Ukrainian refugee situation must stay ‘high’ on political agenda, WHO warns

As Ukraine enters its third year of war, the World Health Organisation (WHO) highlighted the importance of continuing to provide medical and social support to refugees and called for a strong political commitment from the EU.

“It is very important to keep the refugee discussion high on the political agenda, considering the waning support and the reduction in volunteerism,” Dr Nino Berdzuli, WHO’s representative in Poland and special envoy to refugee-receiving countries, warned in an interview with Euractiv. 

Since the Russian invasion started in February 2022, 6.5 million Ukrainians have fled the war, according to the UN refugee agency UNHCR. Two years later, most of them, or around 1.1 million, live in Germany, and another one million in Poland, where they are registered under the Temporary Protection Directive (TPD). 

The 2001 TPD is a tool for EU countries to provide immediate protection in the event of a mass influx of refugees fleeing war from non-EU countries. 

It has been triggered for the first time after the Russian invasion of Ukraine, and rights for the beneficiaries include, for example, access to medical care, education, housing, residence permit, or asylum procedure. 

“The Temporary Protection Directive is a very important mechanism for integrating the Ukrainian refugees into the health and social systems,” Dr Berdzuli stressed. 

In November 2023, more than 4.2 million refugees benefited from the mechanism, according to the European Commission. In September 2023, member states decided to extend the TPD until March 2025, beyond its original expiry in March 2024.

“The EU will support the Ukrainian people for as long as it takes. The extension of protection status offers security to the more than four million refugees who have found refuge in the EU,” said Fernando Grande-Marlaska Gómez, Spain’s acting minister for home affairs.

Some countries like Poland, Belgium, Romania, Czech Republic, Estonia, France or Germany, went beyond the TPD guidelines and granted Ukrainian refugees the same rights as national citizens. 

However, there are no confirmed plans to extend the TPD beyond March 2025, which is why the WHO is calling for a “strong political commitment”, so that the refugees don’t find themselves in a difficult situation. 

“We need to guarantee their access to health care services, to social benefits and many other benefits that are guaranteed by the Temporary Protection Directive,” said Dr Berdzuli. 

Switch in medical needs

It is even more important to extend the TPD given that two years after the war started, there has been a change in the refugees’ needs when it comes to health assistance. 

As the war started, doctors have mainly treated war injuries like head injuries, burns, fractures, or amputations.  The challenge was also to keep providing care and medical support when the Russian army bombed hospitals and maternity hospitals, including in Mariupol, Kherson, or Druzhkivka.

But now, vaccination and mental health have become priorities, said the WHO. The Ukrainian Health Minister Viktor Liashko estimated in January 2023 that 14 million Ukrainians were in need of psychological aid.

“The assessments we did show that among the top healthcare needs are mental health and psychosocial support,” Dr Berdzuli confirmed, as refugees are more at risk of suffering from post-war syndrome, loss, and trauma.

The Ukrainian refugees also have low vaccination coverage rates, which vary from 73% to 85% and represent a threat to host countries as “all countries have immunisation gaps” that could lead to outbreaks, Dr Berdzuli stressed. 

She also warned of the extra burden on the public health systems in the host countries, underlying that the TPD could help them facing pressure and responding to the needs of the refugees. 

Access to the labour market

The TPD provides health and social assistance and is also considered as an economic benefit as it facilitates access to the labour market, and some refugees now work and pay taxes in their host country. 

“It is an investment in human capital that is very much needed to maximize the contribution of the Ukrainian refugees to host countries,” highlighted Dr Berdzuli.

Almost two-thirds (65%) of Ukrainians who arrived in Poland after the Russian invasion are now working in the country, according to the Organisation for Economic Cooperation and Development (OECD).

“This investment in human capital will also help to rebuild Ukraine when they return. So it needs to be continued,” Dr Berdzuli added. 

The total cost of reconstruction and recovery in Ukraine is estimated by the World Bank, European Commission, United Nations, and Ukraine at $486 billion over the next decade.

However, not all refugees have access to the market labour – older people, children, and people with disabilities therefore find themselves in vulnerable situations, living in shelters or with poor access to health services. 

“The Ukrainian refugee situation persists, international protection is still required and the most vulnerable need our support,” Dr Berdzuli concluded. 

[Edited by Zoran Radosavljevic]