World Humanitarian Day: Health workers build new lives serving their fellow citizens far from home

Video - WHD 2018: the trauma surgeon working in the conflict affected area in eastern Ukraine

Years of conflict and humanitarian crisis in the Syrian Arab Republic and eastern Ukraine have had a dramatic impact on health systems in these countries, as well as in places like Turkey – now home to millions of Syrian refugees. Health workers are often on the frontline of escalating hostilities, as they strive to continue delivering medical care amid horrific conditions.

Thousands of doctors, nurses, midwives and other health professionals have been forced to flee from the conflicts, often abandoning careers they had worked hard to build. Many Syrian health workers have become refugees in Turkey; in Ukraine, many have become displaced. But even far from home, many continue to use their professional training to serve and heal their fellow citizens while striving to reshape their own existence. On World Humanitarian Day 2018, WHO honours these people.

“Health is one of the main needs of populations in humanitarian emergencies, and health workers play a critical role in supporting the people who have been most severely impacted,” says Dr Nedret Emiroglu, Director of Health Emergencies and Communicable Diseases for WHO/Europe. “With the Syrian and eastern Ukrainian crises lasting so long, there has been an unprecedented movement of people over the years, demanding relocation of health services in the host territories, including Turkey. The way health workers have understood and followed this need to serve their fellow citizens is commendable.”

“I feel like I have to stay and contribute to the better future of the place where I was born.”

In April 2014, trauma and orthopaedic surgeon Dr Ruslan Vereskun took his wife and 2 children and fled from intensifying conflicts in his city of Luhansk, Ukraine. Like thousands of others, he hoped to return to his normal life within a few weeks. More than 4 years later, he is still among the 1.5 million internally displaced people in Ukraine.
Dr Vereskun turned the challenge into an opportunity. While he could not return to his home, he chose to stay in the conflict-affected region of Luhansk and built the first tertiary health-care department within a municipal hospital in the industrial town of Lysychansk. He was motivated to serve “his own” people.

“I am very proud of my team and the results we have achieved together despite all difficulties,” says Dr Vereskun between his daily surgeries. “I feel like I have to stay and contribute to making a better future for the place where I was born. The way the happy face of your patient makes you feel sometimes cannot be compared with financial benefits.”

“I am happy I can continue supporting my people in this difficult situation and I can also continue my career.”

Dr Firas Osman is a Syrian doctor from Aleppo who has been based in the south-eastern Turkish city of Gaziantep since 2015. “When we first came to Turkey, we imagined that we would have to leave this profession,” he explains. “We thought that we would not be able to continue using our education after the war because nobody would accept our diplomas.”

Dr Osman is one of over 1800 Syrian health workers trained by WHO to serve in the Turkish health system. With this initiative, Turkey’s Ministry of Health and WHO aim at reducing the language and cultural barriers that refugees experience when trying to access health-care services, while at the same time providing new opportunities for Syrian medical workers.

“I am happy I can continue supporting my people in this difficult situation and I can also continue my career,” Dr Osman concludes.

Ongoing emergencies drain health resources in Turkey and Ukraine

In the east of Ukraine, the contact line separating government-controlled and non-government controlled areas continues to divide Donetsk and Luhansk regions. People living on both sides are extremely vulnerable due to the ongoing hostilities, lack of access to health-care services and social insecurity.

According to the WHO Health Resources and Services Availability Monitoring System (HeRAMS), 228 health facilities in government-controlled areas require rehabilitation due to their age and the damage caused by the conflict. Additionally, 73% of partially functioning and non-functioning health facilities identified the lack of medical staff as a key factor in limiting the delivery of health services.

The 3.6 million Syrian refugees in Turkey have posed important challenges to the Turkish health system in terms of shaping policy, organizing services and mobilizing resources. In addition, the national health system has needed to adapt in order to overcome language and cultural barriers and the lack of familiarity of Turkish health workers with the specific health conditions associated with the migration process.

The specific health needs of refugees are related to the mental and psychological consequences of conflict and displacement; difficulties in accessing health care to treat chronic diseases and disabilities; and challenges in preventing infectious diseases due to hard living conditions.

Skilled health workforce a priority of WHO’s operations in humanitarian settings

In both Turkey and Ukraine, WHO experts work with local authorities to train health-care specialists to deliver quality health services to their fellow citizens, among other interventions. Trainings for medical staff cover physical rehabilitation, vaccine and laboratory management, and mental health and psychosocial support.

WHO also focuses on improving the skills of community workers to increase the provision of health services in conditions of limited resources. This includes non-professional health workers in Ukraine who are trained to provide mental health support, and Syrian refugees in Turkey who are trained to provide home care to older and disabled refugees experiencing difficulties in reaching health centres.

“Investing in the quality provision of health care for refugees and displaced people through trained, motivated and socially integrated health-care workers represents an investment in the long term,” says Dr Emiroglu. “It perfectly aligns with WHO’s vision in emergencies of building back better health systems for the future. Health-care staff is a pillar of strong health systems and we will spare no efforts to ensure they are able to build back a new life and career to serve the vulnerable.”