Bombs detonated near the Kyiv airport during the morning of February 24, 2022, as an onslaught of premeditated strikes by Russian forces were orchestrated around strategic sites across Ukraine. Thousands of Ukrainian soldiers and civilians have been killed during the first weeks of fighting, and millions of innocent Ukrainians forced to shelter or flee to Western Ukraine and neighboring NATO-member countries such as Poland and Hungary. 1 The large-scale of these unprovoked attacks are unprecedented since World War II and have produced one of the largest mass movements of displaced people from their homeland in recent history, creating a new humanitarian crisis in Ukraine with short- and long-term public health concerns.
The ongoing conflict in Ukraine has roots beyond the annexation of Crimea by Russia in 2014 but has quickly manifested with shortages of health-care professionals and resources along with disinformation communication campaigns affecting the health-care infrastructure. Reference Patel, Grace and Chellew2 For example, a disinformation campaign was carried out during the early COVID-19 pandemic to disrupt the health-care infrastructure and the national preparedness program. Reference Patel, Moncayo and Conroy3 Conflict tends to increase pre-existing public health issues despite the priority being focused on armed war and physical safety of communities. The damages by the attacks can amplify food and water insecurity along with environmental security issues. For example, some of these issues include discharges and fires from bombed industrial sites, water dam destruction, leaking fuel and hydrocarbons from areas of combat, combustion of ammunition, flooding in underground mines with leaching of chemical wastes, heavy metals, and radioactive materials into drinking water supplies.
There are urgent short- and long-term effects on mental and physical health that must be addressed alongside the conflict and mass migration. In the short term, chronic care treatment and health prevention services, such as diabetes, cardiac disease, or cancer screening, will be neglected. An increased spread of infectious diseases, including COVID-19, tuberculosis, polio, and measles will be challenging to control with outbreaks ensuing due to overcrowding in refugee containment areas and disruption of immunization programs. The long-term mental and physical health effects, such as depression, separation anxiety, and posttraumatic stress disorders will affect many generations to come, especially with mental health consequences that have already been exacerbated by the COVID-19 pandemic. Reference Patel, Suhovii and Zvinchuk4
Historically, from the start of the conflict in Donbass to the annexation of Crimea in 2014, over 1.5 million individuals have been internally displaced (IDPs). The United Nations High Commission for Refugees (UNHCR) has assisted partner organizations to provide humanitarian support and protection of human rights. 5 The recent invasion by Russia and its impact will heighten the behavioral health issues, such as substance and alcohol use disorders. The maladaptive coping mechanisms of substance and alcohol use are a result of the conflict and subsequent trauma experienced. Funding and research focused on populations affected by the ongoing Russia-Ukraine War is desperately needed for those who have fled, and for those who remain to fight. A global response and public health support need immediate action to supplement the resiliency of the Ukrainian citizens.
Author contributions
S.P. and T.E. contributed equally to the concept and writing of this manuscript.
Conflict(s) of interest
The authors have no conflicts of interest to declare.
Funding statement
Mr. Patel was supported by the Fogarty International Center and National Institute of Mental Health, of the National Institutes of Health under Award Number D43 TW010543. Dr. Erickson is funded by NIH NIDA SBIR (R44DA051106) and Massachusetts Consortium for Pathogen Readiness (MassCPR). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or any other institution. Dr. Erickson and Mr. Patel were recipients of NATO Science for Peace and Security Programme, fund numbers: G5432 and G5663. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
