Ukraine Relief: Response Continues into Fifth Year of War

Today, Ukraine enters its fifth year of war. The conflict has caused devastating loss of life and massive damage to the country’s energy grid, hospitals, and schools.

In response, Direct Relief has delivered more than $2.2 billion in aid. This effort—one of the largest in our 77-year history—focuses on immediate survival and long-term recovery.

Key areas of support include:

• Critical Supplies: Ongoing shipments of donated medicines.
• Energy Resilience: Backup power systems for hospitals.
• Specialized Care: Expanding prosthetics, mental health services, and pediatric outreach.

Close cooperation with 14 partners in Ukraine, including the Ministry of Health, ensures that material and financial donations to Direct Relief have a positive effect across the country. This includes the heavily war-impacted eastern and southern regions, where hundreds of healthcare facilities continue to provide services to the population in these areas.

Health Care Continues Amid Outages, Frigid Temps

This winter – the most severe in several years – saw near daily air attacks on Ukrainian cities, especially the capital Kyiv, where millions of people were left without electricity and often heating for days on end as temperatures fell below minus 20 degrees Celsius (minus 4 Fahrenheit).

Amid the outages and surge of cold-related sickness, partners increased their distribution of cold remedies, anti-inflammatory drugs, and vitamins. Additionally, Direct Relief is supporting the establishment of 40 “invincibility points,” tent centers where people can warm up around the clock and charge their devices while drinking hot beverages. Charging power stations are also being provided to support diagnostics departments and pediatric palliative care, as well as fuel vouchers for existing generators at hospitals and clinics.

Most medical facilities in the city and across Ukraine can keep working using their own generators and more than 2,000 large rechargeable batteries supplied by Direct Relief since 2023 under its Power for Health program. These ensure uninterrupted power for operating theaters, blood storage facilities, and other critical units during outages, as well as sustaining equipment, lighting, and heaters in make-shift wards and bomb shelters in hospital basements. Even then, back-up power is not always available during sudden outages, leaving surgeons to carry on with improvised lighting.

Dozens of ambulances and fire trucks donated overseas and delivered with Direct Relief support are helping to tackle the immediate aftermath of attacks. A boiler conversion project in Kyiv and the East is also providing thousands of wood-burning stoves to families deprived of utilities in the freezing conditions. This helps to prevent sickness and reduce the overall strain on the health system.
Direct Relief’s partners have quickly adjusted to the latest upheavals and maintain their distribution and other operations using generators to power heaters and lighting in their premises.

“It’s very difficult to get used to the constant cold, uncomfortable conditions, and communications problems – but we calmly accepted the challenge. Hospitals have sent us 400 new applications for medicines, so we don’t have time to freeze.”

— Yuliia Dmytrova, TAPS Director

Today, as Ukraine enters its fifth year of the conflict, Direct Relief continues to prioritize the following strategic areas in its response to the humanitarian crisis:

• Increasing access to health services, including primary health care, prevention and treatment of non-communicable diseases, emergency medical services, and specialized care
• Ensuring delivery of medicines and medical supplies to Ukraine
• Developing and strengthening rehabilitation services for people wounded by war
• Increasing access to mental health and psychosocial support services
• Expanding access to medical supplies and services for Ukrainian refugees and IDPs

Ukraine Humanitarian Aid 2026

Broad and Multi-Layered Impact

Since the start of the war, Direct Relief has delivered more than 6 million lbs. – over 3,000 tons – of medicine and medical supplies to Ukraine. Each item delivered was requested and approved prior to being sent.

The medical material provided included 494 million defined daily doses of prescription medications and therapies for a broad range of common conditions and specialized care, such as for cancers and a range of rare ‘orphan diseases’ like cystic fibrosis. At the other end of the supply spectrum, basic but in-demand items like tourniquets, crutches, and prenatal vitamins have been provided. Large quantities of personal care items also help bridge those fraught days when families are evacuated from frontline areas to safer locations.

With a total value of over $70 million disbursed in financial aid, the number, range, and scope of projects and initiatives supported by Direct Relief have also grown rapidly since the start of the war. These have had a major impact on unique and specialized areas, with some notable examples in the last year alone:

