Nataliya D. Brantly, PhD
Abstract
This blog post shares reflections from my recent trip to Ukraine (2025), where I conducted interviews and gathered data in Ivano-Frankivsk, Lviv, and several surrounding communities. I spoke with health care providers and patients to understand their perspectives on the state of Ukraine’s health care system, the impact of ongoing reforms, and the challenges of accessing essential resources during wartime. This research was approved by the Virginia Tech Institutional Review Board (IRB #25-028) and the Ukrainian Institute of Public Health Policy (IRB #2025-2). While peer-reviewed publications are forthcoming, what follows offers an early glimpse into these findings.
Keywords: Ukraine, Health Care, War, Security, Technology
Introduction
Over the past few years, every morning in Ukraine begins the same at 9:00 a.m., a nationwide moment of silence stops the country in its tracks. At the sound of the daily remembrance siren, people pause in the streets to reflect and honor those who have fallen in this senseless war. The signs and consequences of war are everywhere, from expanding cemeteries adorned with Ukrainian flags, to memorial alleys lined with photographs of fallen heroes (see photos below), to the growing presence of young people relying on prosthetics in their everyday lives. Russia’s war on Ukraine has not only undermined the country’s geopolitical and socioeconomic security, but it has also caused widespread destruction of healthcare infrastructure. Clinics, hospitals, and other healthcare facilities have been directly targeted. Alongside damaged facilities and disrupted services, Ukraine has relied heavily on humanitarian support to address urgent needs for pharmaceuticals, medical equipment, financing, and medical evacuations.[1]
Now in its fourth year, the ongoing war has become a grim backdrop to daily life. While most Ukrainians have adapted to this “new normal,” the persistent strain and stress of war continue to shock the system into awareness. Frequent air raid sirens, though still disruptive to sleep and daily routines, have become normalized. Many people no longer seek shelter when they sound. I experienced this firsthand while staying in a hotel in Lviv. It is a strange reality in which the everyday risks of war fade into the background as life continues to move forward. Yet moments of collective mourning interrupt this normalization. The return of fallen soldiers, accompanied by kneeling passersby and community members lining the streets, serves as a powerful reminder not only of what is at stake, but also of the immense human cost of this war. Despite the odds stacked against it, Ukraine has sustained a “widespread sense of shared sacrifice” and a “spirited resilience” in the face of russia’s[2] brutality.[3]
The need to adapt and build resilience is especially evident in Ukraine’s healthcare system. Demand for healthcare services has increased not only because of war-related injuries, but also due to large-scale internal displacement of people. Acute shortages of pharmaceuticals, particularly severe at the beginning of the full-scale invasion, have largely been addressed. However, rising medication costs, disrupted production, destroyed storage facilities, and complex logistics caused by the loss of air and sea routes continue to pose serious challenges.[4] During my travels, I repeatedly heard the phrase: “We don’t have healthy [people], we have underexamined [people].” This sentiment captures a troubling reality in which people deprioritize preventative and elective care during wartime. It also reflects shifting funding priorities, which have understandably moved toward acute trauma care, rehabilitation, and mental health services.[5]
“We don’t have healthy [people], we have underexamined [people].”
Original: “У нас немає здорових, у нас є недообстеженні.”
Healthcare has thus become an increasingly multifaceted problem requiring complex, multidimensional solutions. Many stakeholders have turned to advanced biomedical and digital technologies as solutions to the systemic challenges facing healthcare during war. There is a striking paradox in observing the targeted physical destruction of healthcare facilities,[6] seeing boarded hospital windows reinforced with sandbags to protect staff, patients and equipment from a potential explosive blast, alongside ambitious efforts to innovate at the highest levels. Such efforts to innovate are exemplified by the Health Hackathon that gathered students, young professionals, IT developers and health professionals to find digital solutions for Ukraine’s health challenges.[7]
Ukraine has actively pursued healthcare reform and innovation as part of a broader digital transformation strategy. Healthcare digitization has been framed both as an efficiency tool and as a mechanism for addressing long-standing issues such as corruption, underfunding, and unequal access to care. Reform accelerated in 2017 with the pilot implementation of the national electronic health system (eHealth).[8] The COVID-19 pandemic further urged this process, as remote care became essential for maintaining continuity of services while minimizing viral transmission. By the end of 2019, most family doctors, pediatricians, and general practitioners had transitioned from paper-based systems to electronic management of referrals, prescriptions, medical certificates, and other documentation.[9] Following russia’s full-scale invasion in February 2022, Ukraine was forced to rapidly adapt and further expand its eHealth system. Innovations included emergency teleconsultations and remote surgical support, such as the treatment of blast and gunshot injuries in active combat zones using telemedicine platforms, augmented reality devices, and international partnerships.[10] In 2024, Ukraine digitized the provision of rehabilitation services, introducing functionality to track rehabilitation interventions, an expansion that significantly increased the scope and volume of digitized health data.[11]
Ukraine’s digital health reforms have received substantial international recognition. However, feedback from healthcare providers was more mixed. During my fieldwork, I visited a wide range of healthcare facilities, from large regional hospitals to small village clinics. I conducted in-person interviews with medical professionals across multiple specialties, including family medicine, pediatrics, rehabilitation, physiotherapy, oncology, gynecology, radiology, neurology, and infectious disease, among others. Conducting interviews on site allowed me not only to hear clinicians’ perspectives, but also to observe patient flows, clinical environments, available equipment, and other material conditions referenced during our conversations.
