LUGANSK, ONE YEAR ON

One year after fighting broke out in eastern Ukraine, people living in the heavily affected Lugansk region are trying to slowly get life back to a sense of normality. Schools have reopened and teams of residents have come out on the first days of spring to sweep the debris of war off the streets.

However with the healthcare system under intense strain and medical supply lines cut or severely disrupted since last summer, people continue to struggle to access basic healthcare and medicines. MSF runs mobile clinics in 32 locations in Lugansk region, to provide healthcare in towns and villages to residents and to displaced people living in temporary accommodation. The teams carry out an average of 2275 consultations per week.

LUGANSK, ONE YEAR ONSTORY AND PHOTOGRAPHS FOR MSF BY JON LEVY

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The town of Zorinsk, located close to the frontline, experienced heavy shelling in February when a fierce battle raged for

control of the nearby city of Debaltsevo. The town’s clinic, school and psychiatric hospital

were all shelled. Many health staff have left the region since the conflict began and those

who have remained behind have continued working while receiving only one or two

month’s salary since last summer. © Jon Levy

Once a week, an MSF team of two doctors, two psychiatrists and a nurse provide free medical

and mental healthcare to people at Zorinsk’s damaged clinic. Before MSF arrived, there had

been no regular supply of medications in the town for ten months. © Jon Levy

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Residents of Bolshaya Vergunka, a suburb on the outskirts of Lugansk city, crowd the waiting room at MSF’s clinic. The winter

months have been harsh in Lugansk, with food and medicines in short supply and rising

steeply in price, salaries and pensions unpaid, banks closed, and in many places little or no

electricity or water supply. © Jon Levy

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With medical supply lines in the east of the country severely disrupted or cut entirely since

last summer, and health facilities located in rebel-held areas not included in the 2015

Ukrainian government health budget, there has been a critical shortage of medicines in the

area. MSF provides free basic medication in health centres and also continues to support hospitals with medical supplies. © Jon Levy

Most people who have remained in Lugansk are the vulnerable members of

the community – the elderly, disabled, and sick – who did not have the means

to flee the conflict. © Jon Levy

Patients with chronic diseases are particularly affected by the lack of

medicines, with many of MSF’s patients in the mobile clinics needing

treatment for heart disease, hypertension, or diabetes. © Jon Levy

After months of conflict, local schools and kindergartens are slowly reopening and the usual childhood medical complaints are top on the list

of many mothers’ concerns: sore throats, stomach aches, colds and fevers. © Jon Levy

Jana, 23, brought her 21 month old child to MSF’s clinic in Gorodishe with a high

temperature. “This street was hit by shelling, a lot of houses suffered, it was very scary.

Things have changed a bit now, but blasts can still be heard in the distance. It is still scary. My

child is still afraid of loud noises and often runs to the basement to hide. What we need

here is medicines for the children. We went to the local pharmacy but [it is closed] and the

prices are too high anyway.” © Jon Levy

Olga, 23, has brought her two and a half year old son to MSF’s clinic in Bolshaya Vergunka for a

pre-kindergarten check-up. “It is quiet now, but we can still hear some explosions [in the

distance]. No one knows what will happen. Prices are increasing all the time and there are no medicines, especially for children. Before the war we had a good paediatrician, but she’s no longer

here. I need to earn money, but there isn’t any work I can find. My partner left when the war

started and moved to Russia. We are in touch and he tries to support me.” © Jon Levy

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As well as running mobile clinics in health centres, the MSF team is also supporting social facilities, including

hospices for the elderly, disabled, orphaned, and people with psychiatric disorders. An MSF

paediatrician visits this orphanage in Lugansk once a week to provide consultations to the children. Victoria

Alexandrovna is the director of the orphanage: “During the war we were evacuated by the Ukrainian

government to Odessa along with two of the city’s other orphanages. But the children here are from

Lugansk and so when things quietened down I decided to bring them back and stay in Lugansk. We used to have a doctor and two nurses here to look after the

needs of the children, but now we have just one nurse who has stayed with us, even without pay.” © Jon Levy