In Ukraine, mobile teams reconnect remote and frontline areas to medical and mental health care

Because of Russia’s military aggression, populations’ access to medical, psychological and social assistance is a serious challenge for Ukraine. This is especially true in remote, hard-to-reach areas and in communities that have suffered the most from the war or are currently under shelling.

The Pact-led, USAID-funded Public Health System Recovery and Resilience Activity, or PHS R&R, has supported communities with an effective solution: multidisciplinary mobile health teams. Through PHS R&R, such teams were established in the Krolevets community of Sumy region and the Ovruch community of Zhytomyr region. Each team includes a general practitioner, a nurse, a psychologist and a social worker. The work of the specialists is primarily focused on disease prevention, screening, early diagnosis, provision of basic medical care and psychosocial support to residents of remote areas. 

PHS R&R has supported the teams with training. The training sessions help to deepen knowledge on topics including communicable and non-communicable diseases, palliative care, gender-based violence, infection control, immunoprophylaxis and more.

The distance from Krolevets to the Russian border is less than 30 miles. About a third of residents live in more than 70 settlements in the community's rural areas. The ongoing shelling by Russia is causing significant damage to infrastructure and leading many people to delay addressing their health concerns indefinitely.

"We carry out examinations and screening for cardiovascular and oncological diseases, diabetes mellitus, chronic obstructive pulmonary disease and tuberculosis screening. If necessary, we make referrals to other specialists and services. We administer vaccinations and provide palliative care," says Kateryna Ivanchenko, a nurse on the team. "We go to villages and small settlements where there is no medical care at all. Now they know that medical professionals will come and help them. They are waiting for us." 

Tamara Serdiuk, a general practitioner on the mobile team, shares their schedule of visits. "This settlement is a village, and these two are very small hamlets,” she says. “We get as close to them as possible."

Tamara Oleksandrivna described a 61-year-old woman who, with her husband, lives in a place where there is no paramedic station, and it is difficult to get to the hospital. Until recently, they had not visited a family doctor or been examined since the beginning of the war. As soon as the woman found out about the team's arrival, she immediately came to the doctor. She told the doctor that she was losing weight, often felt thirsty, and her skin was very dry. Her high blood glucose level also indicated a suspicion of type 2 diabetes. Her husband was also examined, and his blood glucose level was elevated, too. The doctor gave appropriate recommendations and referred the couple to a family doctor for additional examination. Now the couple is receiving the treatment they need. 

In total, more than 1,800 community members are expected to benefit from the services of the mobile team by the end of January 2025.

"At first I was wary. I wondered whether anyone would come to me or not. Not everyone is ready to talk to a psychologist," says Viktoria Buival, a psychologist on the mobile team. "Going to the doctor is one thing, but going to a psychologist is quite another. But people started coming to me." 

Buival notes that professional and confidential psychological assistance from mobile teams is becoming increasingly popular. “People of various ages and with various problems reach out to us. Some people struggle with sleep, and many are worried because their family members are at war. Others are distressed by the loud explosions coming from the nearby border.”

Many people have lost their jobs and income due to the war. Some of them have children, care for sick relatives or have disabilities. Social worker Tetiana Tretiak explains to people about their rights, what social services they can use, and how and where to apply. She also refers people to organizations and programs that can provide more specialized assistance.

"I am concerned that people are less likely to plan their future,” Tretiak says. “Life is changing fast: Today it's calm, tomorrow it's unclear, the day after – you must pack and leave. That's why it's hard for people to listen to advice that would be appropriate in peacetime. But I say that life goes on. Wherever we are, we need to act and move forward.”