To support the health facilities in Ukraine during the COVID-19 pandemic

Bárbara Scoralick Villela has worked as health coordinator for Ukraine mission of Première Urgence Internationale during the COVID-19 pandemic. She tells us about her experience in the field.

Can you explain us your role at Première Urgence Internationale and specifically about Ukraine mission?

I have been in the position of Health Coordinator on the Ukraine mission, from March 2019 until today. My job normally is to take care of the technical aspects of a mission and of the implementation of the projects.

We have, for example, a project in which we provide e-vouchers for free medicines distributed to children under five years of age, pregnant and lactating women, and emergency surgeries for trauma patients with major and minor surgery kits. In this context, my job consists in working with the team to decide what drugs put in the kits. Then, do the follow-up and quality control. In this case, we have a database where we can check how many drugs and antibiotics were prescribed, if they are used in a correct way and which gaps we can fix by conducting training sessions to the medical staff.

What the context currently about the COVID-19? 

When the COVID-19 arrived in Ukraine (the first case was registered on February 29, 2020)

we had to adapt our activities, as for every mission of Première Urgence Internationale.

I had to take care of thinking, together with the staff, what type of activities should continue, for example in case of distributions, how to manage the social distancing, how to change our behaviour, how to put in place precaution measures.

It’s really about the “Do No Harm” concept that we tried to continue our work: we should always bring a positive impact and not create additional problems, by adjusting our activities.

For example, we decreased the number of field trips: we changed the frequency of visit on the field, where and how they were allowed, especially in hospitals. Every field trip had to then be justified and approved, more than before.

For us, one of the biggest change, due to the COVID-19 situation in Ukraine, has been the closing of the entry exit crossing points (EECP) in the east of Ukraine. There are 5 authorized crossing points between Ukraine and the self-proclaimed People’s Republics of Donetsk and Lugansk, and Première Urgence Internationale has been conducting first aid emergency response for 4 years in 4 of them. In fact, we normally intervene there providing first aid to people that want to cross the contact line. When the pandemic was declared the crossing points closed, but we knew that once opened thousands of people would be there. So while they were closed, we have order proper protective equipment for the team, and we started to train our team for the upcoming re-opening: how to manage people arriving, which type of patient to treat or refer, etc.

In particular, we are worried about elderly people because they already cross the contact line in more vulnerable situation and with additional health concerns, such as cardiovascular diseases. Everyone will be very exposed, so we are trying to work for their safety. So, preparation is fundamental in this moment.

Currently, for some days, just one side of crossing points has been opened and when entirely open, the authorities only approve specific groups of people to cross them: students that have to pass their final exam, for example. This raises additional concerns as the elderly often need to cross to collect their social benefits.

Première Urgence launched a project “Support to health system contact tracing as COVID-19 response Donetsk Oblast”. Can you tell us about this project?

Based on our experience of implementing health programs in Donetsk Oblast, working directly with primary healthcare facilities along the contact line, Première Urgence Internationale proposed an intervention focused on COVID-19 affected districts of Donetsk Oblast, with the overall aim of containing the spread of the COVID-19 pandemic.

Premiere Urgence Internationale proposed to support the affected districts through capacity building of healthcare professionals and provision of kits, incentive for fuel and mobile connection for health facilities.

We discussed with the government about the utilisation of an app for the tracing of cases, but the data protection here is really enforced and authorities were hesitant to allow for this intervention. The government thought anyway that our project was very useful and we started to develop the aspect about the capacity building and the kits distribution of the project that is quite relevant.

I was very surprised, also, about the reaction of the health facilities when we start to call them for propose our training support, which is not always welcomed. They were very receptive and they asked us to be trained on how to use correctly masks and how to manage the stress in the staff. This shows that there is a real need on what we are responding and that our work is useful.

At the end of your mission: what you bring with you about this experience in Ukraine?

I am a true believer of the integrated approach and in Ukraine I could really experience what this means, it was extremely interesting to see how different sectors can work together. For instance, we began to notice that even for us in the Technical Department, it opened up our minds to see behind technical things.

Regarding the context, also, I bring with me the unique experience to work in a context in which elderly people are one of the main groups affected. When you study, the focus is often placed on women and the children, but in this case, this crisis is affecting the elderly in a significant way people and it was very interesting to work on this.

All these activities are implemented by Première Urgence Internationale with the support of the United Nations through OCHA (Office for the Coordination of Humanitarian Affairs).