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In Ukraine, COVID-19 is a threat multiplier

Ukraine
Health
The internally displaced queue at one of the five entry exist checkpoints, many of them pensioners. Credit: Right to Protection

Coronavirus is a global crisis, but it will cause the most suffering for the already downtrodden. Nowhere is this more true than in Ukraine.

The country is still ravaged by war, and now coronavirus poses an acute risk to the country’s conflict-affected population, which includes 1.4 million internally displaced people of whom the majority are elderly. What is most disturbing about this situation is that this is a largely gratuitous threat – exacerbated more by perverse policy than by war itself.

Ukraine’s war with Russia is now dragging into its sixth year. The country’s former television star president, Voldymyr Zelensky, promised to bring peace to the region but hope of a resolution in the near future has faded in recent months.

Although Trump’s ham-fisted intervention briefly brought the country’s plight back into the limelight of Western media, the substance of the war itself seems to have largely been forgotten. The conflict in the Donbas region in the east of the country is still very much hot – according to the United Nations almost 13,000 people have now been killed. But the war’s consequences are no less grave away from the fighting.

The majority of those affected by the conflict in Ukraine are elderly. In a recent poll, 62 per cent of those crossing at one of the five entry-exit checkpoints into government controlled territory were over the age of 60.

This group is of course inordinately susceptible to the most dangerous complications of coronavirus. In Britain, over-70s have been advised to stay in their homes, and statistics from the World Health Organisation indicate that the risk of death increases greatly with age. Among people over the age of 80, the death rate nears one in six.

This heavy demographic imbalance in the Ukrainian displaced population is due in large part to the effects of policy adopted by the Ukrainian Government – policy that has caused great hardship for many since early in Ukraine’s war with Russia, and long before this latest health crisis.

More than half of those having to cross into Ukrainian government controlled area from the occupied eastern regions do so in order to collect the meager pension that they are entitled to as Ukrainian citizens.

This is a quarantine measure that fails to resolve the issue of pensioner migration. Further, it cuts off access to medical supplies that many of Ukraine’s conflict affected people find themselves in need of now more than ever

Since 2014, the Ukrainian government has stopped funding social services in the splinter regions controlled by Russian backed militant groups, and has mandated that pensioners and those entitled to welfare still living in these parts of the east register as internally displaced.

They must also have an address in government controlled areas, and cross the frontline into state controlled territory at least once every 60 days. Vast numbers of the most vulnerable in this warzone are therefore forced into a bimonthly migration.

In addition to those who are able to travel, as many as 1.2 million pensioners who live in this area do not receive their pension at all, and the Ukrainian pension fund is now nearly four billion dollars in debt due to unpaid welfare.

The crossings into government controlled areas are not easy. There still exists a threat from stray shelling, but the bigger problems are more quotidian. Crossing is often time consuming and the checkpoints are overcrowded, on top of this, many of them lack heating or basic facilities. These mundane issues could soon prove lethal.

Protracted periods of close proximity among the elderly and the sick is the perfect breeding ground for infection by the coronavirus. Added to the fact that there is an acute lack of accessible healthcare in the splinter regions, and the perfect storm appears to be brewing.  

The Ukrainian government is taking a proactive approach to dealing with the crisis in the parts of the country not afflicted by conflict – it has closed its international borders, schools, and mass public gatherings. From March 16 to April 3, the entry-exit checkpoints will be subject to restrictions – those without permanent residence in government controlled territory will not be allowed to cross at all. But this is a quarantine measure that fails to resolve the issue of pensioner migration. Further, it cuts off access to medical supplies that many of Ukraine’s conflict affected people find themselves in need of now more than ever.

The humanitarian organization Doctors Without Borders has been working in the Donbas since 2014. The Head of Mission in Ukraine, Grigor Simonyan, has spoken recently of his concern. ‘Ninety per cent of our patients until last year were above the age of 50 and needed care for non-communicable chronic diseases, namely diabetes and hypertension.’

This combination of age, pre-existing conditions, the difficulty in accessing healthcare, and the often-crowded queues to cross the border have led MSF to declare that the COVID-19 pandemic has increased their concern in the region.

This policy of the Ukrainian government has long been subject to criticism, but advocacy for change has fallen on deaf ears. A draft law – No 2083-d – proposes that status as a displaced person be decoupled from pension eligibility, the cancellation of a three-year cap on the payment of pension arrears, as well as a means to effectively pay these arrears.

Earlier this year the Verkhovna Rada, the Ukrainian Legislature, put off making any decision on the draft law until next autumn. In light of this latest health crisis, the passage of such a law is more urgent than ever.

 

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