The critical role of diabetes organisations during humanitarian emergencies - Ukraine 2022: Diabetes and War
Last update: 21/06/2022
According to the IDF-2021 Diabetes Atlas, there are 2.3 million people living with diabetes in Ukraine in 2022, of which 230,000 are receiving insulin.
The war with Russia created about 8 million internal refugees who have been forced to move to the western regions of Ukraine with millions more who have fled the country. War, displacement, and the daily struggle with diabetes are now a combined threat to thousands of Ukrainians. Most refugees abroad in European countries are provided with the necessary equipment and treatment, often with the help from national Diabetes Associations that are part of IDF Europe. For people living with diabetes in conflict zones and occupied territories in Ukraine, the situation is much harder with access to care and treatment being very limited.
Ukrainian nationals living with diabetes are defending the homeland both in the ranks of territorial defense and on the front lines, "volunteering" in all areas, supplying first aid kits to the front lines, snacks to bomb shelters and new equipment to children's endocrinology departments. The Ukrainian Diabetic Federation has greatly intensified its operations across the country and new regional diabetes organizations are being created.
"On February 24, at the beginning of the war... we experienced Grief, tears, the deaths of our children, our elders , our women and our brave soldiers who have stood up to defend their country. In this difficult stage of our lives and the life of our beloved Ukraine, we matured, became wiser, stronger and more attentive to each other. People with diabetes were left alone with their huge burden until they united and helped each other. It was difficult to get access to insulin, test strips for a glucometer, but doctors and volunteers were able to finally regulate the supply for those in need. We are the power! Glory to Ukraine!" Alexander Galaev, director of the Odessa branch of UDF, UDF volunteer since 10 years.
Providing people with diabetes with the essentials medical help.
The war has deprived people with diabetes of their usual contacts with their caregivers and endocrinologists. Two endocrinologists had to leave Chernivsti and five left Kharkiv. In Dnipro and Zaporozhye, everything is in place. In Nikolaev, our heroic doctors work even in a hospital that was partially destroyed due to a direct missile hit.
Access to insulin
There is currently no shortage of insulin in the country. The prescription fee for insulin that has been instored during martial law has also been canceled. The state covers the cost of insulin drugs in full. Logistics issues and the number of working pharmacies that have sharply decreased during the first month of the war created short-term interruptions of supply for insulin. The unstable operation of the Internet also had a negative impact on the availability of insulin across the country. Due to the inability to guarantee compliance with the temperature regime, UDF had no choice but to refuse to receive humanitarian insulin and provided information support instead (information about working pharmacies and the availability of medicines).
Almost 30,000 glucose meters with strips provided for people with diabetes by Direct Relief Foundation were distributed by UDF to cities and villages, to children's hospital emergency rooms in military hospitals and to ophthalmology clinics across Ukraine.
As of May 31, 2022, Direct Relief's efforts to respond to the crisis in Ukraine have resulted in the delivery of more than 650 tons of emergency medical supplies valued at more than $315 million.
Delivering all these medical supplies to areas in need has been challenging. Volunteers and the Red Cross have managed to deliver supplies to occupied cities and communities along the line of conflict. UkrPochta has been delivering our heavy parcels across the country, at the request of regional and district hospitals, to territorial social assistance centers, diabetes NGOs, and UDF branches.
"Organizing the logistics of so many emergency goods, is not an easy task in peacetime and even more so in times of war. I am glad that despite all the difficulties, we coped and were able to deliver aid to those who needed it, even in the temporarily occupied territories and war zones." Kirill Goncharuk, UDF board member and CheckEye CEO.
Before the war, the state provided glucose meters only for children and pregnant women. Adults living with diabetes had to buy self monitoring devices at their own expenses. As the war deprived people with diabetes of their usual contacts with endocrinologists, the availability of self-monitoring devices became even more important. People with diabetes had to switch to an unfamiliar insulin preparation on their own by adjusting the dose to an unfamiliar regimen while sometimes experiencing a poor diet. In just one month, more than 500 people in the remotest corners of Ukraine received test strips for ONE TOUCH SELECT glucose meters on the basis of applications from people living with diabetes.
National Diabetes Programme
A new opportunity has risen in these terrible times to put an end to endless reforms in the area of diabetes care. Drawing on the experience of successful National Diabetes Program (NDP) implementation in other countries and the rise of new technologies to build a modern structure of diabetes care, we received a Direct Relief Grant to help instore a NDP in Ukraine. The focus of the NDP will be on modular management system of diabetes care, innovative technologies, reliable statistics and prevention.
You're not alone
UDF, in conjunction with a military hospital, began a project titled «Analysis of the Prevalence of Diabetes Mellitus in the Military. Development of Preventive Measures» After the results of a military diabetes prevalence study conducted in 15 countries showed the prevalence of diabetes in the military to be at 9.15%. Uncontrolled diabetes has increased the number of amputations and people losing their eyesight due to the inaccessibility of timely diagnosis and treatment. The war has deprived many of them of family and care from their loved ones. The UDF in conjunction with the Department of Palliative and Hospice Medicine at the P.L. Shupik National University of Health Sciences have created the first specialized diabetic palliative care unit to provide care for this category of people with diabetes at a health care institution in Kiev.
Seeing a colorful world
The war has deprived people living with diabetes of regular contact with their endocrinologists and opthalmologists depriving them of access to necessary diagnostics including diabetic retinopathy (DR). To solve this issue, a Ukranian MedTech startup CheckEye with a member of the UDF board Kirill Goncharuk as director, developed a screening tool using a cloud-based platform based on artificial intelligence and machine learning for DR diagnosis in the Chernivtsi region. Innovative technologies based on artificial intelligence are a real opportunity to avoid complications caused by diabetes. CheckEye artificial intelligence can help people with diabetes detect early signs of diabetic retinopathy. The platform which analyses photographs of patient´s eyes make diagnosis to thousands of people living with diabetes in remote rural areas with an 84% accuracy in detecting DR. Training of the algorithm is still ongoing with a goal of reaching an accuracy of over 90% which would exceed expert evaluations. Once diagnosed with DR, the people living with diabetes are provided with the adequate treatment.
Our spirit will not be broken
The DiaEuro-Ukraine team of the Ukrainian Diabetes Federation decided to put aside all their pressing concerns for two days and defend the honor of Ukraine in the Tournament. The DiaEuro-Ukraine team took the third place at the European Diabetes Championship 2022 for people living with diabetes which took place in Warsaw. The Ukrainian Diabetes Federation wishes to thank Direct Relief and the Ukrainian Association of Football for its support.
Children must laugh and live in peace
The spring of 2022 is unlike any other spring experienced in our lives as every Ukrainians lived with great fear. With the shelling that has not stopped in over 100 days and the heat experienced in Kharkov, Galina Mikhno, director of the UDF branch and her team presented the children with rays of sunshine. On June 1, on Children's Day, the famous Kharkov Puppet Theater performed plays for children in the villages of Valkovsky district. Children, laughing with all their hearts, for a couple of hours were able to forget about the horrors of bombing. It turned out to be a real holiday with gifts, sweets, toys, surprises, actors and friends.
Author: Valentina Ocheretenko, on behalf of the UDF TEAM