Intended for healthcare professionals

Feature Ukraine Conflict

Ukraine’s private clinics step into the breach of a targeted health system

BMJ 2022; 377 doi: (Published 29 April 2022) Cite this as: BMJ 2022;377:o1081
  1. Nataliia Bushkovska, freelance journalist
  1. Kyiv, Ukraine
  1. natalidebush{at}

As the war takes its toll on Ukraine’s national health system, the country’s private clinics have stepped in to help patients, reports Nataliia Bushkovska

As war spreads to new Ukrainian cities, access to basic medical services has been hampered, and some patients can’t get to hospitals because of the dangers. The Ukrainian Ministry of Health reported that, as of 21 March, Russian occupants had damaged 135 hospitals, nine of which were destroyed beyond repair. Some patients couldn’t reach hospitals, some were frustrated as they moved to other regions of Ukraine without a job or money, and some hospitals were overloaded with emergency care, with no time to treat more moderate medical conditions.

Ukraine’s private medical industry is stepping into the breach. Most offer primary care free of charge or at hugely discounted costs. Some offer secondary care including emergency surgery, maternity services, and other emergency medicine, although such services are concentrated primarily in Kyiv.

Hanna Ivanova is executive director of a clinic with branches in Kyiv and Kharkiv.“These cities have been under missile attacks since 24 February,” she says. “Kharkiv is the second biggest city in Ukraine that is bombarded heavily, and often we consult our patients to the sound of air raid sirens and air bombs.”

Ivanova tells The BMJ that her teams—including neurologists, psychologists, paediatricians, family physicians, and surgeons—decided to offer their services free, which they do in person or online. “We aren’t earning anything [right] now,” she says.

When asked why, she explains, “On the second day of …

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