Russian escalation in Ukraine could lead to humanitarian crisis

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The massing of Ukrainians at the Polish border is leading to urgent conversations among officials at the State Department and USAID about the need to quickly increase assistance to European countries accepting refugees, according to two senior Biden administration officials with direct knowledge of the situation.

That U.S. support will require additional funding — more than the Biden administration has already committed for Ukraine, the officials said. Talks about supplemental humanitarian aid for Ukraine are also taking place between Congress and the White House, and it’s likely that funding will take more than a week to get approved, potentially delaying the shipment of critical aid.

Over the last several days, as many as 520,000 people have fled Ukraine, according to the United Nations, with the majority crossing to Poland and Moldova. The backup at the Polish border, where cars with fleeing Ukrainians are sitting idle, ranges from one to three days, the U.S. officials said — raising fears about Ukrainians’ physical safety, and access to food, water, and medical support.

“You have seen half a million people move in the space of under a week… which is really an extraordinary speed. It should be a manageable situation but it is also very fluid right now,” a senior USAID official said. “It really is going to come down to access and security and resources. If health care centers are being bombed as we saw in Syria… it makes it much harder to provide health services.”

The U.N. is set to launch a massive funding appeal as early as Tuesday for increased humanitarian aid for as many as 100,000 people internally displaced in Ukraine and the 520,000 who have fled the country. The U.S. in recent days approved an additional $54 million in humanitarian aid for Ukraine, but lawmakers on Capitol Hill have said it is not nearly enough and are now considering an additional $2.9 billion in funding.

“I think we are seeing an unfolding humanitarian crisis. Half a million Ukrainians have fled the country already. If Putin resorts to even more brutal attacks, such as using cluster munitions, I think we will see that number go up,” said Sen. Chris Coons (D-Del). “I think it makes sense for us to appropriate now in anticipation of what may be a significant need in Poland and Moldova, in Bulgaria in the Baltics.”

The $2.9 billion figure could swell as needs evolve and the Biden administration works with allies to “assess on-the-ground needs,” according to a White House budget official.

“We are seeing large numbers displaced inside Ukraine and increasing … numbers of people crossing international borders out of Ukraine,” said Chris Boian, a spokesperson for UNHCR. “It is a massive undertaking, and it requires urgent and immediate and comprehensive response. Urgent financial support is required from the international community.”

The State Department said in a statement that it is “closely coordinating” with international partners to address the humanitarian needs in Ukraine. “We stress that access to health facilities must be safe and sustained with essential medicines, supplies, and services,” a spokesperson for the department said. “We call on all parties to allow immediate, safe, and unhindered humanitarian access for humanitarian agencies and other humanitarian actors to continue their vital work in Ukraine.”

Dire situation all around

Although the number of people who have recently fled Ukraine is rattling officials and humanitarian aid organizations, the situation for people who stayed is equally dire, Boian said.

For instance, several members of Ukraine’s parliament have said Russian troops seized a maternity ward in Vorzel last week.

“Women and their newborns were forced to the street with their lives and health at risk,” said Oleksandra Ustinova, a member of Ukraine’s parliament, who added that Russian soldiers on Monday also shelled the Adonis Maternity Hospital near Kyiv. “The Russian army targets not only houses of civilians but also hospitals, kindergartners, orphanages.”

The hospital’s support team confirmed to POLITICO that the building was hit.

“A shell hit the maternity hospital, the damage is minimal and the building stands,” read an email from the team. “Everyone was evacuated and is in safety now.”

Ustinova said health care personnel have had to shelter newborns from Russian attacks. “Three days ago in Dnipro, about a dozen newborn babies were hustled away from the neonatal unit into a makeshift bomb shelter, a storage room in the hospital’s basement,” she said.

Meanwhile, scenes at the Polish border — women and children walking up to 20 miles and amassing for days at the edge waiting for entry — are pushing U.S. officials and international aid organizations to find new ways to support the Polish government and other surrounding countries in their processing of refugees.

