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Care in Crisis: Failures to guarantee the sexual and reproductive health and rights of refugees from Ukraine in Hungary, Poland, Romania and Slovakia

May 16, 2023

This report from The Center for Reproductive Rights and eight partner organizations documents the gaps and barriers in access to sexual and reproductive healthcare and gender-based violence support services that are faced by refugees from Ukraine in Hungary, Poland, Romania and Slovakia. The report found that legal restrictions, burdensome costs, information shortfalls and other barriers, mean that some refugees are facing a harrowing choice between returning to Ukraine to access essential reproductive healthcare, accessing care outside legal pathways in their host countries or going without much-needed care, according to the new report.

تأثير الصراع على خدمات الصحة الجنسية واإلنجابية في شمال غرب سوريا (The Toll of Conflict on Sexual and Reproductive Health in Northwest Syria - Arabic)

March 14, 2023

أثر العنف الموجه ضد الرعاية الصحية على توفر خدمات الصحة الجنسية واإلنجابية وكذلك إمكانية الوصول إليها، بما في ذلك الخدمات األساسية واالختصاصية. وهذا أدى إلى:نقص خدمات الصحة الجنسية واإلنجابية جراء قلة عدد العاملين والمرافق والتجهيزات واإلمدادات واألدوية في شمال غرب سوريا. * محدودية توفر رعاية الصحة الجنسية واإلنجابية، وخدمات الرعاية األخرى، ألن قسماً كبيراً من مرافق الرعاية الصحية ُيشيد أو ُينقل بعيداً عن خطوط القتال، مما يحد من وصول التجمعات السكانية القريبة من مناطق النزاع إلى هذه الخدمات. كما تعاني هذه المرافق من االكتظاظ بسبب عدد السكان الكبير وزيادة الطلب في المناطق اآلمنة نسبياً.تبني ممارسات تأقلم ضارة بالصحة في المناطق التي تعاني نقصاً كبيراً في خدمات الصحة الجنسية واإلنجابية، ومنها تأجيل زيارات الرعاية األساسية والتخلي عن تناول األدوية، بحسب ما أفاد به المشاركون.آثار سلبية بعيدة المدى على صحة النساء، بما فيها صحتهن النفسية االجتماعية وصحة أطفالهن، بسبب غياب خدمات الصحة الجنسية واإلنجابية األساسية أو تعذر الحصول عليها عملياً.الفئات األكثر تهميشاً، بمن فيها النساء في المخيمات وذوات االحتياجات الخاصة وذوات الدخل المحدود والمتزوجات في سن مبكرة، هن األكثر تضرراً من ندرة رعاية الصحة الجنسية واإلنجابية.----Targeted violence against health care has impacted the availability of and access to sexual and reproductive health (SRH) care, including basic and specialized services. This has resulted in:SRH services are insufficient due to limited staff, facilities, equipment, supplies, and medication across northwest Syria.SRH care provision is limited, among other things, by the fact that many health care facilities have been built in, or relocated to, geographic areas far from the front lines, limiting access to SRH services for communities close to conflict zones. Because of the large population and demand in safer areas, these facilities experience significant overcrowding.In areas where SRH services are largely unavailable, respondents reported harmful coping practices, including postponing essential SRH visits and forgoing medication.When required SRH services are not available or practically inaccessible, there are far-reaching, negative consequences for women's health, including for both their psychosocial well-being and that of their children.The most marginalized people, including women residing in camps, those with a disability, those with limited income, and those married at a young age, are most adversely impacted by the paucity of SRH care.

She Pays the Highest Price: The Toll of Conflict on Sexual and Reproductive Health in Northwest Syria

March 14, 2023

Targeted violence against health care has impacted the availability of and access to sexual and reproductive health (SRH) care, including basic and specialized services. This has resulted in:SRH services are insufficient due to limited staff, facilities, equipment, supplies, and medication across northwest Syria.SRH care provision is limited, among other things, by the fact that many health care facilities have been built in, or relocated to, geographic areas far from the front lines, limiting access to SRH services for communities close to conflict zones. Because of the large population and demand in safer areas, these facilities experience significant overcrowding.In areas where SRH services are largely unavailable, respondents reported harmful coping practices, including postponing essential SRH visits and forgoing medication.When required SRH services are not available or practically inaccessible, there are far-reaching, negative consequences for women's health, including for both their psychosocial well-being and that of their children.The most marginalized people, including women residing in camps, those with a disability, those with limited income, and those married at a young age, are most adversely impacted by the paucity of SRH care.

