Accessing food and medicine in a warzone: Ukraine’s supply crisis
For those who require insulin or other prescription drugs, the situation is a matter of life and death
A few days ago, my daughter turned 25. She has the world at her feet.
She has studied at a university in the Czech Republic, can speak several European languages and has volunteered with a childrens’ school in France.
We have friends across Europe who are ready to take her in. She could have a great future. But this week, she told me that this is not her path.
Like so many others in Ukraine, she is instead preparing to turn her back on that future, deciding instead to risk her life to defend her home town of Kamyanske, on the Dnipro river.
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Writing this article is difficult. The duty of a father calls on me to protect my daughter from the horrors of war. But the duty of a journalist, even under martial law, requires me to be honest and objective. This is a cruel predicament that breaks the hearts of many Ukrainians, and is the clearest illustration of the military and humanitarian crisis that has befallen our country.
Kamyanske, located almost in the centre of Ukraine, is next to the regional capital, Dnipro.
We don’t have any bombing yet. The area is considered safe for civilians. But even here, air raid alerts sound several times a day and you can feel the cold and inexorable pressure of war, despite our distance from the Russian bombardment.
As Russia began its invasion, locals rushed to sweep food off supermarket shelves, fearing supply disruptions. Almost immediately, fresh meat, canned food, cereals and pasta disappeared from the shelves.
Most people in Ukraine simply do not have the resources to make any significant food supplies, with at least 60% of the population living in poverty. Monthly pensions before the war, on average, did not exceed €100-150 per person. Those who work in the public sector, enterprises and organisations that are financed by local and national state budgets, receive very low wages.
This social division can also be seen on supermarket shelves, at least in Kamyanske. Most food shortages have been visible in the cheaper shops and supermarkets. By contrast, in the town’s supermarkets designed for more affluent consumers, it has still been possible to buy expensive varieties of meat, sausages, butter, cereals and other products.
Local authorities are doing their best to calm the panic around food scarcity. For a week now, in different parts of the city, a local poultry farm has been distributing free packages of chicken for making soup with. Authorities have been forced to limit the number of soup kits – chicken carcasses from which the meat has already been removed – a person can take.
After two weeks of war, the panic-buying frenzy began to calm down, though the threat of food shortages remains. Maryna Gurska, director of humanitarian affairs at the Kamyanske city council, told openDemocracy that people fleeing eastern Ukraine have begun to arrive in the city, worsening the situtaion. “People come without things and any products, we try to provide them with everything they need. But this also affects the resources available to the city,” Gurska says.
Public concern over the availability of food, she says, also arises because of the unusually empty shelves in stores. That, combined with the large budget grocery chain, ATB redirecting part of its supplies to the Ukrainian military, has led to emptier shelves.
And while Gurska assures me there are no hungry people in the city, there is a need for children’s goods, cereals and the like.
“When people see that something is running out, they try to immediately buy up the leftovers,” Gurska explains. “Supermarkets simply don’t have time to fill the shelves with products that are currently in stock.
Just like the country’s food systems, Ukraine’s healthcare system is facing similar problems amid war and a global pandemic, as noted recently by medical journal The Lancet. On the eve of the Russian invasion, COVID was in full swing in Ukraine. The current COVID rates are unknown since public authorities have stopped publishing relevant data. Doctors confirm that patients with severe cases of the virus are still being admitted and treated in hospitals.
People who have caught COVID or other colds in mild or moderate severity, meanwhile, have to find scarce medicines by themselves. At the start of the war, bandages and haemostatic drugs disappeared from pharmacies, as did antibiotics, cold medicines and painkillers.
People bought medicine in a panic, while sending other materials to reserves in hospitals in case the city came under attack. The military also required additional medical supplies. Now, authorities are forced to resort to drastic measures, calling on the owners of pharmacies to retrieve the necessary drugs from warehouses to ensure supply.
The problem with that is that in a city like Kamyanske, there was previously no need to keep large stocks of medications. Now, due to hostilities, the logistics chain for medicine delivery has been disrupted, leaving authorities and pharmacies attempting to build new supply chains.
For those who require insulin, the situation is especially difficult. For many, it is quite literally a matter of life and death. However, getting hold of insulin is extremely challenging, even with a prescription. Where regular deliveries are impossible because of fierce fighting, volunteers or the military try to deliver insulin and other drugs to those who desperately need it. Those deliveries are not always possible.
“The situation and assortment in pharmacies has improved a bit, but there is a shortage of other drugs, for example, those related to the regulation of thyroid hormones,” explains Natalya Ktitareva, a secretary of the Kamyanske city council who oversees healthcare.
“The main problem is that our system developed in peacetime. We simply cannot imagine what stocks of dressing materials, haemostatic drugs will be needed if hostilities begin here,” she says. “We see that in other cities there are a lot of wounded, including among civilians. But existing supplies may not be enough if the scale of shelling, destruction and injury is catastrophic.”
According to Ktitareva, the influx of refugees from eastern Ukraine has created an additional burden on the city’s healthcare system. Many have severe colds, having been forced to hide from shelling in cold basements.
Ktitareva describes Kamyanske’s access to medicine and medical care as “normal in wartime conditions, in comparison with cities that have been shelled and bombed”.
An exacerbated economic crisis
One of the challenges of providing people with food and medicine is the rise in prices. The official exchange rate for the Ukrainian hryvnia was fixed on the first day of the war, but it is impossible to buy currency at this rate. Instead, it can only be sold at that rate. At the same time, on the black market, the dollar exchange rate has jumped to almost 40-44 hryvnias, and the euro has reached 50 hryvnias. This is a 50% increase from what it was before the war.
The exchange rate jump has led to a sharp increase in prices in shops and pharmacies, including in Kamyanske. This further spurs panic among people. But if the authorities manage to contain price rises on food and certain everyday goods because they are produced in Ukraine, then the situation with medicine is more complicated.
Poorer people in Ukraine simply cannot buy enough food or medicine in the current situation
Many drugs are imported from other countries, and therefore medicines have risen in price in the wholesale markets where pharmacies buy them. As a result, Ukrainian pharmacies have to sell drugs at new, higher prices.
Shops selling household appliances, clothing and other goods, which are mainly imported, are also closing. Some retail business owners fear their property will be destroyed by shelling or be subjected to looting, which has happened in other parts of the country.
To save at least some of their stocks, large retail chains selling household appliances and building materials have announced a sale of existing warehouse stocks. But even this may fail to prevent a shortage of goods after the war has ended. And when such goods do become available, they are likely to be too expensive for those in poorer communities.
Protecting the poorest in society
The crisis that we are witnessing in Ukraine has once again raised the question: how much does the market economy protect the poorest sectors of society, especially during conflicts that affect a whole country?
Ukraine’s model of social assistance, introduced in recent years, involved the provision of various kinds of cash subsidies and additional payments to people who need it most, through state institutions. However, in the face of lightning-fast price increases and a shortage of goods, this model has been unable to work effectively. Poorer people in Ukraine simply cannot buy enough food or medicine in the current situation.
Europe and the international community should, of course, be providing humanitarian assistance to Ukraine. But if the sowing campaign on Ukrainian farms is disrupted by the fighting, it will have fast-paced consequences. And it will be the poorest people living in Ukraine’s cities – who do not have their own land to grow at least some food for themselves – that will suffer the most.
10 March: Article has been corrected to state that the number of soup kits local residents of Kamyanske can receive has been limited, but not to one per person.
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