As we mark a grim 2-year anniversary since the onset of the full-scale war in Ukraine, it becomes increasingly evident that effective risk communication, community engagement and infodemic management (RCCE-IM) are indispensable in navigating humanitarian emergencies. Since the escalation of conflict in February 2022, the critical role of RCCE-IM in shaping responses has become ever more apparent, underscoring the imperative of prioritizing these measures in humanitarian efforts.
Helping displaced people find their way into hosting health systems
When the long-running conflict in Ukraine escalated into full-scale war in February 2022, millions of people nationwide were confronted with situations that they had never experienced. Many people found themselves at a new location within or outside of Ukraine, often in distress due to family separation or the experience of violence. Their need for clear information from trusted sources, guidance on maintaining their health, and feeling engaged in the co-design of response activities increased. Tailored RCCE-IM interventions can improve the ability of displaced people to navigate and access hosting health systems for treatment and prevention, but also give people a sense of orientation and belonging, thus increasing their well-being.
Now, 2 years into the war, refugees have become more integrated in host communities with better understanding of the health services available to them. Thanks to RCCE-IM interventions people are more equipped with knowledge and skills to manage their health and seek professional care for themselves or their children.
Establishing an RCCE-IM blueprint for future humanitarian emergencies
“Unfortunately, the reality is that health emergencies have become more frequent in the European Region over the last few years. This has led to the mainstreaming of RCCE-IM, which has become a key pillar in all emergency responses. In the context of the Ukraine war, it has been central to link affected people to health services and care,” noted Cristiana Salvi, Regional Adviser on RCCE-IM at WHO/Europe.
The multifaceted nature of the Ukraine war has meant that health actors have had to act quickly to prepare and distribute lifesaving RCCE-IM interventions specific to the humanitarian emergency. This has ranged from supporting cancer patients needing lifesaving care in foreign countries, to ensuring those whose homes were flooded by the Kakhovka dam destruction in Ukraine understood how to make their food and water safer for consumption. Working in this way has engendered a wealth of learning which can also be adapted and applied to addressing the health needs of affected communities in other humanitarian emergencies.
Tailoring RCCE-IM interventions to communities impacted by war
“Since the war broke out, RCCE-IM has been a core element of the WHO humanitarian response,” explains Dr Jarno Habicht, WHO Representative in Ukraine. “The work on RCCE-IM has been essential in targeting people with the relevant public health advice in the evolving emergency; supporting social cohesion between internally displaced people and the host population; gathering insights into people’s perceptions and behaviours to inform response operations; detecting false narratives; and engaging with communities to co-design solutions.”
Vita Kolomiets, who was the Head of Communications for the Ukrainian Ministry of Health at the time of writing this story, explained the importance of providing health information and advice at a time of crisis: “It’s important to ensure that people have the information they need to make responsible choices.”
Most Ukrainians have a high level of digital literacy, and most are familiar with accessing information online and using health apps. But damage to infrastructure in Ukraine means that online information sources are not always available, so it is also essential to provide information in different formats.
“When Bucha was under the military control of Russian Federation, people were forced to hide in basements for weeks, without access to running water,” Kolomiets said. “Thus, they needed information about how to treat rainwater so that it was safe to drink. At the Ministry of Health, we provided advice on that through online channels, and we learned that people were trying to memorize it in case they lost power, or the internet was not working. This taught us that information needs to be very clear, short and visual to be memorized, and that printed information is also important.”
Olexandr Babenko, Head of the Health and Care Department of the Ukrainian Red Cross Society, has seen the importance of RCCE-IM interventions first-hand. After Bucha and Irpin were retaken by the Government of Ukraine, the Red Cross provided medical evacuation cars, but with so many civilians in need of care, it was essential to triage those in the worst condition. Many wounds had not been treated for days or weeks, putting people at risk of life-threatening sepsis. It was essential to ensure that people understood how to recognize the signs of sepsis so that medical teams could attend to them first.
Supporting refugees to navigate host health systems
“From the very start of the war, WHO worked closely with national health authorities to ensure that Ukrainians received relevant health information and advice when and where they needed it,” said Dr Nino Berdzuli, WHO Representative in Poland and WHO Special Envoy to Refugee Receiving Countries.
“Many needed urgent access to lifesaving care for long-term conditions. Expecting mothers needed to understand how to access antenatal care. When people had arrived in a foreign land without their health records, vaccination certificates or medication, accessing crucial information in their own language was a lifeline.”
Two years after the conflict began, priorities have changed. More parents are seeking to have their children vaccinated. Prejudices about seeking help for mental health disorders have started to be addressed as more people recognize the need for support and seek help. Risk communication interventions that embed empathy are instrumental to achieving that.
Katarzyna Drazek-Laskowska, Director of the International Cooperation Department at the Ministry of Health of Poland, recognizes the importance of tailored messaging. “The most important part is a human touch in risk communication. When we try to develop or design some measures to respond to people in crisis, we need to think about their lives, about the real human beings who are on the other side and that we are trying to support them in their hour of need.”
To draw on their shared learning, over 40 RCCE-IM practitioners and health leaders came together at a 3-day event in Warsaw, Poland, on 14–16 November 2023. With participants from governments, civil society organizations, WHO and partners attending from Ukraine and refugee receiving countries, the event provided a milestone opportunity to discuss past experiences, reflect on lessons identified and pave the way forward. The captured learnings will form the basis of new guidance on RCCE-IM in humanitarian emergency settings.