The overwhelming majority of physicians expressed support for the healthcare reforms, often referring to them as the “Suprun reforms,” named after Dr. Ulana Suprun, Acting Minister of Health of Ukraine from 2016 to 2019, who led efforts to modernize the system. At the same time, some interviewees voiced frustration with aspects of implementation, pointing to persistent structural shortcomings. Nevertheless, all respondents reported having sufficient access to biomedical technologies, pharmaceuticals, and other essential resources. They emphasized that, despite the immense disruptions caused by the full-scale war, healthcare facilities have largely been able to meet patient demand and continue delivering care. As exemplified by Ukrainian doctors I spoke with, the human capacity for adaptation and resilience, particularly under conditions of prolonged crisis, is quite remarkable.
Ukraine’s healthcare system today exists
in a state of contradiction: it is simultaneously under attack and advancing, constrained by war yet spurred by innovation. My fieldwork revealed not a system in collapse, but one under constant pressure, forced to improvise, prioritize, and endure. Healthcare providers operate in environments shaped by scarcity, uncertainty, disruption, and loss, yet they continue to deliver care, adopt new technologies, and support patients whose needs extend far beyond physical injury. Wartime healthcare in Ukraine is not only about treating wounds or restoring function, but also about sustaining life under conditions in which normal assumptions about stability, prevention, and long-term planning no longer hold.
Digital health reforms and biomedical technologies have played a critical role in maintaining continuity of care. However, they are neither absolute solutions nor neutral tools of care. Moreover, the destruction of public infrastructure has disrupted heating, water, and electricity, further undermining health service delivery and digital system functionality, and contributing to widespread suffering.[12] Digital health technologies also generate new ethical, logistical, and governance challenges, especially in a context defined by insecurity, that require further investigation.
Ukraine’s experience offers important lessons beyond its borders. It demonstrates how healthcare systems can adapt under extreme conditions, while also revealing the limits of technological solutions. As Ukraine continues to defend its sovereignty, its healthcare system stands as both a site of vulnerability and a source of resilience, attesting to the human costs of war while actively shaping the conditions for survival, recovery, and hope.
Image 1. Cemetery of Fallen Heroes. Boryslav, Ukraine (2025)
Image 2. Alley of Fallen Heroes. Boryslav, Ukraine (2025)
Image 3. Cemetery of Fallen Heroes. Ivano-Frankivsk, Ukraine (2025)
References
Alexseev, Mikhail A., and Serhii Dembitskyi. “Victory-in-Freedom: Ukraine’s Democratic Resilience in the Face of War.” Sociology: Theory, Methods, Marketing 2 (2024): 40–55. https://doi.org/10.15407/sociology2024.02.40.
Attacksonhealthukraine.org. “Attacks on Health Care in Ukraine.” Insecurity Insight, 2025. https://www.attacksonhealthukraine.org.
Goniewicz, Krzysztof, Frederick M. Burkle, Marta Dzhus, and Amir Khorram-Manesh. “Ukraine’s Healthcare Crisis: Sustainable Strategies for Navigating Conflict and Rebuilding for a Resilient Future.” Sustainability 15, no. 15 (2023): 11602. https://doi.org/10.3390/su151511602.
Khanyk, Nataliia, Bohdan Hromovyk, Oksana Levytska, Tamas Agh, Björn Wettermark, and Przemyslaw Kardas. “The Impact of the War on Maintenance of Long-Term Therapies in Ukraine.” Frontiers in Pharmacology 13 (2022): 1024046. https://doi.org/10.3389/fphar.2022.1024046.
MOH. “A Year after Ukrainian Parliament Passed Health Reform Law: What Has Changed.” Ministry of Health of Ukraine, October 19, 2018. https://moz.gov.ua/en/a-year-after-ukrainian-parliament-passed-health-reform-law-what-has-changed.
———. “[The first medical institutions have joined the eHealth system pilot.] Перші медичні заклади долучилися до пілоту системи eHealth.” Ministry of Health of Ukraine, June 9, 2017. https://moz.gov.ua/uk/pershi-medichni-zakladi-doluchilisja-do-pilotu-sistemi-ehealth.
