the big WHO does it this way: with local organizations and the Ministry of Health, deliveries are calculated using local data, risk analysis and transport capabilities.

Ukrainian War - One of the symbols of the war in Ukraine: a wounded pregnant woman is brought from a bombed-out maternity hospital in Mariupol.  She did not survive, and other people were also killed.

One of the iconic images of the war in Ukraine: a wounded pregnant woman is carried from a bombed-out maternity hospital in Mariupol. She did not survive, and other people were also killed.

(Photo: Evgeniy Maloletka/dpa)

Meanwhile, OCHA, the UN agency for humanitarian affairs, is looking for ways to deliver more aid and create escape routes. Amanda Pitt, in the Ukraine mission for OCHA, describes it Süddeutsche Zeitung So: It’s working with the Russian and Ukrainian defense ministries to set up a humanitarian notification system. Both parties to such agreements must be informed at the same time to obtain safe routes, with constant communication about schedules and movement of trucks and people. “We’re open to all possibilities,” Pitt said.

In Mariupol lack of everything

However, the UN was not involved in the creation of previously announced humanitarian corridors. Hardly any were produced, so nothing can be delivered. One of the desperate messages from Mariupol, for example, is that not only is food and water lacking, but medicines and medical supplies have also run out. In Ishum, for example, it should be the same.

According to Katzener, around 100 employees work for MSF in Ukraine: doctors, nurses and logistics. In Lviv, Mariupol, Zhytomyr or Sieverodonetsk. Also in kyiv, where they are supposed to stay. Of course, the first thing is the safety of its people and patients, which is currently restricting the possibility of movement. Colleagues in Russia, dicekatzer, would inform the Ministry of Defense in Moscow about the whereabouts of the MSF people. She doesn’t know if that protects her.

There are still roads to kyiv. With the large MSF delivery there on Sunday two weeks ago, he says, it was a great help that the Ukrainian railways offered to transport the material. That saved time and a lot fits in the freight cars. The material arrived in Lviv on Saturday, they loaded it onto the train at night, and the next afternoon they were able to receive 40 cubic meters of salvage items in the capital.

The material is one thing, but you also have to know how to use it. That is why MSF, says Christian Katzener, carried out “trials” in hospitals in kyiv and other cities. How to do it? mass casual, situations in which a large number of wounded suddenly arrive. Which rooms are suitable, where is what, who is doing what, and yes, also what are the triage criteria in deciding who should be treated first, when it no longer makes sense. Surgeons, who usually specialize in a narrow area, are instructed to operate on gunshot wounds. As many as possible should also be able to perform caesarean sections, which has proven important everywhere.

WHO brought 36 tons to Lviv

The WHO also reports that medical supplies are running low in some places. She also tried to make provisions, with huge amounts. On March 5, they brought 36 tons to Lviv for further distribution. Three days later, ten tons were shipped to seven regions via kyiv. On March 12, the WHO had ten tons of medical supplies and medicines transported to Kharkiv, Sumy, Dnipro, Cherson, Mariupol, Mykolaiv, Zhytomyr, Zaporizhia and Cherkasy. Each delivery is to last for 150 wounded and another 15,000 patients for three months. In addition to the usual material, the WHO names oxygen and oxygen equipment, blood transfusion material, power generators, defibrillators, monitors.

But the hospitals are not only isolated, they are being fired upon by Russian units, against the laws of war. According to Ukrainian information, more than 100 clinics have already been damaged, some destroyed. Not only that, the Ukrainian General Staff announced on Wednesday that in Makiivka, a city of 350,000 people near Donetsk, “the situation in local hospitals is catastrophic, they cannot provide medical care to civilians due to the lack of qualified medical personnel.” “. “.

The risk of epidemics grows

The WHO, together with the Ukrainian authorities, is trying to get an overview of the general health situation with the help of clusters and 3D maps. In this way, it must be discovered as quickly as possible if an epidemic breaks out, another concern of experts, including Doctors Without Borders. OCHA warns that the fight against tuberculosis must continue. Clean water is no longer available in Mariupol and other cities. People drink rainwater, melt snow, use water from heating systems when they need it. Boiling is often not possible.

This carries risks, diarrheal diseases, in the worst case cholera. This was stated by Kate White, MSF emergency coordinator. It is known from an outbreak in 2011 that cholera bacteria are present in the region. And Christiankatzer points out that not only contaminated water is dangerous, but also the lack of it: children in particular are at risk of dehydration, as well as debilitated people. This is life threatening. Children in particular could also develop pneumonia from the cold. War, that hasn’t changed, it doesn’t just kill on the front lines.

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