Natalia Sapronova (39) is the head nurse of the palliative care department of the Kreminna multi-field hospital. She takes care of bedridden patients after a stroke who require constant attention. Natalia and colleagues feed the patients, bathe them and fulfil the prescriptions.

“Now we have 33 people in the department. These are mostly older people. However, one person is under 30 years old with a spinal injury and one – aged 30 to 40 – after craniotomy associated with trauma. People usually come from other departments, so they are fully examined,” explains Natalia.

Natalia is showing the entrance to the palliative care department. 

Photo: Violetta Shemet/Norwegian Refugee Council
Ukraine

Protecting the most vulnerable during unprecedented times

Eastern Ukraine was already exhausted by the ongoing conflict when the pandemic hit. The Norwegian Refugee Council (NRC) has been rapidly adapting its work to protect vulnerable people at this extraordinary time, despite numerous lockdowns. Here’s a snapshot of our response.

Safety first on the “contact line”

As Covid-19 restrictions have gradually eased throughout Ukraine, freedom of movement across the 427-kilometre-long frontline for millions of people living in non-government-controlled areas remains mostly limited.

While Covid-19 restrictions have gradually been eased across Ukraine, freedom of movement across the “contact line” for half a million people living in non-government controlled areas (NGCA) remains mostly limited due to the uncoordinated re-opening of the crossing points, complicated crossing procedures, restrictions on who had permission to cross. 
Civilians repeatedly became stranded in the “grey zone” being stuck and spending several days in tents surrounded by mine-contaminated fields.
Besides, people who cross are subject to self-isolation or observation in a health facility for 14 days, meaning the vast majority who seek to cross for just a few hours to receive pensions or access services are unable to do that.
Moreover, crossing points still lack essential services such as hygiene facilities, drinking water and first aid and risk turning into the cluster of infections unless sanitation and hygiene conditions are improved.
We are securing access to disinfectant means and improving sanitary there as well as providing vital information to increase people’s knowledge on how to protect themselves and prevent the spread of the virus.

Photo: Violetta Shemet/Norwegian Refugee Council
Read caption At the crossing point in Stanytsia Luhanska. Photo: Violetta Shemet/NRC

Civilians regularly become stranded in the “grey zone” – the space between two crossing points on the front line which is not controlled by the parties in the conflict. They can spend several days in tents surrounded by mine-contaminated fields. Those who are able to cross are subject to self-isolation. They may be tracked via special mobile applications or observed in a health facility for 14 days. This means that the vast majority who seek to cross for just a few hours to collect their pensions or access services are unable to do so.

Crossing points lack essential services such as hygiene facilities, drinking water and first aid equipment. There is a high risk of infection unless sanitation and hygiene conditions are improved.

NRC is working to improve the conditions at these crossing points by providing hand sanitiser and improving sanitary conditions. We are also distributing information to increase people’s knowledge on how to protect themselves and prevent the spread of the virus.

The financial impact of Covid-19

According to our recent food security and livelihoods assessment, almost eight out of ten families in the Donetsk and Luhansk regions have been negatively affected by the financial consequences of Covid-19. These include increases in the prices of food and hygiene items, additional transport costs and loss of household income during the four months of national quarantine.

According to the recently conducted food security and livelihoods assessment, almost eight in ten families reported having been impacted by increased prices of food and hygiene items, additional transport costs and loss of household income in less than four months after the introduction of the national quarantine measures. 

“It affected my family so much. My son and daughter-in-law live in Kharkiv; they became jobless due to the Covid-19.  I am a pensioner. Pension is the only source of income for me. As I live with my elderly mother, I should look after her. But, the prices for food and medical services increased significantly, and we are not able to cover our needs anymore,” says Mykola (56) during the visit to one of the shops provided with sanitising equipment by NRC. 

Photo: Natalia Patlatiuk/Norwegian Refugee Council
Read caption Mykola is using hand sanitiser provided by NRC to protect himself and those around him. Photo: Natalia Patlatiuk/NRC

Mykola, 56, is one of the people affected. “It affected my family so much,” he says. “My son and daughter-in-law live in Kharkiv and they lost their jobs due to Covid-19. I am a pensioner. My pension is my only source of income. As I live with my elderly mother, I should look after her. But the prices for food and medical services have increased significantly, and we are not able to cover our needs anymore.”

We have been able to continue to provide emergency cash assistance during lockdown by working with other service providers to avoid increasing the risk of infection.

Virtual legal protection

Given the rapid development of the Covid-19 situation and the corresponding legal changes, we have seen a need to strengthen our efforts to protect those affected by the conflict.

To ensure vulnerable people continue to receive legal information and counselling, we have increased the capacity of our hotline and introduced additional communication means such as Skype and Viber. We have also updated our information materials to include all new relevant information coming from the government, including recent announcements about displacement issues and rules for crossing the “contact line”.