Myronova, Galyna. “Digitalization of Healthcare in Ukraine: Legal Support for Public and Private Interests.” Entrepreneurship, Economy and Law, no. 3 (March 2022): 40–47. https://doi.org/10.32849/2663-5313/2022.3.05.
WBG. “Strengthening Ukraine’s Healthcare in the Midst of War.” The World Bank, September 7, 2024. https://www.worldbank.org/en/news/immersive-story/2023/10/30/strengthening-ukraine-healthcare-in-the-midst-of-war.
WHO. “1000 Days of War in Ukraine: Resilience in Health Response, Recovery and Reform Efforts despite Attacks and Ongoing Challenges.” World Health Organization, November 18, 2024. https://www.who.int/ukraine/news/item/18-11-2024-1000-days-of-war-in-ukraine–resilience-in-health-response–recovery-and-reform-efforts-despite-attacks-and-ongoing-challenges.
———. “Health Hackathon: Finding Digital Solutions for Health Challenges in Ukraine.” WHO Newsroom, May 7, 2024. https://www.who.int/europe/news-room/07-05-2024-health-hackathon–finding-digital-solutions-for-health-challenges-in-ukraine.
Zabarna, E, and V Liubchenko. “To the Issue of Digitization of the Service Sector in Ukraine.” Proceedings of Odessa Polytechnic University 1, no. 69 (January 2024): 134–42. https://doi.org/10.15276/opu.1.69.2024.14.
[1] Krzysztof Goniewicz et al., “Ukraine’s Healthcare Crisis: Sustainable Strategies for Navigating Conflict and Rebuilding for a Resilient Future,” Sustainability 15, no. 15 (2023): 11602, https://doi.org/10.3390/su151511602.
[2] I am writing russia in lowercase as a sign of disrespect for its egregious actions against Ukraine and its disregard for basic human rights.
[3] Mikhail A. Alexseev and Serhii Dembitskyi, “Victory-in-Freedom: Ukraine’s Democratic Resilience in the Face of War,” Sociology: Theory, Methods, Marketing 2 (2024): 40–55, https://doi.org/10.15407/sociology2024.02.40.
[4] Nataliia Khanyk et al., “The Impact of the War on Maintenance of Long-Term Therapies in Ukraine,” Frontiers in Pharmacology 13 (2022): 1024046, https://doi.org/10.3389/fphar.2022.1024046.
[5] WBG, “Strengthening Ukraine’s Healthcare in the Midst of War,” The World Bank, September 7, 2024, https://www.worldbank.org/en/news/immersive-story/2023/10/30/strengthening-ukraine-healthcare-in-the-midst-of-war..
[6] Attacksonhealthukraine.org, “Attacks on Health Care in Ukraine,” Insecurity Insight, 2025, https://www.attacksonhealthukraine.org.
[7] WHO, “Health Hackathon: Finding Digital Solutions for Health Challenges in Ukraine,” WHO Newsroom, May 7, 2024, https://www.who.int/europe/news-room/07-05-2024-health-hackathon–finding-digital-solutions-for-health-challenges-in-ukraine.
[8] MOH, “[The first medical institutions have joined the eHealth system pilot.] Перші медичні заклади долучилися до пілоту системи eHealth,” Ministry of Health of Ukraine, June 9, 2017, https://moz.gov.ua/uk/pershi-medichni-zakladi-doluchilisja-do-pilotu-sistemi-ehealth.
[9] MOH, “A Year after Ukrainian Parliament Passed Health Reform Law: What Has Changed,” Ministry of Health of Ukraine, October 19, 2018, https://moz.gov.ua/en/a-year-after-ukrainian-parliament-passed-health-reform-law-what-has-changed.
[10] Galyna Myronova, “Digitalization of Healthcare in Ukraine: Legal Support for Public and Private Interests,” Entrepreneurship, Economy and Law, no. 3 (March 2022): 40–47, https://doi.org/10.32849/2663-5313/2022.3.05.
[11] E Zabarna and V Liubchenko, “To the Issue of Digitization of the Service Sector in Ukraine,” Proceedings of Odessa Polytechnic University 1, no. 69 (January 2024): 134–42, https://doi.org/10.15276/opu.1.69.2024.14.
[12] WHO, “1000 Days of War in Ukraine: Resilience in Health Response, Recovery and Reform Efforts despite Attacks and Ongoing Challenges,” World Health Organization, November 18, 2024, https://www.who.int/ukraine/news/item/18-11-2024-1000-days-of-war-in-ukraine–resilience-in-health-response–recovery-and-reform-efforts-despite-attacks-and-ongoing-challenges.