• Pediatric outreach services were expanded in several rural regions, providing top-level diagnostics and psychological support to another 10,000 children with limited access to care (more than 22,000 since 2023)
• Mobile medical missions in high-need and frontline areas provided more than 3,400 medical services (ultrasounds, EKGs, screenings).
• Conclusion of a portable ultrasound probe project in northern Ukraine to train doctors in remote communities to use donated diagnostic equipment.
• Strengthening therapeutic access for underserved medical conditions saw the distribution of critical growth hormone treatments to scores of families in 11 regions of the country. Positive early clinical outcomes were reported for pediatric patients.
• Support to children in institutional care resulted in multi-layered medical and psychological services initiated in four state-run children’s facilities and orphanages across Ukraine.
• Educational support of children saw the introduction in schools in five Ukrainian regions of a narrative book on emotional responses to modern life for young readers, also addressing Ukraine’s current conditions.
• National blood safety advancement was spearheaded by the Walking Blood Bank program. Launched with Ministry of Health recognition and funding from Direct Relief, the WBB expands free blood typing nationwide, aiming to improve the culture of voluntary blood donation and boost emergency readiness.
• Expanding psychological support services facilitated emergency psychology training for another 168 mental health workers from seven regions, and 248 first responders through Psychological First Aid courses, bringing the total number of professionals trained since 2023 to almost 700.

Prosthetics and Rehabilitation

According to unofficial but expert sources, there were between 50,000 and 100,000 amputations among Ukraine’s population in the past four years of fighting, with many casualties – military and civilian – losing more than one limb.

In collaboration with partner organizations, Direct Relief has made prosthetics and rehabilitation a primary focus area in Ukraine, providing funding since 2022 to strengthen local resources – clinics, training programs, and workshops – rather than simply shipping finished prosthetic devices.

Together with the Ukrainian Interior Ministry and with support from Direct Relief, the Minnesota-based Protez Foundation last year broke ground for a new clinic outside Kyiv that will provide comprehensive prosthetics services after its opening in the spring. This not only enlarges the organization’s existing capacity – around 2,300 prosthetics provided so far to 1,200 patients – but also reflects Direct Relief’s goal of supplementing and enhancing state programs.

The organization also successfully delivered the Amputee Rehab Summit 2025, its third annual event attended by over 800 in-person participants and 1,000 online, strengthening professional networks and national rehabilitation standards. This helped create “a truly collaborative environment that connects multiple rehabilitation centers across Ukraine,” said Yura Aroshidze, CEO and co-founder of the organization, together with Ukrainian prosthetic surgeon Yakov Gradinar.

In the western city of Lviv, the UNBROKEN National Rehabilitation Center – part of the First Lviv Medical Union, Ukraine’s largest hospital network – has also been at the forefront of Direct Relief’s cooperation in this field. Since the start of the full-scale invasion, more than 20,000 wounded Ukrainians have been treated here, including 360 children, receiving a full cycle of treatment, from emergency care to prosthetics and psychological rehabilitation.

As well as supporting the center’s daily work with civilian and military war casualties, including burn patients, since 2022, last year saw a €1 million commitment by Direct Relief for the UNBROKEN University in Lviv. This new facility is envisioned as a national postgraduate training and research institution focused on trauma care, surgery, rehabilitation, and mental health – a huge and growing area of need in the country overall.

Recovery does not end with the fitting of artificial limbs or facial reconstruction, and mental trauma management and rehabilitation are crucial for many patients. With support from Direct Relief, UNBROKEN set up a large mental health center with a range of therapies for neural conditions, from post-traumatic stress disorder (PTSD) to trauma-related concussion and epilepsy. This requires new paths of groundbreaking research and treatment that can be applied beyond the end of the war in Ukraine and for the common good, said mental health director Oleh Berezyuk.

Mental Health: Invisible Wounds of the Ukraine War

In addition to the tens of thousands of physically injured casualties, the war continues to impact the mental health of Ukraine’s broader population. Much ground fighting occurs in still inhabited areas, while deadly air attacks on cities increased to such intensity that underground schools are being built and wailing sirens are now as much part of the urban soundscape as traffic noises and church bells.

Combined with widespread burnout among people working and surviving in harrowing conditions, this creates a major mental health challenge for the country’s future, especially among millions of children growing up in the shadow of war. Veterans returning home also face major readaptation challenges and ingrained trauma, which, as many other previous world conflicts have shown, can last for months, years, and even a lifetime.

Several Direct Relief partners run psychosocial care programs with a unique focus – from treatment of injury- or captivity-related trauma at UNBROKEN, to mental health centers and initiatives designed to assist people in need who might otherwise neglect themselves.

With Direct Relief support since 2024, RAZOM z Toboyu (“Together With You”) operates a growing network of psychological support centers across Ukraine, offering free, trauma-informed care to civilians, veterans, families of service members, and frontline communities. It also sustains the people who sustain the system – medics, social workers, and mental health professionals.

In 2025 alone, the NGO provided 11,656 individual counseling sessions, with 2,215 clients receiving direct support, with 7,952 indirect (online) beneficiaries. Almost half of the clients were engaging with a psychologist for the first time – a key indicator of reduced societal stigma in seeking help. It also conducted 133 psychoeducational trainings, reaching more than 5,900 participants.