Given the rapid development of the situation with Covid-19 and corresponding changes in the legal framework, there is a need to strengthen efforts in protection as well as timely and effective dissemination of information on the impact of those changes on the lives of people affected by the conflict. 
In order to ensure vulnerable populations, including NGCA residents, are being assisted with legal information and counselling, we increased the capacity of our hotline modality. We introduced additional communication means such as Skype and Viber. Also, we updated our information materials to include all new relevant information coming from the government, including recent announcements regarding displacement issues and regulation of the crossing the “contact line”. This also includes maintaining our legal aid Facebook page and launching an ad campaign for each post with useful information to ensure people know how to reach us via mobile and digital channels.

Photo: Natalia Patlatiuk/Norwegian Refugee Council
Read caption Providing online counselling via Viber. Photo: Natalia Patlatiuk/NRC

“The hotline allows us to compensate for the significant reduction in field presence. Our legal officers, in some cases, have managed to enable people to use electronic court procedures, allowing them to protect their rights without attending court hearings or even crossing the contact line,” says Maksym Solovey, our information, counselling and legal assistance project manager.

Being on the frontline

There is a particular concern that eastern Ukraine – ravaged by six years of armed conflict, weakened health systems and an ageing population – risks facing a Covid-19 outbreak of considerable scale. Healthcare workers are not only at higher risk of infection but can also amplify outbreaks within healthcare facilities if they become ill.

Natalia Sapronova (39) is the head nurse of the palliative care department of the Kreminna multi-field hospital. She takes care of bedridden patients after a stroke who require constant attention. Natalia and colleagues feed the patients, bathe them and fulfil the prescriptions.

“Now we have 33 people in the department. These are mostly older people. However, one person is under 30 years old with a spinal injury and one – aged 30 to 40 – after craniotomy associated with trauma. People usually come from other departments, so they are fully examined,” explains Natalia.

Natalia is showing the entrance to the palliative care department. 

Photo: Violetta Shemet/Norwegian Refugee Council
Read caption Natalia is showing the entrance to the palliative care department. Photo: Violetta Shemet/NRC

“No-one knows when exactly this virus awaits us. We urge all people to follow the well-known rules of protection,” says Natalia Sapronova, 39, head nurse of the palliative care department of the Luhansk regional hospital.

We provided the palliative care department in the city of Kreminna with sanitising equipment to help protect patients, as well as the health workers serving them.

Helping the hardest hit

Despite the many unknowns surrounding Covid-19, there is evidence that older people are at the highest risk. There is a significant proportion of elderly people in Ukraine – approximately 23 per cent of the population are aged 60 or above. Almost all of them have at least one chronic illness, making them extremely susceptible to Covid-19.

Tetiana Zelenska, 35, works for the regional centre for social services, providing single low-income older people and people with disabilities with home care, in-kind targeted assistance and social adaptation.

“During the first half of 2020, we managed to serve over 1,800 people despite the quarantine. From 13 March onwards, we stopped admitting new patients at the centre. However, we did not stop supporting people at home,” says Tetiana. “They are extremely vulnerable and have no-one to help them. They die, or get sick and find themselves in difficult situations. Many of our employees save lives. NRC provided us with hand sanitiser dispensers, which we ask visitors to use when entering the ward.”

During the first half of 2020, the territorial centre managed to serve 1,829 people despite the quarantine measures imposed due to the outbreak of Covid-19 in Ukraine.
“Since 13 March, we cancelled the reception of people in the institution. However, we did not dare to stop servicing wards at home. Our social workers had a tough time. They stood in line in front of shops to buy all the necessary products for older people who have no relatives and who need external help. Often they had to travel long distances on foot, as public transport was stopped,” recalls Tetiana.
Territorial centre and its staff started fighting the coronavirus on their own. 
“We had bought gauze and sewed masks for all the workers, gave out gloves, and carried out outreach activities. All employees immediately expressed their willingness to help their wards, despite the pandemic, since many of them have no one even to buy bread, and people themselves did not reject any support. Now we ask visitors and wards to use a dispenser with disinfectant and put on a mask when entering,” says Tetiana.

Tetiana is testing a dispenser installed by NRC. 

Photo: Violetta Shemet/Norwegian Refugee Council
Read caption Tetiana is testing one of the hand sanitiser dispensers installed by NRC at the regional centre for social services. Photo: Violetta Shemet/NRC

NRC's response:

  • By mid-August, we had installed 1,800 hand sanitiser stations and distributed 17,000 litres of the antiseptic liquid at crossing points, shops, administrative buildings, social institutions and on public transport.
  • Since the beginning of the quarantine, we have provided legal aid services to 1,570 people via remote communications means.
  • In the first half of 2020, we granted cash assistance to 8,703 of the most vulnerable people in eastern Ukraine.

Read more about our work in Ukraine.