Ukraine war: Extreme contamination from explosive remnants cuts off entire communities from the world

• In Ukraine, the use of explosive weapons is having terrible consequences for the population, injuring and killing civilians, reducing access to essential services such as health and livelihoods and impacting people’s mental health, their social interactions, and their education  
• The extreme levels of contamination by explosive remnants of war has cut some communities off from the rest of the world. HI’s teams are trying to reach the most vulnerable and isolated communities 
• In its new report OUT OF REACH - The impact of explosive weapons in hard-to-reach areas in Ukraine, Humanity & Inclusion (HI) details the specific harm impacting hard-to-reach areas of the country, such as rural areas or areas close to the front line. 
• HI is leading the development of early rehabilitation services in Ukraine for people injured by explosive weapons to help improve their recovery 

Two years after the escalation of the conflict in Ukraine, an estimated 25% of the country has been exposed to intense fighting. Humanity & Inclusion (HI) has been working in Ukraine to provide assistance to all victims of the war. HI’s teams have put a multi-sectoral response in place, including rehabilitation and psychosocial support, explosive ordnance risk education (EORE), delivering humanitarian goods to conflict-affected populations, and providing essential hygiene items and cash to meet the most urgent needs of displaced people, while advocating for an inclusive humanitarian response.  

Reaching the most isolated communities  

In some areas, such as Kharkiv and Dnipro in the east, and Mykolaiv and Kherson in the south of the country, the frequency of bombings and the extent of the contamination by explosive remnants of war have cut some communities off from the rest of the world.

In populated areas close to the front line, most of the inhabitants have been evacuated or have fled the fighting. But not everyone has been able to leave and seek refuge elsewhere. In fact, according to testimonies gathered by HI, a large majority of older people, including a high proportion of people with disabilities, have remained despite the relentless airstrikes, either because they were reluctant to leave or because they were unable to do so.  

In areas under constant attack, residents have no electricity, gas or water, and are dependent on generators for limited mobile data and internet access. Food and non-food items are also in limited supply. Where communities are accessible, the main needs are for fuel and generators to power water pumps, which continue to be affected by the bombing and power surges.  

The needs are particularly acute in small rural towns and villages, far from medical facilities, dependent on transport systems, and where resources are often centralised in a single shop, grocery store or post office.  

“The only café we had is in ruins. We don't have a shop here; there’s nothing left. For medical care, we have to take the car and drive at least 25 kilometres. Otherwise, a doctor comes to the village once a week. Who cares about us?”

says Inna who used to be a farmer. She lives in Velyka Komishuvakha, a farming village in the Kharkiv region. From April to September 2022, the village was occupied by Russian forces. According to the authorities, it is now 90% destroyed. 

Explosive remnants of war: an invisible threat 

The large-scale contamination of land by explosive ordnance has created an ”invisible threat” in people’s minds. As a result, people’s movements are extremely reduced or restricted, they can no longer cultivate their land and their social, economic, or professional activities are interrupted. HI’s teams are providing Conflict Preparedness and Protection and Explosive Ordnance Risk Education sessions to enable children, adults and humanitarian workers to spot the danger signs in areas contaminated by explosive ordnance and to protect themselves by adopting safe behaviour. 

"I used to be a deminer and I can tell you that it will take decades to clear the contamination here. As time goes by, people in the big cities are more and more aware of the risks. But it's important to keep going to these isolated villages to inform people of the dangers. These are areas no-one wants to go to because they're too hard to reach. So the people there are less aware of the risks. I want to save as many lives as possible" says Victoria Vdovichuk, HI's Risk Education team leader in Kharkiv region.   

Early rehabilitation: New approach to treating patients injured by explosive weapons in Ukraine 

HI’s teams are also currently providing rehabilitation and psychosocial support to nine Ukrainian hospitals, most of them close to the front line in the Kharkiv and Dnipro regions, where there are many people injured by explosive weapons. Mobile teams also go to centres for internally displaced people and do home visits to provide rehabilitation services to vulnerable people who can’t reach health facilities.  

Hospitals in the East of the country, where the front line is located, continue to receive large numbers of patients with complex, multiple and very serious injuries which, once treated as emergencies, require multidisciplinary support with the implementation of early rehabilitation - very little developed in Ukraine, if at all - and enhanced psychological support.  

Some injuries require advanced medical treatment, particularly severe burns caused by the blast of an explosion. As a result, some patients are transferred to health facilities in the safer western part of the country, particularly in Lviv, where HI’s teams are also present, notably in the Burns care unit at St Luke's Hospital.  

Ksenia, one of HI’s physiotherapists, working in the Burns Unit, at St Luke’s Hospital in Lviv says:

“Following the full-scale invasion, the number of burn patients has increased significantly. This is particularly the case for war-affected people from the East of Ukraine. When HI started working in this unit, there was not a single physiotherapist. Patients were not being treated by physiotherapists. After physiotherapy was introduced to the unit, the patients' results improved significantly, and they recovered much faster.” 

Oleksandr Dunaev, a surgeon in the Burns Care Unit at St Luke's Hospital, says:

" This is a completely new approach to treating patients in Lviv and Ukraine in general. It's something we didn't know about before. Thanks to this collaboration, we have understood how this approach can significantly increase the survival rate of patients". 

Notes 

• Interviews available upon request with HI’s expert including Rhiain Moses, HI Senior Project Manager East (based in Dnipro) and Anne-Laure Bauby, HI Program Director ( based in Kyiv 
• HI’s new case study report “OUT OF REACH - The impact of explosive weapons in hard-to-reach areas in Ukraine” is under embargo and will be released on 22 February. You can register here to attend the presentation webinar on Thursday 22nd February at 3pm UK time : https://bit.ly/3OD5znd 
• Case studies and professional photos available 

Humanity & Inclusion’s response in Ukraine:  

• Almost 16,000 rehabilitation sessions (approx 2,400 beneficiaries) provided in Ukraine, including 689 receiving specialised rehabilitation services (burns)  
• 540 health staff trained in physical rehabilitation and Mental Health and Psychosocial Support (MHPSS)  
• 1,300 frontline community focal points trained in physical rehabilitation and MHPSS  
• 3,700 group and individual MHPSS sessions provided to 6,700 beneficiaries 
• 11,700 hygiene kits distributed to 15,000 beneficiaries and 54 collective centres supported  
• 3,700 individuals identified, assessed and referred to appropriate services and 120 individuals (frontline workers, community representatives) trained on protection and inclusion principles  
• 3,200 community-based Explosive Ordnance Risk Education (EORE) sessions (on-site and online) conducted, reaching more than 89,000 beneficiaries. 2,800 humanitarian workers and 337 community focal points trained.  
• HI Staff: 306 Staff (270 nationals + 36 international) in Ukraine and 6 in Moldova (3 internationals and 3 national staff)