Russia’s invasion a year ago has exacerbated the problems that afflicted Ukraine’s health care system, creating a new threat to the lives of patients struggling with cancer.
Between Feb. 24, 2022, the first day of the invasion,and Dec. 21, 2022, Ukraine’s healthcare system sustained an average of two attacks per day, including bombing of hospitals, shelling of emergency medical vehicles, and torture of medical personnel.
These attacks on Ukraine’s healthcare system are war crimes. They also fit into a certain set of actions that could potentially be considered crimes against humanity.
According to “Destruction and Devastation: One Year of Russia’s Assault on Ukraine’s Healthcare System,” a report published by Physicians for Human Rights, 707 brutal attacks on hospitals, other health infrastructure, and medical workers were recorded during the first year of Russia’s full-scale invasion.
Patients with cancer who were already at a hospital on Feb. 24, 2022, were forced to choose whether to go home and not know when it would be possible to resume treatment, or stay in the hospital for an indeterminable time.
Both options entailed their own risks: either the progression of the disease or the staying at a hospital that was in no way protected from being hit by enemy missiles.
In the first weeks of the full-scale invasion, only 18 out of 29 oncology centers were operating on their usual schedule, while others had to limit their hours and services. Oncology centers suspended radiotherapy and resumed it only in April. PET-CT imaging was no longer available in Ukraine, and patients were forced to travel abroad to find it. Similarly, pharmacies, laboratories, and diagnostic centers were closed in the first days after the invasion.
In most cases, availability of oncology care varied by region.
While it was difficult to resume regular operations in critical oncology facilities in Kyiv, patients in Western Ukraine could continue to receive care. This affected not only those who lived in the region before the war, but also those patients who were forced to go as far as possible from active combat zones.
Many medical professionals had to leave the country or move to the western part of Ukraine, leading to a shortage of skilled healthcare workers. Furthermore, the evacuation of international students meant that they had to continue their studies online.
This created a problem: oncology centers in Western Ukraine were overcrowded, with the number of patients increasing by 150-200%.
When patients living near the front lines asked Inspiration Family, our non-profit organization to provide assistance, they told us about the harrowing conditions they faced during their cancer treatment.
A patient from Mykolaiv told us that at first there were practically no nurses and doctors left, while those remaining shouldered all the burden of seeing patients. Pharmacies were barely functioning, and people stood outside, for an hour, with active shelling and gunfire nearby, to buy chemotherapy and supportive care medicines.
The choice was akin to a game of Russian roulette: What will kill you sooner? Cancer or artillery?
Today, we still need to intensify humanitarian assistance to help cities and towns that are so close to the front lines as well as those suffering from missile strikes. This need is urgent.
A year after the invasion began, cancer patients continue to travel across Ukraine in search of treatment and medications. Some oncology centers remain overcrowded and have long wait times for treatment.
The biggest problem for cancer patients has been access to cancer drugs. We have gaps in the supply of medicines purchased by the state for public oncology centers. Basic chemotherapy drugs, including oxaliplatin, rituximab, paclitaxel, and capecitabine were not available for several months. Due to the lack of medications, women with breast cancer were forced to interrupt endocrine therapy.
These drugs are not available in pharmacies—period. Patients cannot buy them even by paying out-of-pocket. As a result, selling of fake medications that are marketed as cancer drugs has become more widespread.
Access to targeted therapy and immunotherapy is especially constrained. These modalities were not covered by universal health insurance before the war began, and so were not free for cancer patients, who were forced to raise funds through social networks, sell property, or take loans.
Today, when everyone is using what extra money they have to support the Ukrainian army, especially when they have relatives who are in the armed forces, these expensive medicines are becoming simply unattainable.
We cannot calculate how many cancer patients have died due to the war, and not only from enemy shells, but also because of the progression of cancer due to lack of access to cancer drugs and medical care.
Ukraine still faces several challenges, including the absence of high-level strategic documents like a national cancer control plan or nationally recognized policies of cancer prevention and screening, ineffective funds distribution, corruption, and a shortage of some specialists.
Behind these numbers are stories of real people who could not get to the hospital, could not receive chemotherapy or pain medications in time. In addition, according to oncologists, the number of cases of cancer diagnosed in the later stages has increased.
Ukraine needs not only medicines for those patients who are already ill, but also a powerful information campaign and opportunities for early detection, prevention, and cancer screening.
Also, it’s essential to investigate how war has affected cancer treatment.
The number of organizations that help adult cancer patients in Ukraine is small, while the number of adult cancer patients enormous.
Before the COVID-19 pandemic, every year, about 1,000 new cases of cancer in children and about 140,000 new cases in adults occurred in Ukraine. In total, more than 1 million adult cancer patients live in Ukraine, including 300,000 who are undergoing active treatment.
Since the first days of the war, our cancer patient advocacy foundation Inspiration Family has been coordinating treatment and medication of adult cancer patients in Ukraine, in collaboration with the Ministry of Health and international medical and non-profit organizations.
We submit requests for humanitarian assistance for specific cancer medicines on behalf of patients and we represent patients who must travel abroad for treatment as part of collaborations and joint projects. Inspiration Family works to raise awareness about cancer in our society and in state policy related to equitable treatment of cancer patients and access to high-quality cancer treatment in Ukraine.
What have we accomplished during one year of the war?
- 1,480+ consultations related to cancer treatment in Ukraine
- 463+ consultations about cancer treatment abroad (183+ patients are receiving treatment in Europe)
- 518 patients received humanitarian aid in the form of cancer drugs including letrozole, capecitabine, and tamoxifen
- 83+ patients received translation of medical documents into English and German to enable them to continue treatment abroad
Thanks to collaboration with the Israeli Hadassah Medical Center, Ukrainian onco-hematologists have been trained in bone marrow transplantation and CAR T therapy under the guidance of Prof. Polina Stepensky.
Among the patients whom our foundation helped to get treatment abroad through medical evacuation in cooperation with the Ministry of Health is Tetiana Stepanishyna, a metallurgist from Mariupol.
Tetiana worked at Azovstal and lost her leg due to an artillery explosion in the city. “The only thing that helped me hold on was my husband’s knitted hat. I was scared or in pain, I pulled it all over my eyes and felt my husband’s love and his arms around me,” she said.
Tetiana was taken to occupied Donetsk against her will. It was there that she was diagnosed with breast cancer. She managed to escape to Zaporizhzhia.
Tetiana, along with her husband and children, was evacuated to Sweden. She now lives in Stockholm, receiving treatment for breast cancer, and learning to walk again with a prosthesis. Her house in Mariupol was destroyed by Russian troops, so there is simply no place for her or her family to return.
How can our foundation be supported?
Inspiration Family can be supported by using the following link:
https://inspirationfamily.org/charity
