2024 ESO statement on the war in Ukraine

This month marks the second anniversary of the war in Ukraine. This is a devastating crisis for Ukraine and for Europe. Large part of the population fled the country seeking refuge in neighboring and far countries, mostly women and children. Leaving the most intense conflict zones, survivors were pushed into degraded living conditions, which presented a unique strain upon the healthcare system, that found no parallel in recent history of Europe.

According to the United Nations Office for Human Rights, 27,768 civilian casualties (9,806 fatalities and 17,962 injured) were reported between February 24, 2022, and October 8 2023. An estimated 17.6 million people in Ukraine require urgent humanitarian support, over 6 million Ukrainian residents became internally displaced persons, and 6.3 million refugees from Ukraine were recorded globally, most of whom (5.9 million) reside in Europe.

With respect to stroke care, the health and wellbeing of the Ukrainian population was heavily affected. Access to thrombolysis and thrombectomy, stroke units, and to services for secondary prevention rehabilitation and palliative care has been affected in conflict regions, especially for vulnerable patients such as stroke survivors and their families.  Before the conflict Ukraine was among the top five countries in Europe for stroke incidence, morbidity, and mortality: each year, there are 100–110,000 primary and 40–50,000 recurrent cases of stroke. Because of this high burden, stroke remains a priority for the Ukrainian Ministry of Health and National Health System. Investments in new equipment allowed all Ukrainian regions to offer mechanical thrombectomy (MT) to acute ischemic stroke patients. The MT rate is 1.5%, whereas access to thrombolysis is 10%. In 2024 new policies were issued to ensure improved access and quality of inpatient rehabilitation, increasing the number of days (up to 112) covered by the NHS.

In 2022, the European Stroke Organisation (ESO) established the Task Force for Ukraine (TF4UKR) chaired by Dr. Francesca Romana Pezzella (Italy) and Dr. Yuriy Flomin (Ukraine) to provide a dedicated team providing a continuous channel for the Ukrainian stroke community to network effectively with European national Societies, healthcare professionals and the WHO.

The ESO TF4UKR organized educational and communication events and funded grants in favor of Ukrainian stroke professionals. Among the main activities conducted in the last 2 years are: 1) supporting Ukrainian stroke physicians to relocate to other European institutions; 2) offering grants to Ukrainian Neurologists to visit Stroke Units in other European countries in 2023; 3) building educational forums, including virtual educational event series; 4) forming collaborations with WHO and other European Institutions, such as the University of Oslo, the Danish Stroke Society and Stroke Support Organization, to address gaps in stroke care, using mapping services and providing equipment. ESO’s solidarity with the Ukrainian stroke community remains steadfast. We trust that this collaboration will reinforce the link between our communities and provide opportunities for growth and recovery of Ukrainian stroke healthcare systems.