The UNHCR has already delivered beds and sleeping mats for 10,000 people in Moldova. USAID, which has a disaster assistance response team on the ground, delivered to Ukraine high-thermal blankets for 23,000 internally displaced people as well as 640 satellite phones to help maintain communications. And the WHO warns that Ukraine’s medical oxygen stockpiles are running low, and could be depleted in the next two days.

Filippo Grandi, the U.N. high commissioner for refugees, told the U.N. Security Council Monday that the organization has already received more than $40 million in the last few days to help refugees fleeing Ukraine. But that won’t be enough to help the perhaps millions of people who leave the country in the coming days, he said. “I am counting on governments to do the same — and quickly,” he said.

The heightened concerns come as Samantha Power, the administrator of USAID, met with counterparts in Ukraine and elsewhere in Europe, including Krakow, to discuss how to ramp up aid. Power visited the Polish border to observe the people crossing from Ukraine.

In an interview with CNN Monday, Power said the Polish government is responding promptly to the influx of refugees, but that it would likely take several more days to clear the queue of people waiting at the border.

“Most of the backup is on the Ukrainian side, because the numbers are just the likes of which no one really had contemplated inside Ukraine,” she said. “It was just very hard for people to believe that their Russian neighbor would turn on them in this way.”

Power also said the global aid community is contingency planning for the possibility that as many as five million people flee the country in the coming weeks.

For the estimated 100,000 people displaced by the conflict inside Ukraine, global health organizations are working to get more supplies inside the country, particularly to still-functioning hospitals.

‘Indiscriminate bombardments’

In cities where fighting has raged for days, trucks are unable to find safe passage to transfer medical supplies to hospitals running short on oxygen and the tools needed to administer it. The WHO has called for the creation of a safe corridor through Poland to Ukraine that could allow it and other aid organizations to more easily transport aid.

“I don’t even want to think about the hospitals. Luckily, we have electricity even though Russia is trying to actively bombard our power stations,” Igor Novikov, a former adviser to Ukrainian President Volodymyr Zelenskyy, said from Kyiv. “For those people with Covid and bad conditions in the hospital, it must be horrifying because at any point inside, the death warrant can be signed. And it won’t be a bomb. It’s just that slow death of knowing that there’s no way of helping you.”

Novikov said Kyiv was experiencing “constant” and “indiscriminate bombardments” that prevented people from accessing necessities including food.

“Elderly people who are stuck at home alone — volunteers are trying to help as much as they can,” he said. “If you can’t get up or you can’t go to the shop that is too far because all the shops in your area are closed, you’re not doomed but you’re in a bad situation.”

Galyna Maystruk, a gynecologist-oncologist and head of an NGO called Women Health and Family Planning, said she has left Kyiv for western Ukraine and is counting down the days until she can go back home.

“All my life, I was working for [the] quality of life of people,” she said. “What’s going on now, it’s my heart which is absolutely broken. And I now try to make it full.”

Her husband, an obstetrician-gynecologist, remains in Kyiv. Some doctors have been in the hospital for five days — they can’t go home because of the bombing, she said. The war is taking a toll on a workforce already exhausted by the ongoing coronavirus pandemic.

But it’s not just stamina that risks running low. Maystruk described a need for blood products, kits for emergency cesarean sections, birth kits, and medications for severe bleeding during birth.

Providing humanitarian aid during conflict is a challenge, even for organizations like the International Committee of the Red Cross, which has had 600 staff on the ground for the last eight years, mostly in the country’s east.

On Friday, the ICRC delivered between 15,000 and 16,000 liters of drinking water in Olenivka, northeast of Kyiv. To do so required planning to ensure it could be done safely, said Florian Seriex, spokesperson for the ICRC.

“We had the guarantees from the authorities. We knew that we could go with our trucks, with our cars, with our teams safely,” Seriex said. “Those guarantees are paramount.”

Ukraine’s government, meanwhile, has asked the U.N.’s World Food Programme for help.

“Food and drinking water shortages are reported in pockets of the capital Kyiv and in Kharkiv, the two cities currently bearing the brunt of the ongoing conflict,” WFP said in a statement on Monday. WFP staff in Kyiv report nearly empty grocery store shelves.

Alice Miranda Ollstein and Jennifer Scholtes contributed to this report.

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