“War never ends at the frontlines – it continues in the hearts and minds of those who carry its invisible wounds,” said Program Director Iryna Gudyma. The goal is to build stigma-free and systemic resilience so “the next generation can grow without the shadow of untreated trauma.”

Since 2023, Chernivtsi-based partner Hromada Hub also trained 431 Ukrainian mental health professionals in Emergency Psychology, responding to the effects of wartime conditions among the population. Another 258 first responders, doctors, and teachers were instructed in Psychological First Aid – skills that will allow them to assist deeply traumatized people in the immediate aftermath of attacks and other disasters like floods.

The program has strengthened emergency mental health capacity, including in conflict-affected areas. This was seen in the effective deployment – with the approval of civil defense authorities – of trainees to attack sites on several occasions.

During field visits, the core team of trainees provided direct assistance to nearly 4,000 individuals, expected to reach 40,000 people over four months, based on these professionals supporting at least 24 beneficiaries each per month.

Some issues can be proactively averted or tempered among the younger generation, with many children seeing their normal family dynamics overturned by the war. Through its “ABC of Empathy” book and program, Poland’s Czepczyński Family Foundation provides educational tools, online support, and specialized training for Ukrainian teachers to enhance social inclusion and resilience among children.

Implemented jointly with the Ministry of Health and regional administrations in several regions of the country, the program has been recognized in the European Commission’s report on children’s mental health.

Power for Health: Sustaining Essential Care in Dark Times

The threat to healthcare and other critical services became clear in the early stages of the war as Russian attacks increasingly targeted energy infrastructure. This campaign ramped up massively in the past year, especially as peak winter conditions set in.

The installation since 2023 of hundreds of Tesla Powerwall 2.0 units – large 13.5 kWh lithium-ion emergency battery systems – provided by Direct Relief and the Polish government through the Ministry of Digital Transformation in Kyiv, helped to achieve additional energy resilience. Local technicians were also trained to maintain the resource.

“The Tesla Powerwall system was a real solution to the hospital’s energy instability problem. Today, it provides uninterrupted power to the maternity ward, operating theaters, adult, pediatric, and cardiology intensive care units, and the emergency department,” said Ruslan Vrahov, director of the Kharkiv Regional Clinical Hospital in eastern Ukraine.

Diesel generators could not always provide a stable power supply as they take time to start up and are fuel. “Thanks to the autonomous power supply, more than 1,500 patients receive medical care every month without the risk of interrupting procedures or treatment.” Lives have been saved as a result, said the head of the hospital.

Together with the digital ministry and Kharkiv-based core partner Yevhen Pyvovarov Charitable Foundation, Direct Relief donated more than 2,000 units in the past two years. This cooperation “allowed our people to continue to live despite all attempts to break their will,” said former Deputy Minister for Digital Transformation Yegor Dubinsky, who for two years worked closely with Direct Relief on the project.

Stories Behind the Headlines

The initial months of the war were marked by huge movements of people and the temporary breakdown of medical services and supply chains. However, thanks to the resilience of Ukraine’s medical community, and with international support, the provision of specialized healthcare was quickly resumed – and has often exceeded pre-war hopes of advancement.

Patients and families long affected by rare and underserved health conditions could now access imported next-generation medications that were previously unattainable without paying thousands of dollars out of pocket.

One of these conditions is cystic fibrosis, or CF, which impacts hundreds of Ukrainians, including many children, with persistent symptoms: thick mucus that clogs their lungs and digestive tract, causing frequent infections, breathing problems, and malnutrition. Specialized medication can help patients manage their symptoms and has been provided to patients in Ukraine. “This is a fantastic program, unbelievable help for Ukraine,” said Dr. Lyudmila Bober, director of the CF program at the Clinical Center of Children’s Healthcare in Lviv.

To further work in this area, Direct Relief issued a $200,000 grant for the expansion of its pulmonology department to include a dedicated cystic fibrosis center. Due to open in the coming weeks, the center will help bring treatment with this and other medicines to many more families after years of struggle.

“Parents cry when they get the medicine for the first time. The patients don’t always understand what is happening, but the parents say, ‘It was our task to live to this day’,” said Dr. Nataliia Samonenko of the orphan diseases department at the Okhmatdyt National Specialized Children’s Hospital in Kyiv – Ukraine’s largest pediatric hospital, and another program participant.

Other specialized medicines supplied to Ukraine included thrombolytic therapy for thinning blood clots for the treatment of stroke patients. Even before 2022, Ukraine posted particularly high numbers of such patients, while high stress levels, trauma, and prolonged exposure to extreme conditions during the war have deepened the trend. If administered soon after a person suffers a stroke – the so-called ‘golden hour’ for averting permanent neural damage – a full recovery becomes possible.

