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Peculiarities of providing medical services during martial law

In connection with full-scale hostilities, the issue of citizens’ access to medical services in the conditions of martial law has become urgent. Many Ukrainians were forced to escape from the invaders and leave their homes, evacuating to other regions of Ukraine as internally displaced persons. This led to the need to make corrections to the mechanisms of providing medical care, taking into account the actual circumstances.

It should be noted that all state guarantees for the provision of medical care continue to apply, and some features of their application will be analyzed below using examples of emerging questions and the practice of solving them, taking into account the position of the Ministry of Health of Ukraine.

Where and under what conditions can internally displaced persons receive medical assistance?

Ukrainians currently have simplified access to primary medical care: internally displaced persons can be admitted to a medical institution in any region of Ukraine in which they are located if such an institution is able to provide the necessary treatment. A declaration is not required for this.

How can you get “affordable medicine” during martial law in another city?

For those citizens who need medical treatment, the “Affordable Medicines” program works in Ukraine, thanks to which patients can receive the medicines free or with a small surcharge. If, for example, a patient needs medication for cardiovascular disease, bronchial asthma, or type II diabetes, and if he has been forced to change his place of residence due to military action, one needs to see any other family doctor, therapist, or pediatrician, even with whom there is no declaration. Immediate assistance for IDPs is provided in full. At the same time, the doctor must conduct an examination, diagnosis, and prescribe the necessary treatment, including medication. If medication is needed due to mental and behavioral disorders, one should consult a psychiatrist, epilepsy – psychiatrist, or neurologist. If the patient needs to be prescribed the first insulin treatment regimen, this is done by an endocrinologist. He also makes changes to the scheme. And after approval of the scheme, the family doctor can write prescriptions for insulin.

Medical documents were lost during an emergency evacuation, how can they be restored?

As a result of Russian military aggression, many Ukrainians lost their documents, including medical ones, during evacuation. There are several ways of restoring lost medical documents recommended by the Ministry of Health of Ukraine, depending on their type:

  1. To restore such medical documentation as examination results, treatment, performed inpatient and operative interventions, and rehabilitation recommendations, one needs to contact the family doctor or any other primary care doctor at one’s place of stay. The doctor must make a decision on the restoration of medical documents through the Electronic Health Care System and/or conduct additional examinations to restore further treatment.
  2. If it is necessary to restore documents related to disability, it is necessary to contact the social security authority in the city of actual stay, which has access to the Centralized Bank of data of persons with disabilities and can make an extract for a person with a disability.
  3. Suppose it is necessary to restore or renew the MSEC certificate or there is a need to pass a medical and social examination. In that case, such a person can apply to the medical and social expert commission at the place of the actual stay. It should be noted that all forcibly resettled persons are examined by commissions regardless of the city of residence, according to the person’s place of stay.

Do persons with disabilities need to undergo a repeat medical examination?

In case of impossibility of examination and registration of referral to MSEC, the period of re-examination for persons with disabilities, which fell during the period of martial law, is postponed for a period of up to 6 months after its termination/cancellation. At the same time, all payments and relevant benefits are kept for the person until the end of the re-examination period. It is important that during the period of martial law and 6 months after its termination/cancellation, Ukrainians have the right to apply to the MSEC to establish disability not only regardless of the place of residence or stay, but also in absentia. That is, if a person does not have the opportunity to come to the MSEC, the commission can make a decision on the establishment of disability in absentia on the basis of a referral from a health care institution.

The attending physician, including the family physician, to whom the patient sought medical help, should, if necessary, issue a referral to the MSEC. At the same time, it is not required to make a declaration between the internally displaced patient and the doctor who makes the referral to the MSEC, and there are no legal grounds to need it. Conducting a medical and social examination at the direction of the medical and advisory commission is carried out regardless of the place of registration, residence, or stay of the person applying for the establishment of disability.

How to make a planned operation during the war?

Planned operations, which were suspended in the first days of the war, can now be carried out by the decision of the chief doctors of health care institutions. In order to perform the operation free of charge, it is necessary to receive an electronic referral from the family or attending physician. It should be noted that during martial law, planned operations can only be carried out by those institutions that have the resources for this because in some regions hospitals are overloaded with helping the wounded. One can get up-to-date information about hospitals where elective surgeries are performed at the contact center of the National Health Service at number 16-77. Also, after receiving the information, one should call the hospital and clarify the possibility of performing the surgery you need.

How can one get HIV treatment abroad and in Ukraine during the war?

Ukrainians living with HIV who have remained in Ukraine can still receive antiretroviral therapy. According to the new requirements, according to the place of the actual stay. That is, a person can receive ART at his place of residence or at the AIDS Center, or at the “Trust” office where he is registered. If a person had to leave the place of permanent residence, it is necessary to contact the AIDS Center or the “Trust” office in the new city.

If, as a result of military aggression, a person was forced to move abroad, then he needs to go to one of the hospitals that provide similar assistance to Ukrainians abroad. Such assistance became possible thanks to the intergovernmental initiative “ART for Ukrainians Abroad”. The complete list of these hospitals in different countries of the world is given at the link

For an application to a person applying for ART abroad, it is advisable to have information about the history of treatment for HIV infection with you. But even if the person does not have any medical documents (lost during evacuation and relocation), with his consent, the doctor can ask colleagues from Ukraine for the necessary information, and the person will be able to receive appropriate help.

How can you get medical services and help for Ukrainians who fled the war abroad?

Information on the medical care of temporarily displaced Ukrainians abroad is now available on the website of the Ministry of Health. Most European countries provide a wide range of free medical services for Ukrainians who were forced to seek refuge abroad due to the beginning of Russian aggression on the territory of Ukraine.

You can find out on the official resource of the Ministry of Health:

  • verified contacts of medical institutions;
  • a list of services that are available to displaced persons free of charge;
  • information on where to get doctor’s consultations in Ukrainian;
  • how to issue a prescription for medicine and much more.

Information on medical care for forced migrants abroad is available at the link