By Noah Smith
LODZ, Poland – Three days after the Russian invasion, 42-year-old Zoia was hiding in a bunker amid a Russian missile assault. She had hoped to stay in Kyiv, but after eight hours at the shelter she decided to flee with her five-year-old daughter, 61-year-old mother and 14-year-old nephew.
They left with nothing, heading for Poland after a relative invited them. After four days at the border, in the middle of winter, they finally entered Poland.
But shortly after settling in, Zoia’s daughter caught a virus, which led to high fever, gastrointestinal complications and a severe earache. The rest of the family also fell ill. Because she had to take care of the children, Zoia could not work.
Yulia, 34, had a similar experience escaping from her home in Kherson when the war started. She traveled by train, car and bus to the border towards the Polish border, hoping to join her sister. Her husband joined her for half of the trip, but she made the rest of the trip alone as he was forced to stay in the country due to emergency rules.
After arriving in Poland, Yulia learned that members of her family had been killed.
“I needed psychological support,” Yulia told Direct Relief. “I had never sought mental health care before, but it was a very difficult time in my life,” she said.
Her sister worked in the same office as a translator for the Health4Ukraine program, a non-profit initiative set up by a Polish healthcare company, Pelion, which offers free telehealth visits, pharmaceuticals and some supplies. medical services to Ukrainian refugees.
Yulia decided to register. “It was very effective,” she said of the five sessions she had with a mental health care provider on the platform.
“There really is a need for this kind of help,” she said.
For Zoia, the program enabled her to obtain treatment for her daughter and other members of her family.
“We really needed help and before I had no access to any medicine. Since I signed up we have had to use it regularly… I can just go to the pharmacy and use the code that ‘they gave me,'” she said. noting that her daughter had to go to the hospital four times in a single month.
An industry responds
The Health4Ukraine program was launched in the days and weeks following Russia’s invasion of Ukraine.
Executives at Pelion, Poland’s largest healthcare company, began reviewing their existing programs and systems to determine which might be suitable for this newly needed charitable use. Two programs have emerged as candidates – a telehealth platform called Dimedic, which was built during the Covid-19 pandemic, and a fintech system called epruf, which allows users to determine co-payment and the final cost of pharmaceuticals. .
Pelion decided to adapt the two programs to help meet the health needs of millions of people entering Poland. In total, more than 7.5 million border crossings have taken place between Ukraine and Poland, out of a total number of 12.5 million crossings from Ukraine to European countries since the start of the war, according to UNHCR data. The data does not include Ukrainians who traveled to Russia, voluntarily or by force.
Today, about 1 million Ukrainian refugees from the Russian invasion currently live in Poland, according to data provided by Meta’s Data for Good program, which was analyzed by Direct Relief. About 19% of all displaced Ukrainians are in Poland, making it the most popular choice for those fleeing the war, which began on February 24.
Poland has a population of around 38 million and spends the least public funds per citizen on pharmaceuticals compared to all other members of the European Union, providing on average 36% of the cost of medicines, compared to an average of 57% in the EU, according to 2021 OECD data.
The high number of new arrivals and Poland’s decision to welcome them and provide them with a PESEL number (similar to a US social security number) has presented the nation with a challenge on how to provide services and medicines. to a group of people representing about 20% of their current population.
Health4Ukraine, which is supported by a $15 million grant from Direct Relief, $1 million from Pelion, as well as donations from the Polish Red Cross, ING Dzieciom Foundation, Deloitte Polska Foundation and private donors , was created to address the healthcare access gap in Poland among Ukrainian refugees.
The program began accepting entries on April 22, just weeks after the decision to go ahead, according to Robert Socha, vice president of finance and operations at Pelion, which oversees the charity program.
“IT HELPS. IT REALLY HELPS”
To date, Health4Ukraine has recruited around 276,000 people, according to data provided by Pelion. The program was used by participants in almost all but three of Poland’s 380 local districts and in more than half of all pharmacies in the country.
Demographically, 55.3% of registrants are women over 18, 37.7% under 18 and about 7% men over 18. Although it is an internet-based system – the program’s barcodes are only distributed online due to the difficulties and costs associated with sending items to many people who do not may not have a permanent address – the largest proportion of the population who have registered are people over the age of 65. year.
Pelion data shows that $7.1 million was spent by Health4Ukraine participants through the end of October. Of this amount, 36% was spent on non-pharmaceutical products in pharmacies, such as vitamins, medical devices, skin treatments and supplies such as bandages. 35% was spent on over-the-counter drugs and 29% on prescription drugs.
Among children, antibiotics were the most common purchase. For adult men and women, these were cardiovascular therapies. Socha said that the first group of registrants bought more medical supplies and devices than the general Polish population, because they “left in such a hurry that they did not bring these supplies with them”, a- he declared.
However, as the year progressed, data showed that the needs of program participants mirrored those of the general population, suggesting later refugees had time to pack more essentials. Most of the participants, Socha pointed out, are women and children since men of military age were, and are, forced to stay in Ukraine.
Because the Health4Ukraine team didn’t know what participants would need to buy and didn’t want to keep funds locked away in unused cards, they decided to make the barcodes valid for 120 days. Since the start of the program, approximately 15% of barcodes issued have not been used by the declarant.
Each card is charged with 500 Polish zlotys (about 110 USD), of which 450 zlotys are reserved for prescription drugs and 150 zlotys are reserved for over-the-counter drugs and other medical products. A standard size packet of Tylenol costs around 20-30 zlotys in Poland. The program covers 100% of prescription co-payments and 85% of non-prescription drug costs in all Polish pharmacies.
As the barcode is linked to an individual’s identification number, the system allows for transparency and reduces fraud. Socha also noted that physicians play a role in reducing unintended use of the program because they are responsible for prescribing medications.
Socha’s colleague, project manager Michalina Å ubisz, said that one aspect she hopes to change, based on past findings, is that they allow participants to request a third 120-day period for use the barcode, given the continued need she and her team have seen, based on usage. With winter approaching, Å ubisz and Socha said the weather so far has been relatively mild and flu cases have not started to rise more than usual, which has helped alleviate any broader public health crisis in the country. Socha said he expects weather – Ukraine’s civilian infrastructure is coming under increasing direct attack from Russia – and military action to be the main drivers of any new emigration since Ukraine.
For Ukrainians already in Poland, the wait continues – accompanied by pain, in many cases, even as they work to get on with their lives.
“The situation and the new life here can be tragic, but I have to find myself so that I can go to the future,” Yulia said. “This [access to mental health care] assistance. It really helps.
In addition to $15 million in direct support for Ukrainian refugees through the Health4Ukraine programme, Direct Relief has provided over £2.1 million in medical aid to Ukraine and other refugee-hosting countries since February 24.