For the JC May 2022
An Israeli doctor, who retired after 17 years in high-level roles with the World Health Organisation, is back in the front line in Ukraine’s war, and is now the Incident Manager for WHO Ukraine.
As Dr Dorit Nitzan explained, she was formerly the Regional Health Emergencies Co-ordinator for WHO Europe. “I was supposed to retire on February 1, but then I got Covid, so I went back to Israel”. In fact, she had lined up a prestigious job with Ben-Gurion University and was due to take up that appointment once she recovered.
“But the war broke out on February 24”. Dr Nitzan wasted no time and volunteered to go to the Polish-Ukrainian border with an Israeli NGO, Natan, which works internationally in humanitarian disaster relief.
“I was leading the first mission of Natan to Poland’s border with Ukraine. I came back home after two or three weeks, and then WHO asked me to return to work for them in Ukraine”.
Now Dr Nitzan, 65, is responsible for co-ordinating all WHO medical responses to the war, the pandemic, and all health emergencies in Ukraine. It’s a huge job which involves travelling all over the country, working both in areas which have been hard-hit by the Russian invasion, and those not yet affected. She and her team move around between Lviv, Kyev, Dnipro, Zaporizhzhia, Poltava and Vinnytsia. “We are establishing medical hubs in these places and I go there with our teams to ensure that everybody is in the right place”.
This is not Dr Nitzan’s first experience of Ukraine. She worked for WHO in Ukraine between 2012 and 2016, during the time of Russia’s occupation of Crimea. “I felt I must come back to help”, she said. “I know the country, I know the authorities, I know the teams”.
She is clear-eyed and realistic about the issues she and her colleagues face. “WHO’s biggest challenge is to address the war, I call it a disease. The war is a disease, but the cure is peace. We are providing a life-saving intervention for people, but this is not solving the problem here. We are running, to prepare the health system, the work force, the people, and then responding… but this will not end, until there is some kind of agreement to allow people to go back to their lives”.
Dr Nitzan and the WHO teams work with the Ukrainian health system in cities such as Kyev and also with its regional authorities. “We work with them to make sure that there is continuous and seamless, good quality essential care, including preventive services. This includes, for example, when vaccinations are needed, or medicines”.
They deal with conditions such as cancer, hypertension, and patients who require dialysis; “and then there are ‘new diseases’, which involve trauma and injuries and mental health” — the latter of which often involve children, and of which Dr Nitzan, who originally trained as a paediatrician, is sensitively aware.
WHO works with health partners on a global basis, using whatever is necessary, including mobile clinics or “med-evaccing” — to get people who don’t have access to the right care to another place, either inside or outside the country, where they can be properly treated.
Under the heading of OSL — Operations, Supplies and Logistics — WHO has established warehouses where they can stockpile medicine and consumables for the primary care hospitals, mobile units, and for people who need care at home. “One of the biggest challenges here is transportation. Ukraine is a vast country and because we cannot fly any more, everything has to go either by trucks or trains — and sometimes the trains have been shelled. It can take two to three days at least to get from one part of the country to the other. That’s why we have established the hubs, in order to have a warehouse, and the teams, on the ground, as close as possible to the people in need”.
Dr Nitzan’s teams work close to the fighting and the front line. She was involved in the recent rescue of civilians from the Azovstal steelworks in Mariupol: “we received the people and saw what had happened to them. It was terrible.”
She’s also been near to shelling in Dnipro, “and the sirens go off very often. You feel the war here. It is such a big country that in some parts you do feel that things are normal, but it’s absolutely not”.
Home for Dr Nitzan in Israel is Atlit, on the northern coast of the country, while her parents live in Rishon le Zion. Her daughter, Maya, lives in the southern moshav of Netiv Ha’sara, where she is both a vet and a midwife. “She says she delivers children to women, she doesn’t care how many legs they have”, laughs her mother.
Though she is clear that “you never get used to war”, Dr Nitzan acknowledges that having grown up in Israel and completed army service, “it helps me to take personal responsibility. I know that when there are sirens, I go to the shelter, and I make sure that the team knows what to do. In war you cannot trust what happens”.
Even if the war stopped at the end of the year, as has been predicted, Dr Nitzan believes that its impact “will continue for generations, particularly among women and children. The fear and the trauma will last a long time. And the health system will take a long time to recover. We had 217 health institutions — hospitals and primary care — which were destroyed. Rehabilitation and the building back of Ukraine is going to take a long time.”
The doctor has promised her family that she will return to Israel “in a few months”. But, she says, “I will always be ready to jump on a plane and go back to help.”