In Ukraine, amid war, Pact and partners bring vital health services directly to communities

Since the start of the war in Ukraine, the health care system has faced unimaginable challenges. According to a recent report by the Global Fund, there have been more than 1,500 attacks on Ukraine's health infrastructure over the past two years, impacting hospitals, warehouses, vehicles and workers. The attacks have devastated services, leaving many, especially in remote and de-occupied areas, with little to no access to essential medical care.

In the face of these overwhelming obstacles, the USAID-funded Community Action for HIV Control project, led by Pact, has become a lifeline for thousands of Ukrainians. Mobile health teams, mobile pharmacy points, patient transportation services and psychological support have been made available to the most vulnerable populations, including the elderly, people with chronic diseases and families in hard-to-reach villages – all right in their communities.

Halyna, a resident of the village of Zakusyli, Zhytomyr region, shares her experience.

"I never thought much about psychological help before the war, but now it feels like everyone needs it,” she says. “The pressure on our entire country is immense, and people—especially children—are seeking support more than ever. Thanks to the psychological help space in our village, residents can connect with specialists online and get the care they need. I encourage everyone to reach out for help—there’s no shame in it.”

In remote villages like Halyna’s, 32 specially created spaces now provide local residents with qualified psychological assistance online. One of the main challenges in implementing these services has been overcoming the "small village" mentality, in which the stigma around psychological help runs deep. It’s not common to talk about feelings, especially with a stranger, and many worry that others will find out and judge them. Despite this, nearly 500 people have already received online psychological counselling through these support spaces. Pact-supported Health Ambassadors are actively addressing this stigma, raising awareness about the importance of mental health and encouraging people to seek help.

Nadiya’s name means "hope," and she truly lives up to it. As a Health Ambassador, her vibrant energy inspires her community to take charge of their health. 

"By living a healthy lifestyle myself, I can inspire others to make positive changes, both physically and mentally. When families embrace healthy habits, they pass them on to their children and grandchildren. If you think of it, a healthy community means healthy workers and, ultimately, a healthy nation," Nadiya explains.

She is one of 46 Health Ambassadors promoting a healthy lifestyle in communities across Ukraine. These ambassadors are not medical professionals, but trusted members of the community, bridging the gap between doctors and patients. They come from different walks of life, with diverse motivations, but all share the same goal: providing support.

Nina, another ambassador from Peremoha village, Kyiv region, lost her son and found solace in becoming an ambassador. 

"Helping others helps me," she says. Together with community members, they knit socks for the military and enjoy activities like Nordic walking.

Svitlana Nazarko lives in Zvirovka village, Kirovohrad Region, with her husband and six children, aged from 4 months to 12 years.

"Psychological help has been incredibly important to me. As a mother of six, the emotional load is heavy, and I often feel overwhelmed. It's hard to discuss my feelings with anyone because there’s no one I can truly talk to about these struggles,” she says. “When the psychologist visited, it felt like a huge relief. They listened to me and offered the support I desperately needed. It made such a difference, especially since my husband is often away working, and I am left to manage everything on my own."

Svitlana’s family also used the services of the mobile health teams. With so many children, it is difficult for her to travel to see doctors. More than 8,200 people, mostly elderly, have received medical and psychosocial services from the mobile health team.

Alongside the medical teams, mobile pharmacy points travel the same routes, delivering medicines, including those provided under Ukraine’s Affordable Medicines program. So far, more than 900 people have received essential medicines. 

Anatoliy Nahornyi sits on a bench by his house. He has trouble walking long distances. For people like him, this means travelling more than 50 kilometres (31 miles) to see a doctor and undergo necessary tests, often relying on several bus connections, so the transportation services provided by the medical teams have been a blessing.

"I was told there would be a car to take me to see the doctor. At first, I didn’t believe it could be free of charge. I was very happy with the whole service. They picked me up, I saw a doctor, was prescribed medicine and the driver took me back home," he says.

The patient transportation service helps those with severe chronic diseases, limited mobility and patients referred by mobile health team doctors get to medical facilities. To date, more than 100 people have benefited from this service, receiving crucial medical care that they otherwise would not have been able to access due to the challenges of distance, mobility and war.

These services continue to be a beacon of hope in Ukraine’s most challenging times. The stories of people like Halyna, Svitlana, Nadiya, Nina and Anatoliy highlight the profound impact of these interventions. USAID’s ongoing commitment to rebuilding Ukraine’s health care system is not just restoring services—it is restoring hope.