“For physicians, having reliable access to thrombolytic drugs is essential,” said Dr. Oleksandr Holub, the head of interventional surgery at the First Lviv Medical Union, which received part of a large shipment in 2025. “When a patient arrives within the golden hour, the outcome can change dramatically. I remember a 45-year-old man with an acute ischemic stroke – after timely thrombolysis, he stood up, walked, and gradually regained neurological function. Moments like these are why we do this work. When treatment works, and a patient recovers, it brings immense professional and human fulfillment.”

Meanwhile, as Kyiv’s population hunkered down in subzero temperatures during the early winter attacks, parents like Alyona Smityukh were equally worried about their children’s continued access to vital growth hormone medication.

For the past 11 years, Alyona and her husband dedicated all available resources to treating their son Sasha’s pituitary dwarfism, paying sums way beyond the family budget for imported medicines. Last year, Direct Relief shipped a large shipment of hormone therapy that gave a growth spurt to the boy and many others, as much as 1.5 cm in just 2 months, parents reported. Thanks in part to this donation, Sasha, now 16, is almost equal to his peers in height.

“This support came at a very important time,” said Marina Makarenko, director of Direct Relief’s partner Charity Foundation Modern Town and Village, which delivered the medicine to the Kyiv Institute of Endocrinology and to hospitals in several regions of Ukraine. “Thanks [to this], these children now have a real chance to grow, develop, and live healthy lives.”

Other conditions are far more prevalent and are often exacerbated by the physical and psychological stresses of war. In one of its largest supply drives, Direct Relief in the past year alone supplied Ukraine with immunosuppressant drugs for the treatment of autoimmune diseases, including rheumatoid arthritis, or RA, psoriasis, lupus, and Crohn’s disease.

This assistance brought life-changing relief to patients like Oleksiy Pigarev, a long-distance coach driver from Odesa, who suffered from acute backache and skin outbreaks for months until he was finally diagnosed correctly with RA, just days before the full-scale invasion.

Today, thanks to a concerted effort by Direct Relief’s local partner organizations and health practitioners in Ukraine, Oleksiy and thousands of others living with rheumatic diseases, including many children, can better manage their symptoms.

Upgrading for the Future

While Direct Relief does not reconstruct war-damaged medical premises, it has assisted some health providers, including the First Lviv Medical Union, located in western Ukraine, in setting new benchmarks in treatment by renovating and upgrading their facilities:

Approximately 12,000 children in Ukraine are hospitalized with burns each year. At the pediatric burn unit in St. Nicholas Children’s Hospital – part of the Lviv network – Direct Relief, among others, contributed tothe two-year renovation and the procurement of medicines, medical consumables, equipment, and furniture. This has increased the center’s capacity to around 1,200 children per year.

A renovated otolaryngology department at the hospital also admits over 1,000 children from across Ukraine each year, including those with hearing and airway injuries resulting from the war. Direct Relief also supported an Emergency Department upgrade that increased its capacity by 30 percent.

Another project equipped a new Pain Management Center at the associated St. Panteleimon Hospital with essential diagnostic, interventional, and monitoring equipment to deliver advanced pain relief and rehabilitation for war-affected Ukrainians.

With no swift end to the war in sight, Direct Relief’s support for Ukraine continues at full pace, as does the growth of its partners and the expansion of their operations into new areas.

In the eastern city of Kharkiv, the NGO Mission Kharkiv recently saw the number of patients it supports with cancer medicines increase to more than 3,700, up from 700 unique cases in the first year of work in 2023. It also won an unusual distinction along the way: According to organizations that form the Ukraine health cluster, “no one provided a complete course of chemotherapy in a city under siege before,” said founder Ross Skowronski, a Spanish national with Ukrainian roots. The missing piece of the cycle was the psychological counselling sessions it launched in 2024, helping patients to adjust to their diagnosis.

In the past year, Direct Relief supported the organization in branching into palliative care access and specialized transport for oncology and severely ill patients, aiming to serve more than 700 patients.

As this report went to publication, partner organizations relayed further positive updates, including news of the successful evacuation of a 22-month-old child across the country to Lviv before the final transfer to Poland for urgent bone marrow surgery.

Zlata and her mother, Olena, were transported by the Ambulance for Kids project supported by Direct Relief since July 2024. The small team of medical professionals from Germany, Denmark, and Ukraine has evacuated more than 100 seriously ill children in its specially adapted pediatric ambulance to western Ukraine and the European Union for specialist treatment.