In the face of war, the visible destruction — ruined buildings, shattered lives — often captures news attention. However beyond the obvious physical devastation of the Russian-Ukrainian conflict lies a less visible, profound, devastating impact: the erosion of public health services. The war-torn landscape in Ukraine tells a story of disrupted lives, a compromised health system, and communities on the brink of a humanitarian crisis that ripples beyond the battlefield.

As winter approaches, the effects of the conflict will push Ukraine’s health infrastructure to the brink. With public works systems attacked, water supply systems damaged, food chains disrupted, and heating systems in disrepair, Ukrainians must contend with dual dangers — physical wounds and a looming public health catastrophe.

A Broken Health System

In addition to its borders, Ukraine’s health system is also under siege. According to the World Health Organization (WHO), nearly 1,000 health facilities have been damaged or destroyed since the conflict began in 2022. Hospitals struggle to operate with limited resources, a shortage of medical supplies, and overburdened staff. The lack of access to essential medicines, compounded by interrupted supply chains, means that essential health services are increasingly inaccessible to millions.

Since the war began, the Ukrainian population’s health needs have changed dramatically. War injuries, trauma, and mental health conditions are on the rise, while chronic diseases like diabetes, hypertension, and cancer — conditions that require regular treatment and medication — go unchecked and untreated. Patients are unable to receive the care they need while doctors are stretched thin, tending to the war-wounded, displaced, and people with long-standing health concerns. Under the best conditions, sick people get sicker when they lack access to care. What happens when care becomes nonexistent?

The public health toll is expected to skyrocket without access to quality care. The indirect consequences of this war — poor sanitation and lack of heating — add to Ukraine’s already precarious health situation, leaving millions vulnerable to illness and preventable deaths.

Public Works Under Siege

War doesn’t just target people — it targets infrastructure. Public works, the backbone of daily life, have been severely compromised. Cities across Ukraine — particularly on the Eastern front — have suffered the bombing of power stations, water treatment plants, and sewage systems. The assault on infrastructure isn’t just an inconvenience — it’s a public health time bomb.

Water quality, in particular, is a growing concern. Contaminated water sources have led to an increase in waterborne diseases, including dysentery, which are particularly threatening to the elderly and the young. Clean drinking water is becoming scarce in many regions, forcing civilians to resort to unsafe alternatives. The WHO has already warned of the potential for large-scale outbreaks if the water supply continues to degrade.

With sanitation systems destroyed, the spread of disease becomes even more likely. Waste disposal has been disrupted, and raw sewage contaminates streets and water systems in many areas. The health risks are immense, especially for children and those with weakened immune systems.

Food Supply: The Silent Hunger Crisis

War may not always bring immediate famine but plants the seeds of a silent hunger crisis. Ukraine, the so-called “breadbasket of Europe,” has become a nation where food insecurity is a growing threat. The conflict has upended agricultural production, destroyed farmlands, and blocked essential transportation routes, making it nearly impossible for many to access fresh food.

International relief organizations have warned that the food supply chain is on the verge of collapse. Farmers have abandoned their fields, both out of fear for their lives and because they are called to serve and defend. Crops have been left to rot, and livestock has been slaughtered prematurely due to a lack of resources to care for them. As food prices soar, more families cannot afford even basic staples.

Malnutrition is a natural and present danger, particularly for children. Without proper nutrition, growth and cognitive development are stunted, leaving long-term scars on the next generation. As winter approaches, the lack of food and energy shortages will only exacerbate this crisis, pushing more civilians into hunger and despair.

Meanwhile, the destruction of the Ukrainian agricultural sector has a ripple effect on global food security. Ukraine is a major exporter of grains and other essential food products. The disruption of these exports contributes to rising food prices and shortages worldwide, particularly in emerging nations that rely heavily on Ukrainian imports.

The Winter Threat: No Heat, No Shelter

In Ukraine, winter is not just a season — it can be a test of survival. For millions, the coming months will be defined by the struggle to stay warm in a country where the infrastructure that supports heating has been obliterated. With power plants targeted and fuel supplies dwindling, many Ukrainians will be forced to endure sub-zero temperatures without adequate heating or shelter.

The loss of heating is not just uncomfortable — it’s unbearable and deadly. Hypothermia, respiratory illnesses, and other cold-related conditions pose a significant threat. Hospitals, already overburdened with war casualties, may soon face a surge in patients suffering from the cold.

The mental health toll of enduring another freezing winter in a war zone cannot be understated. The constant strain of survival and the physical challenges of the cold erode millions’ emotional resilience. Anxiety, depression, and post-traumatic stress disorder (PTSD) are already widespread, and the coming winter will only deepen these psychological wounds.

Beyond the Battlefield: The Global Impact

While the immediate suffering is concentrated mainly in Eastern Ukraine, the war’s health implications extend far beyond its borders. The displacement of millions of Ukrainians has led to one of the most significant refugee crises in recent history, with neighboring countries — Poland, Romania, and Moldova — bearing the brunt of this humanitarian wave. Moldova, perhaps the poorest nation in Europe, has demonstrated how kindness and empathy are part of the healing process, going beyond merely opening its borders. It has made room in schools and public buildings to house, clothe, and educate new residents.

Refugees face a host of health challenges in their new environments, from urgent access to healthcare to the anxiety of overcrowded shelters. Despite best efforts, host countries struggle to provide adequate services to these displaced populations, putting further strain on their public health systems.

In addition, the war is exacerbating existing health crises globally, such as the COVID-19 variants. Resources and attention have been diverted to the conflict, undermining efforts to combat other health emergencies. The war’s strain on the global economy is also limiting the capacity of international organizations to provide aid, leaving millions in Ukraine and beyond in dire need of support.

A Call for Urgent Action

The war in Ukraine is more than a geopolitical conflict — it’s a humanitarian disaster with profound health consequences. As the world watches, the health of millions hangs in the balance. The international community must act swiftly to provide the resources and support necessary to prevent further loss of life — medicines, warm clothes, temporary shelters, and mental health support.

Humanitarian aid is desperately needed to repair the health infrastructure, restore clean water supplies, and ensure access to food and heating. Governments, NGOs, and private sector organizations must work together to deliver life-saving assistance before the full impact of winter sets in.

This war has shown us that health is not only a question of access to hospitals and doctors — it is intertwined with every aspect of life. From public works to food systems to mental health, the well-being of the nation’s civilians is inextricably linked to its survival. Beyond discussions of continued support for defense, health access must be prioritized. Lives are at stake, and time is running out as winter approaches.