“We Must Provide a Family, Not Rebuild Orphanages”: The Consequences of Russia’s Invasion of Ukraine for Children in Ukrainian Residential Institutions

March 13, 2023

This report documents risks to children from institutions in areas directly affected by the conflict as well as those evacuated to other areas of Ukraine or to European countries. According to government figures, Ukraine had more than 105,000 children in institutions before Russia's full-scale invasion in February 2022, the largest number in Europe. Nearly half were children with disabilities, according to UNICEF. Russia bears responsibility for the crisis facing these children, but the war adds to the urgency for Ukraine, with support from foreign governments and humanitarian agencies, to stop institutionalizing children and expand family- and community-based care.

Ukraine Humanitarian Response Impact Report

February 27, 2023

The war for Ukraine's sovereignty began in 2014 when the Russian Federation forcibly occupied Crimea and supported insurrection in the eastern regions of Donetsk and Luhansk. At the outset of 2022, the United Nations estimated that nearly three million Ukrainians were in need of humanitarian assistance as a result of the eight years of conflict. As the Russian military began to concentrate its forces along the eastern border of Ukraine in the beginning of 2022, the threat of an expanding war became a present reality. On February 24, 2022, the Russian Federation launched an all-out invasion of Ukraine which, through the course of the year, has resulted in massive displacement of civilian populations, the rise of a refugee population in Europe of over eight million, devastation to Ukraine's infrastructure and economy, and the loss of over 7,000 civilian lives, including over 400 children.Russian attacks have increasingly targeted civilian infrastructure, including over 700 verified attacks on health facilities in 2022. Industry across the country has been badly compromised or completely destroyed while supply chains and the country's power grid have been under direct attack. Ukrainians are facing innumerable challenges, including displacement, loss of homes and livelihoods, physical and mental trauma, and separation of families. Moreover, from a demographic perspective, Ukrainians make up one of the oldest populations affected by humanitarian crisis in the world. With access to chronic medications and basic health care badly disrupted and natural support networks destroyed, this has compounded the suffering of a particularly vulnerable cohort and complicated the emergency response efforts.Project HOPE began preparations for a response in early February as the threat of invasion grew. It initiated contingency planning with the Health Cluster in Kyiv, under the chairmanship of the World Health Organization (WHO). Project HOPE also reached out to partner organizations and medical facilities in Ukraine in the weeks leading up to the invasion, while simultaneously putting emergency medical supplies on standby for immediate shipment.

Research Ethics and Professionalism on the Line: A Critical Analysis of Rockefeller Foundation Support of Neurosciences in Nazi Europe, 1933-1945

January 5, 2023

The Nazi movement, heavily rooted in eugenics, caused the persecution and exile of hundreds of neuroscientists. Additionally, eugenic research took place in Nazi Germany with the motivation of improving the so-called "German race" through elimination of hereditary neurological diseases. With the advent of illegal killing of neuropsychiatric patients after World War II started, those patients could be used unethically as research subjects. Thus, neuroscience was at the heart of immoral and unethical activities in Nazi Germany from 1933 to 1945. The Rockefeller Foundation (RF) supported at least twenty exiled academic neuroscientists who either had prior RF support, or who showed "merit" to justify their being awarded limited funds to restart their careers abroad. The RF also supported eugenic neuroscientific research in Nazi Germany (and Denmark) despite escalating racial persecution in pre-war Germany. Some RF funds went to an institute which was also funded by the elite Nazi paramilitary group, the SS. And, an initially RF-funded project, a monkey farm in Würzburg, was used in unethical experiments to prove the cause of multiple sclerosis (MS) with subjects targeted for killing. Overall, the RF walked a fine line between supporting some victims of Nazi persecution, while ironically continuing to fund some neuroscientific research that could be linked to their persecution in the first place, or to destruction of neuropsychiatric patients. While supporting academic refugees was laudable, there was an undercurrent of supporting "best science" without regard for the ethical implications, from which current neuroscientists and others can learn valuable lessons.

