In 2019 alone, more than 40 deaths were recorded at the entry-exit checkpoints (EECPs) in Donetsk. In order to address this, it is necessary to urgently review the healthcare system and modify the medical infrastructure to suit the particular necessities of the region. This was discussed during the presentation of the report “Investigating the Conditions of Access to Care at EECPs.” The report was prepared by experts of the Charitable Fund Right to Protection (R2P) based on the monitoring results of the five checkpoints operating on the line of contact.
According to Anastasia Odintsova, Advocacy Coordinator at R2P, the reason for conducting this complex research was concern about the statistical results obtained from Lugansk and Donetsk regions. For example, in 2018, more than 50 people were killed either by shelling at the EECPs or by health problems exacerbated while crossing the line of contact, and another 38 people died in the first nine months of 2019.
Only one of the above mentioned EECPs is actively involved in the provision of medical assistance to the civilian population through the use of public services. In the other cases, access to medical assistance came entirely from non-governmental and international organizations, as well as volunteers. Thanks to the efforts of groups like these, many tragedies have been avoided. However, this does not solve the systemic problem-one which should come under the responsibility of the state.
Iryna Pesko, Legal Analyst at R2P, said during the presentation that, of the approximately 130,000 people who cross through the EECPs every month, the majority are over 60 years of age. For many of them, the journey across the contact line is a severe aggravator of health conditions: “Every day, people seek the advice and assistance of monitors and medical tents at the EECPs because this is the only available alternative to public health care…In Ukraine, we have no precedent or previous experiences to draw a standard operating procedure from. This is a problem that needs to be addressed comprehensively-taking into account the particularities of each potential patient, the weaknesses of local government bodies along the line of contact, and the obvious consequences of the destroyed infrastructure of medical facilities in both the government-controlled and non-controlled territories of Ukraine.”
A separate point of discussion was the lack of on-site medical infrastructure and the lack of adequate staffing for emergency medical centers. According to Valery Panteyev, a medical doctor at Première Urgence Internationale (PUI), their specialists have been providing medical assistance to people at the EECPs since 2016. But the lack of essential medical infrastructure is more evident now despite efforts of physicians, and despite the numerous instances when PUI representatives saved lives. This is a problem that can only be addressed at the state level.
Inna Golovanchuk, Adviser to the Vice Prime Minister and Minister for Reintegration of the Temporarily Occupied Territories of Ukraine, stressed the need for a unified approach and for the provision of medical care at all EECPs: “There are already principled decisions being made at the EECPs along the administrative border with [non-government-controlled areas], and we’re in the process of developing a way to provide medical care to the population at the EECPs and along the line of contact.” She emphasized that the state, as a guarantor of the right to access to medical care, should accept the responsibility from the non-governmental and international organizations that have been providing medical assistance at the EECPs in recent years.
At the same time, in Ms. Golovanchuk’s opinion, given the experience gained by these organizations, it is advisable to consider the possibility of developing a mechanism for the state to contract these organizations to continue their work and define key performance indicators: “A number of formalities-in particular the uncertainty surround the chain of command and the optimal funding of the EECPs–will be eliminated by systematic regulatory work to unify the structure and define the complex of services at the EECPs. This will help meet the needs of the population as soon as possible at the EECPs,” she concluded.
As a result of the presentation and discussion, the participants plan to form a coordination group in the near future with the involvement of representatives of the relevant authorities and, in particular, the Ministry of Health and certain NGOs, to formulate further steps to overcome the identified problems.
The study was carried out under the auspices of the ‘Provision of multi-sectoral humanitarian assistance to the conflict-affected population of Eastern Ukraine’ project, implemented by Right to Protection and with financial support from the European Commission through the EU Civil Protection and Humanitarian Aid’s ACCESS Consortium.