Aid workers brace for disease outbreaks in battle-weary Ukraine

Aid workers are preparing for the possibility of cholera and measles outbreaks within war-torn Ukraine, as water infrastructure continues to be damaged and increasing numbers of the elderly and people with disabilities flee Russia’s relentless attacks.

Australian aid worker Nick Prince, who has been stationed in bordering Hungary to help co-ordinate the Red Cross public health response to the war, said the conflict was one of the most complex conflicts he had seen in his decades in international aid work.

Victorian aid worker Nick Prince says the Ukraine conflict is one of the worst he has seen.Credit:Red Cross

“I’ve done a lot of work with ICRC [International Committee of the Red Cross] responding to complex situations,” he said.

“Ukraine is a conflict, but it’s also a complex emergency disaster. It’s so different to a tsunami, where something happens in a very short space of time, and therefore you know how to respond.

“With this, there is no way to know how this is going to end. It’s this slow onset with all these peaks and troughs, but you can’t actually plan how to respond because it is so complex, and it can change.”

As the war enters its 111th day, aid agencies have seen an increasing number of older people and people with disabilities fleeing over the border to Hungary, he said, pointing to a realisation the war will not finish any time soon.

Albert Gomez, a doctor from the Spanish Red Cross, comforts an elderly refugee who fled her home in Ukraine.Credit:Spanish Red Cross

“We believe that’s down to the situation deteriorating to the point the services have become very, very limited, and they’re now making that journey after initially deciding to stay,” Prince said.

“Seeing them come out now is an indicator for us that the wear and tear can just be slowly grinding [people] down. And that resilience is going.”

An Amnesty International report released on Monday accused Russia of committing war crimes in Kharkiv, Ukraine’s second-largest city, in repeated and indiscriminate attacks on civilian neighbourhoods. Amnesty detailed the use of cluster bombs against civilians, documenting a litany of attacks including on a playground and on hundreds of people queuing for humanitarian aid.

Prince, who is from Ballarat in Victoria, said the world’s attention seemed fixed on the military aspects of the conflict, but the health effects sparked by the war would ripple for generations.

“A lot of the focus is on the military images – you know, the guys in military fatigues outside a building that’s been destroyed, or destroyed tanks. I don’t often see a huge amount around the civilians themselves.

“From a public health perspective, it’s not just what’s happening during the conflict, but all those things that can happen afterwards. The health problems don’t stop. And in fact, they’ll probably increase. The evidence is there from previous conflicts. And we can’t underestimate that the trauma that will come from this will last for generations.”

The Australian Red Cross says about 5.8 million refugees have fled Ukraine for neighbouring countries since the war began. Another 7.7 million are displaced within Ukraine.

The UN Office for the Coordination of Humanitarian Affairs has estimated that between March and August, 10.2 million people will need food and livelihood support and more than 12 million will need health support.

Prince, who has worked to set up an emergency response unit in Hungarian border-town Zahony, said agencies were bracing for disease outbreaks.

“With broken sewage pipes and infrastructure damage, obviously that will lead to poor sanitation and water treatment, and we know … there are risks of cholera, which is something that we have been concerned about,” he said.

“If you look at the conditions in Ukraine, where you have broken infrastructure, you have possible contamination of water. That means people are living in very poor conditions. And with that [damaged] water source, that’s obviously a carrier of a lot of waterborne diseases.

“So if you get one instance of cholera against a vaccine derivative of polio, in that environment, that could potentially lead to a big outbreak.”

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