Since Russia’s invasion of Ukraine began over four months ago, Direct Relief has sent more than 790 tons of medical aid and over $15 million in grants to health care providers in Ukraine and neighboring countries, with additional shipments currently planned as part of an ongoing and anticipated long-term humanitarian response.

Much of this requested support, which has included medicines, medical supplies, prepared kits, oxygen concentrators, and cold chain storage facilities, has been requested, received and distributed by local nonprofits, which are playing a critical role in shoring up the public healthcare system as the nation’s resources are largely being focused on defending against the Russian military’s attacks.

While a diverse range of focuses, goals, and office locations exist among these organizations, a common thread among the most effective nonprofits – as almost always the case during disasters of any sort – has been an ability to draw on preexisting relationships and expertise.

“We have been able to build trust because we are doctors… It’s an exchange of experience,” said Dr. Christian Carrer, a French physician who co-founded AICM and AICM Ukraine, which was created in 2006. He has been in Ukraine since 2004.

Help Ukraine Romania (HUR), a Chernivtsi-based nonprofit started about a week after the invasion, has also benefited from its volunteers’ connections within their home country.

“My network has been very helpful… I’ve been amazed by my friends and partners who have been approaching me with their help,” said Oleksii Leshchenko, HUR’s partnership coordinator, who worked as a social science researcher for the Gorshenin Institute.

During his research, Leshchenko said he was able to gain a deeper understanding of both the political and social processes in his country and the demographics and attitudes of Ukrainians.

“It helps us with where and how to move forward,” he said.

In some cases, these nonprofits have indicated they are directly supplying people sheltering in place without critical medications for chronic conditions such as diabetes and cancer and with only minimal rations and electricity access for several months. Nonprofits are also working with health care institutions at all levels of the Ukrainian system to assist in sourcing medications that are in short supply, as the nation’s domestic pharmaceutical industry has seen a 40% decline in production since hostilities began.

To date, AICM Ukraine has received and distributed about 34 tons of aid from Direct Relief, including a complete field hospital created by the California Governor’s Office of Emergency Services, in addition to food, solar lamps, water treatment systems, and goods supplied by other donors. The group has accomplished this despite being forced to relocate from Kyiv to Poltava at the onset of the war due to the Russian bombardment. In addition, out of the half dozen warehouses AICM Ukraine had before the war, only one is still accessible and active.

HUR has received about 31 tons of aid from Direct Relief, including two Emergency Health Kits containing supplies requested frequently after emergencies, including chronic disease medications. Leshchenko said HUR is working with 96 out of the 195 communities affected by war in Ukraine and is similarly providing a range of requested humanitarian aid.

Both Carrer and Leshchenko were effusive in praising the drivers who have been risking their lives to deliver medicines amidst active warfare to locations where locals are in dire need.

“They had no food, heating, or medicines,” said Leshchenko, referring to people in many communities to which HUR has delivered aid, most often rural communities in the country’s eastern regions.

The humanitarian crisis is still ongoing, said Carrer, nothing that some hospitals his team works with are totally stocked out of critical medicines for their patients. Many other hospitals, he said, have dangerously low levels of medicines, especially expensive therapies like those for cancer.

“There are places where people are still living in basements and in the metro. They’re like zombies after 3 months or more, you can imagine…I see them all the time. They need many, many things and a lot of time to come back to real life. They’ve lost their homes, job, and even some of their family members, sometimes,” Carrer said.

With such high stakes, HUR and AICM Ukraine know it’s essential to ensure aid gets to where it was intended to go and can help as many people as possible. To accomplish this, the groups have chosen to work with local elected officials, including mayors and regional council members. Such officials are most attuned and accountable to the needs of their respective communities, according to Carrer and Leshchenko.

Carrer said he is also able to add a layer of accountability due to both his medical expertise and that of his Ukrainian colleagues.  

“We speak the same language,” he said about AICM Ukraine and the hospitals they support. “We know what they should need and sometimes we can anticipate their needs and will ask them.”

“I have worked in different hospitals, in Africa and different places…  I know what’s needed to treat a bullet injury, burns, amputees, we can see before if they are playing a game with us or not, “he said.

About the aid they provide, he said, “It’s not a wishing list, it’s not for Christmas, it’s for needed stock.”

Though the safeguards are required, Carrer complimented his Ukrainian colleagues and said the care they provide in-country rivals anything in France and throughout the continent and perhaps surpasses it in some respects due to the experience local doctors have had with war wounds since 2014. Carrer said that when colleagues from the U.S. and Europe offer to volunteer, he rejects them, saying that local doctors are more than up to the task and that foreigners need time to adjust to an environment where there is no such luxury.

“I will not forget it until the end of my life”

As the war grinds on, the nature of the most needed aid has not changed since late February. AICM Ukraine and HUR both reported that their partners are in dire need of medicines, food, and hygiene products.

Leshchenko noted that one change has been the reduction in communities they are helping since some have been occupied or are currently under siege by Russian forces.

Working conditions for both groups have somewhat stabilized since the early days of the invasion, though Carrer noted that air raid sirens currently go off, on average, about every two hours in Poltava. Recent diesel shortages have also made logistics more complicated and expensive, according to Carrer.

Reflecting on the past months, both men said the war had brought them closer to their colleagues, as they’ve worked through shared hardship and towards a common goal.

“We live together, it’s a sort of community,” Carrer said.

“This period changed a lot in me, said Leshchenko. “This period of making a joint work, common thing, it is unforgettable…. Working with these young people, who fled bombs in Kyiv, I’ve been very impressed… they just wish to do things, wish to make things happen,” he said, adding that HUR began operating prior to securing any kind of funding as a volunteer effort.

“I will not forget it until the end of my life, these impressions,” he said.

Following the first interview with Direct Relief, Carrer turned his focus on the next delivery, which was scheduled to go out at 6 a.m. the following day. It was an anticipated 11-hour journey each way, which took less than 4 hours, pre-war due to destroyed bridges and roads.

The delivery ended up being a success. AICM Ukraine delivered medicine, ultrasound machines, monitors, defibrillators, electrocardiogram machines, and other supplies to 21 facilities in the east and north of Ukraine — some of which, according to Carrer, had not been resupplied since the war began.