![]() ![]() At the same time, civil society programs have proven resilient, and some areas of the country have managed to sustain routine services. The disruption of health services has not been universal, and it has been difficult for authorities to assess the scale of destruction of health infrastructure, with damage only becoming apparent as fighting recedes. Fleeing populations have been met with a surge of support, but receiving health systems, both within and outside Ukraine, are under stress. Over 5 million people have fled the country, while an estimated 7 million or more are internally displaced out of a pre-war population of 44 million. The long-term mental health consequences of war-related trauma will be considerable. Interruptions to chronic care and routine health services threaten to increase mortality and decrease life expectancy. Disruptions to surveillance and treatment programs risk an eruption of infectious disease outbreaks. The security and safety of healthcare facilities, workers, and supply lines remain paramount concerns. As a renewed Russian assault against Ukraine’s southeast begins, Ukrainians are likely to face persistent and intensifying public health challenges as a direct result of the conflict, compounding the impact of the Covid-19 pandemic. Russia's invasion has inflicted extreme physical and psychological trauma inside Ukraine. ![]()
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