Ukrainian Culture Under Attack: Erasure of Ukrainian Culture in Russia's War Against Ukraine

December 2, 2022

In the first days of the Russian invasion of Ukraine, a missile struck the Ivankiv local history museum, setting it on fire. It was the only building in the village to be struck. The Mariupol Drama Theatre was sheltering hundreds of civilians, including children, when Russian aircraft dropped two bombs on it in March 2022. Amid that rubble and death is a stark casualty: Ukrainian culture, identity, and heritage.PEN America and PEN Ukraine's new report gathers evidence of intentional and indiscriminate attacks on Ukraine's cultural infrastructure, in cities and rural areas. The report is damning, undeniable evidence of a concerted campaign of erasure. Hundreds of cultural buildings, monuments, and places of worship have been destroyed. Museums looted. Language suppressed. Books destroyed. Poets, writers, journalists, and translators detained, tortured, and killed. Preserved cultural heritage sites uprooted.The report makes clear that culture is not collateral damage in the war against Ukraine: it's a target, a central pillar of Russian President Vladimir Putin's justification for the war. Putin has repeatedly claimed that Ukrainian culture and language simply don't exist. By targeting art museums, music halls, libraries, theaters, and historical sites, he attempts to make it so

Fault Lines: Global Perspectives on a World in Crisis

September 8, 2022

During the last days of July and early August, 2022, the Open Society Foundations commissioned polling of more than 21,000 people living in 22 countries to gauge public opinion on key issues facing the world today.The polling, by Datapraxis, YouGov, and two local providers asked a series of questions that ranged from attitudes towards Russia's war in Ukraine; the fallout from the COVID-19 pandemic; the need for international climate action; and the current cost-of-living crisis. The survey also sought to gauge support across a range of ambitious policy options.More than two-thirds of the respondents live in Africa, Asia, Latin America, and the Middle East, providing broad insights into how people around the world are reacting to this spiral of crisis. The findings suggest a high level of agreement regarding the most significant challenges facing the world today—and a common desire for effective global action in response. But they also show continuing divisions over Russia's aggression against Ukraine, and a lack of confidence in the international community's ability to work together to address global threats.

Designing Ukraine’s Recovery in the Spirit of the Marshall Plan: Principles, Architecture, Financing, Accountability - Recommendations for Donor Countries

September 7, 2022

US Secretary of State George C. Marshall, speaking at Harvard University 75 years ago, laid out a plan that combined aid to war-ravaged European countries with the strategic goal of building an alliance against Soviet expansionism.West German Chancellor Willy Brandt, speaking at Harvard University 50 years ago, presented the idea of the German Marshall Fund of the United States (GMF) as a gift to the American people, a sign of gratitude by the German people and a living memorial to the original Marshall Plan.Today, the idea of another Marshall Plan is in the air. For the first time since 1947, a project for an expansive recovery effort on the European continent is needed and realistic. Russian President Vladimir Putin's war of aggression against Ukraine, with daily widespread devastation in the name of his neo-imperial plan, cries out for a strong, creative response by the global community of democracies. The vision of a free and democratic, modernized and European Ukraine is the answer to Putin's challenge.For decades, the German Marshall Fund of the United States (GMF) has supported the idea of a Europe whole, free, and at peace. It has supported the strengthening of civil society across Central and Eastern Europe. It has helped to generate and circulate ideas that honor the concept of enlightened self-interest and promote a collaborative, rules-based international order. At the core of GMF's work has always been the belief that the transatlantic community is stronger together.In July 2022, at an international conference in Lugano, Ukraine presented its National Recovery Plan. So far, its democratic partners have not responded in kind by agreeing on a plan to help the country rebuild after the war, leaving a void.This paper is an effort by GMF to help fill this void and to stimulate the debate about a meaningful Western plan for Ukraine's recovery. It is not a full blueprint for such an effort but a structured collection of recommendations for donor governments and international institutions. It limits itself to the challenges of designing and implementing such a plan and does not comment on Ukraine's National Recovery Plan. GMF hopes to follow this up with a broader, more comprehensive publication later in 2022 that will cover areas that this paper only touches upon, such as the role of civil society in the recovery process.

