Donbas war has been lasting for five years; fewer and fewer civilians reside the temporarily occupied territories of Donetsk and Luhansk regions. There are several reasons for the decline in the population, but one of them is the poor quality of medical care against the background of the constant increase in the number of patients. Let us try to understand the situation from the example of Donetsk People’s Republic (DPR).
I have talked to the doctors and "potential patients" from the temporarily occupied territory of Donbas, and I was really shocked. An extremely unfavorable situation has developed there. Thus, since the end of 2014, cancer, tuberculosis, and HIV-AIDS cases have sharply increased there. At the same time, as of the end of 2018, there are about 40% of vacancies among DPR doctors. This year, the local authorities are trying to resolve the critical situation by assigning the status of "military service" to all medical workers. They expect that this will stop the massive dismissals of healthcare employees, who do not want to work for $ 100.
In the first half of 2015, "26,781 cases of HIV infection were officially registered (the prevalence rate is 1,157.4 per 100,000)" in the temporarily uncontrolled territory. According to their own data, Donetsk, Torez, Khartsyzk, Kirovske, Yenakiyeve, as well as the Telman district demonstrate the highest indicators. The number of patients registered at the dispensary reached 15,687 people, including 3,635 people with AIDS. HIV prevalence is 678.0 per 100 thousand. In 2016 – 2019, any "official data" were published. According to the Ukrainian specialists, there is no objective data on the situation with the spread of HIV infection in occupied Donbas, and there is no effective control system there.
In 2017, DPR has faced a critical situation with tuberculosis and associated diseases. Local doctors say the figure has increased by 54%, and "over 75 cases of deaths have been recorded." Russian outlets, in particular, Komsomolskaya Pravda, referring to the “DPR Ministry of Health,” tried to convince us otherwise. This media posted information that in 2017, the “DPR managed to reduce the growth rates of tuberculosis, the incidence of which decreased by 21% compared with the pre-war time. The mortality rate from this disease in the current year, compared to the pre-war period, has decreased by 53 percent." But the "officials" and journalists did not take into account one important factor. These data, however, as well as other statistical data, were obtained due to a large number of patients who left the area because of the increased emigration of the population, including infected militants. We should not exclude the fact that the statistics were corrected in favor of the Russian curators.
It was impossible to openly get some credible information about the situation in the DPR healthcare system. The "ministry" hides these data, and their disclosure is equal to "high treason."
The local doctors say that the number of cancer patients in Donetsk, Makiyivka, and Horlivka has significantly increased during the years of war. According to the “softest” estimates of pulmonologists, the level of tuberculosis, including those with an open form, exceeded the pre-war figures at least three times, and the trends in this area of medicine cause serious concern among the specialists. And this is not surprising. Donetsk city and regional clinics have purchased any disinfectants, detergents, etc. since the second half of 2014.
Against this background, in January 2019, telephone messages were sent to all hospitals and clinics of the so-called “DPR.” The message says that it is impossible to finance the purchase of disinfectants and detergents. Money for the repair of medical equipment, vehicles, and buildings will be allocated residually.
One more indicative challenge is the issue with the supply of medicines. Local doctors recommend buying drugs in Ukraine. Those drugs, supplied from Russia, are defective; at best they contain chalk, calcium or other harmless substances. The pharmacies of occupied Donbas towns and cities are full of drugs, which have almost expired or have counterfeit medicines, which can cause significant harm to the patients’ health.
Moscow is well aware of the critical situation in the DPR healthcare system, but since 2014, sufficient funds for the needs of the civilian population have not been allocated. And when the Kremlin leaves Donbas, hundreds of thousands of patients with tuberculosis, HIV-AIDS, cardiovascular diseases, cancer, and people with acute depression would have to be treated by the Ukrainian doctors.