Risk of disruption of essential healthcare and social services in , Shyrokyi, Nyzhnoteple ATCs incorporated in the new Schastia district (former Stanitsa Luhanska district), oblast GCA.

By: Irina Maslovskaya General Coordinator, Medicos del Mundo in

COMBATIMOS TODAS LAS ENFERMEDADES, INCLUIDA LA INJUSTICIA Influence of Decentralization reform

» A new districts have been created on January 2021 » The State Administration of the former districts were liquidated » Temporary administrative entity to be headed by the Military and Civil administration has not been established » Elections of the local councils for ATCs situated on the line of contact were cancelled for security reasons and the administrative bodies were not established.

As a consequence, funding from the local budget for healthcare and social services in the area was suspended since January 2021.

COMBATIMOS TODAS LAS ENFERMEDADES, INCLUIDA LA INJUSTICIA Health services: » Payment of public utilities (electricity, water, heating, internet) are suspended (CNI “Center of primary medical and sanitary assistance of Stanytsia Luhanska raion council” and CNI “Stanytsia Luhanska territorial medical union” ) => risk to have no more access to electronic patients files / prescriptions of free drugs / referrals / new declarations

» Fuel for cars of PHC facilities is not funded by the municipal budget any more (CNI “Center of primary medical and sanitary assistance of Stanytsia Luhanska raion council”) => Doctors are running out of fuel and will be forced to stop doing home visits.

» Health facilities are running out of medications purchased with local budgets (tuberculin, medications for emergency aid in feldsher stations and ambulatories). => Risk of disruption of the supply for 3-4 months

NB: Health workers of the CNI “Center of primary medical and sanitary assistance of Stanytsia Luhanska raion council” and of the CNI “Stanytsia Luhanska territorial medical union” are continuing receiving salaries through reimbursement system from the National Health Service of Ukraine. COMBATIMOS TODAS LAS ENFERMEDADES, INCLUIDA LA INJUSTICIA Social services:

❖ Stanytsia Luhanska Territorial Center of Social Service: social workers continue working, although they are not paid. The payment of salaries stopped in January.

❖ Stanytsia Luhanska Territorial Center of Social Service for family, children and youth: the employees were furloughed (i.e. on unpaid vacation). The further existence of the facility is unclear.

❖ Inclusive Resource Center of Stanytsia Luhanska Raion Council: the employees were furloughed. The further existence of the facility remains unclear.

❖ Children Protection Service of Stanytsia Luhanska Raion State Administration: the numbers of employees were significantly cut. Currently there is only one person left. The payment of salaries stopped in January.

COMBATIMOS TODAS LAS ENFERMEDADES, INCLUIDA LA INJUSTICIA Cultural and Educational services:

• Centralized Library System of Stanytsia Luhansk Raion: workers continue working, although they are not paid. The payment of salaries stopped in January. The further existence of the facility remains unclear.

• Art Palaces, Museums and other cultural facilities: workers continue working, although they are not paid. The payment of salaries stopped in January.

• Staff of educational institutions continue working, although they are not paid.

The payment of salaries stopped in January. Majority of schools and kindergartens are working part-time due to the heating problems. The food stock is available for 2 months. Additionally, the schools and kindergartens are supported by the parents. 2 school buses require renovation, but due to the lack of funding, transportation of children is impossible.

COMBATIMOS TODAS LAS ENFERMEDADES, INCLUIDA LA INJUSTICIA Calling for:

Partners: » to react pro-actively to the situation in eastern Ukraine, in particular in the territorial cluster of Stanytsia Luhanska, and engage in properly coordinated and resourced response to humanitarian needs, which are arising from the present situation, including advocacy. National and regional authorities: » To strengthen their coordination, propose emergency solutions and financial support to the ATCs in eastern Ukraine, in particular in the territorial cluster of Stanytsia Luhanska, to ensure the continuity of healthcare and social services to the population suffering from the consequences of the conflict. » National authorities should consider the specifics and infrastructural situation of the conflict-affected communities when implementing the reform agenda.

COMBATIMOS TODAS LAS ENFERMEDADES, INCLUIDA LA INJUSTICIA