“We Had No Choice”: “Filtration” and the Crime of Forcibly Transferring Ukrainian Civilians to Russia

September 1, 2022

Since Russia's full-scale invasion of Ukraine on February 24, 2022, Russian and Russian-affiliated officials have forcibly transferred Ukrainian civilians, including those fleeing hostilities, to areas of Ukraine occupied by Russia or to the Russian Federation, a serious violation of the laws of war amounting to a war crime and a potential crime against humanity. Many of those forcibly transferred were fleeing the besieged port city of Mariupol.Russian and Russian-affiliated authorities also subjected thousands of these Ukrainian citizens to a process referred to by Russia as "filtration," a form of compulsory security screening, in which they typically collected civilians' biometric data, including fingerprints and front and side facial images; conducted body searches, and searched personal belongings and phones; and questioned them about their political views. Ukrainian civilians were effectively interned as they waited to undergo this process, with many reporting that they were housed in overcrowded and squalid conditions, for periods as short as several hours for up to almost a month.Forced transfers and the filtration process constitute and involve separate and distinct abuses against civilians, although many Ukrainian civilians experienced both.This report documents the forcible transfer of Ukrainian civilians from Mariupol and the Kharkiv region to Russia and Russian-occupied areas of Ukraine. Unlike combatants who, once captured, are held as prisoners of war (POWs) and may be moved to enemy territory, the forcible transfer of civilians is prohibited under international humanitarian law, or the laws of war, and can be prosecuted as a war crime and a crime against humanity. The report describes various kinds of pressure the Russian military and other Russian and Russian-affiliated officials used to make Ukrainian civilians fleeing hostilities go to Russia or the so-called "Donetsk People's Republic" (DNR), an area of the Donetsk region controlled by Russian-affiliated armed groups and currently occupied by Russia (DNR is used in this report as a reference to this area, not as recognition of any claims to sovereignty). The report also describes the many challenges Ukrainian civilians faced and the abuses they suffered as they attempted to flee Mariupol for Ukrainian-controlled territory and avoid going to Russia, or as they tried to leave Russia for a third country.

International Medical Corps Situation Update: #21

August 25, 2022

Following the Russian invasion in February 2022, International Medical Corps—which had been operating in Ukraine since 2014 in the southeast along the conflict's "line of contact," providing medical and mental health services—expanded operations throughout the country, implementing programs in health, mental health and psychosocial support (MHPSS), protection, gender-based violence (GBV) prevention and treatment, nutrition, food security, non-food items (NFIs), multipurpose cash (MPC), and water, sanitation and hygiene (WASH).International Medical Corps currently has operations in Chernihiv, Dnipro (extending to Kharkiv), Kyiv, Lviv, Odesa, Stryi and Vinnytsia. In liberated and post-conflict zones in the northern part of the country—including Kyiv, Chernihiv and Sumy oblasts—communities have experienced widespread and significant devastation, leaving health facilities and lifesaving medical equipment damaged or destroyed, and rendering WASH infrastructure inoperable, resulting in surging health- and mental health-related needs, as well as significant needs in other sectors. International Medical Corps has established programmatic hubs in Kyiv and Chernihiv to address these needs, and has launched an integrated multi-sectoral response focusing on health, WASH, nutrition, protection, food and NFI distribution, and MPC assistance. We also are providing durable medical equipment and supplies, including vehicles, to health facilities to support the restoration of healthcare services.

Ukraine Response: Six-Month Update

August 25, 2022

On February 24, 2022, Russia began its "special military operation" in eastern Ukraine, causing a humanitarian crisis across the region. In the last six months, we have provided nearly 3.1 million people in Ukraine, Poland and Moldova with critically needed supplies and health services.