Imaging and radiology centers are among the least affected hospital services in Ukraine since the beginning of the Russian invasion in 2022, a study published May 17 in JAMA Health Forum found.
A team led by Ubydul Haque, PhD, from the Rutgers Global Health Institute in New Brunswick, NJ, found that such services have experienced a slight decrease in availability, while services for cancer screening, laboratory testing, and gynecological care, among others, have been the most impacted.
“The ongoing war has inflicted profound devastation on Ukraine’s hospitals,” the Haque team wrote. “The findings of this cross-sectional survey offer valuable insights into the formidable challenges that hospitals confront in war-affected regions and underscore the pressing necessity for bolstering support to sustain and enhance hospital services during wartime.”
Since February 2022 when Russian forces began invading Ukraine, reports have described the impact of the war on health services. Radiologists in Ukraine have shared stories on their experiences, from living in the basement of their respective clinics to treat patients while evading bombings, to adjusting their workflows to continue delivering care. A July 2022 missile attack in Vinnytsia killed radiology staff and civilians.
Since the start of the war, hospitals in Ukraine have been compelled to close or reduce their health services due to inadequate supplies, damage, or destruction.
Haque and colleagues analyzed these services during the periods before and after the start of the Russian invasion. The survey study included 74 Ukrainian hospitals from 12 oblasts (regions or provinces). The periods included were pre-war (February 2022) and during the war (February 2022 to May 2023).
Daily emergency admissions increased from 2,773 pre-war to 2,830 during the war. The researchers reported that imaging and radiology centers were among the least affected services since the start of the war. These services decreased from 55 (74% functionality) to 51 (69%). Other services that experienced lesser impacts included routine pediatric services, intensive care units, dialysis centers, addiction treatment centers, and obstetric deliveries.
The most affected services included laboratory testing (97% to 85%), tobacco education (70% to 49%), cancer screening (66% to 50%), gynecological services (58% to 43%), rehabilitation services (50% to 36%), pharmacy services (49% to 36%), and telehealth programs (45% to 28%).
Finally, respondent hospitals reported the following additional difficulties faced during the war: supply chain disruptions for essential equipment and pharmaceuticals, laboratory test kit shortages, delays in the delivery of crucial medications, and power outages causing problems for appropriate medication storage.
The study authors suggested that through international support, responses that are prioritized and “well-considered” can address needs for Ukrainian hospitals while also restoring essential health services that have been lost to destruction from the war.
“Priorities for public health services in the short to medium term can be to ensure appropriate surveillance, preparedness, and responses to communicable disease threats or outbreaks, expected as a result of lapses in preventive care,” the authors wrote.
One radiologist based in Ukraine shared her perspective on the current state of medical imaging in Ukraine. Uliana Pidvalna, MD, PhD, from Danylo Halytsky Lviv National Medical University in Lviv, Ukraine told AuntMinnie.com that at one radiological center in Lviv, one well-known experienced doctor is on the frontlines and another doctor moved abroad, which has affected the number of endovascular procedures performed and the distribution of more duties to other radiology staff.
Pidvalna added that people who have been displaced from the war have nothing after their homes were bombed, meaning increased poverty, increased prices for medical supplies, and a decreased number of procedures. Also, cyberattacks which Pidvalna described as “frequent” have made communication with patients difficult.
“We can’t work effectively being under stress for two-plus years,” Pidvalna said.
She also told AuntMinnie.com that there is “no possibility” to perform contrast-enhanced CT in the Donetsk region of Ukraine and that larger radiology vendors cannot install new CT machines in the country “while there is no insurance in case of damages caused by war.”
Pidvalna is a member of the editorial board for the journal European Radiology, as well as the Ukrainian delegate and educational committee member for the European Society of Radiology.
The study can be found in its entirety here.
