EU healthcare systems adjusting to arrival of 2.5m Ukrainian refugees

The EU’s healthcare systems, already stretched from the COVID-19 pandemic, are adjusting to deal with the huge influx of new arrivals from Ukraine – numbered over 2.5 million, as of Friday (11 March).

Poland has already received over 1.5 million people based on UNHCR data, making it the member state that has taken in the largest number of new arrivals.

The Polish health ministry’s spokesperson told EURACTIV on Thursday that the country has prepared around 7,000 places for Ukrainian citizens, across approximately 120 hospitals.

The total number of patients in Poland was not specified, but the ministry said that over 700 children have been treated in the country’s hospitals as of Friday. “Their most common diseases are pneumonia as a result of travelling from Ukraine. There are a few children who need dialysis and there are children with cancer,” the spokesperson said. 

Sandra Gallina, the director-general of DG SANTE, the Commission’s health policy-making body, said on Friday (4 February) in an information-sharing webinar that fleeing people do not only “have to spend time in the cold” but also are coming with cancer conditions, heart conditions or psychiatric illnesses.

“You get a perfect recipe for unhealthy states at the end of the day,” she said, adding that “we need to extend to them a helping hand”.

And countries bordering Ukraine cannot manage this alone. 

As the refugee flow continues, the Polish Health ministry is cooperating with the European Commission and the French Presidency of the EU in discussions on relocation of patients coming from Ukraine.

“Currently a mechanism of relocating Ukrainian patients from Poland to other countries is being worked out. The Commission reported that over 10,000 beds are available in the EU Member States,” Polish health ministry’s spokesperson said.

Isabel de la Mata, the principal advisor at DG SANTE, explained on the webinar that the coordination mechanism for the transfer of patients is provided through the Directorate-General for European Civil Protection and Humanitarian Aid Operations (DG ECHO) and the Emergency Response Coordination Centre (ERCC). Both organisations work closely with the national competent authorities, she explained. 

Medicines and medical devices are also included in the transfers via the EU civil protection mechanism, and the requests received so far can be shared with any interested stakeholders. 

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Following seven days of the war in Ukraine, one million refugees have fled to neighbouring countries and to help those fleeing and staying, $1.5 billion was pledged for humanitarian support on Tuesday (1 March).

Addressing chronic diseases

John F. Ryan, acting deputy director-general at DG SANTE, highlighted that of those fleeing Ukraine, the “majority will be healthy on arrival”, while others may have “physical exhaustion, distress, dehydration, cold”. Finally, he added, some “may have suffered from established chronic conditions”.

“In a crisis of this kind, many people think of casualties and injuries but they don’t necessarily think of the problem of cancer patients, people with diabetes, people with HIV, people suffering from COVID,” Ryan said. 

The refugee crisis in the time of pandemic is concerning as less than 35% of the Ukrainian population is vaccinated. Ryan stressed that “the environmental conditions in which they travel or in which they’re staying in the reception centres may increase their exposure to COVID”.

As for cancer patients, Mike Morrissey, chief executive at European Cancer Organisation (ECO), highlighted the issue of patients arriving “without any information about the treatment that they’ve already received, which obviously makes life very difficult for the healthcare professionals who receive them”.

Another issue is translation. “Translation is a massive priority. People arriving, crossing the border looking for help with the fact that they have cancer and are not able to communicate effectively with healthcare professionals,” Morrissey said.

Ryan also stressed the importance of cultural mediators, interpreters, and translators. 

“Citizens from Ukraine may arrive with prescriptions in Cyrillic. They would need to be heard and understood,” he said. 

Ryan also highlighted that “NGOs with specialised expertise may be able to assist authorities that would need help, for example, in understanding the differences between the HIV medications used in Ukraine and those authorised in the European Union.”

EU ministers activated temporary protection directive for Ukrainians

EU ministers unanimously agreed to offer temporary protection to refugees fleeing Ukraine during a meeting on Thursday (4 March), as a million have left the country.

Monitoring the needs

The EU Health Security Committee, which was set up in 2001 at the request of EU Health Ministers as an informal advisory group on health security at the European level, is the link between member states and DG SANTE. 

“This is a specialised committee with experts, that, for instance, gives us immediate replies on the availability of hospital and intensive care unit beds, surgical capacities, treatment of burns and other conditions,” Gallina explained, adding that the committee is “a very important actor”. 

The European Centre for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA) are also involved. ECDC is supporting member states at the border with Ukraine and Moldova to manage arrivals in a way that is best for managing communicable diseases by providing risk assessments. 

In the meantime, the EMA is monitoring “a possible impact on the supply of medicinal products, including in the EU if there are any shortages,” Gallina said.

At the moment, all people fleeing Ukraine – irrespective of their nationality – are entitled to immediate assistance. This includes temporary shelter and the fulfilment of basic needs such as food and medicine, the EU Commission’s spokesperson told EURACTIV.

For those eligible for temporary protection access to the medical care needs to be ensured. The Commission is preparing guidelines to support the Member States in the use of the Temporary Protection Directive, that EU ministers activated on Friday (4 February), for healthcare and treatments for chronic illness and long-term care. It’s under Member States’ responsibility to develop procedures to ensure access to different healthcare services. 

As for those applying for international protection,  the rights to healthcare will be ensured under the Reception Conditions Directive.

EU announces funding sources to support fleeing Ukrainians

The European Commission adopted on Tuesday (8 March) a proposal for Cohesion’s Action for Refugees in Europe (CARE) that allows EU countries and regions to provide emergency support to people fleeing from Russia’s invasion of Ukraine. 

[Edited by Nathalie Weatherald]

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