[000:00:00;00] if we fight our children protect ours we still live in those days endless february 24 day after day month after month full of pain and despair but you have to finish it there are weapons there is equipment there is a plan start the year of retribution join the armed forces of ukraine documentary trilogy military intelligence ukraine, on the sea, in the sky, on the ground, the most successful

ukrainian counteroffensive of the entire war - this is a truly ukrainian city of more than eight and a half thousand square kilometers , 2,000 kilometers less, about 400 settlements liberated, almost 150 thousands of local civilians were saved. we will never see you. the kharkiv offensive operation as a military masterpiece of a strategic level, we hand over to the headquarters, the headquarters that manage all of this, the honor of thanking all of you for liberating our country from the enemy, the film third land kharkiv counteroffensive watch on wednesday, march 22 at

9:15 p.m. in this year of our independence, we saw how ordinary people become extraordinary heroes, how hells of battle are born, new ukraine, ukraine, which is protected by you, our native friends, neighbors, colleagues you were not always military but you were always ukrainians you are our pride and our hope this year we survived thanks to you a year of indomitability together to victory a smile a look acquaintance the first flowers and jokes are stupid in my head i scroll again these minutes hours and

days we have been with you for a long time we didn't meet, we learned to read minds, how do you want to just hug these minutes, hours and days, how do you just want to say i love the whole universe , it's you, son, daughter, mother, hug, i love, and that's why the project of kateryna osadchai from the search missing people to find their own that monday at 9:15 p.m. stories of families that were divided by a full-scale war, their houses were destroyed by enemy shells and under rubble, i did not find anyone, they are nowhere, there is no hope

to find loved ones, if anyone has it , pass on this information. we find that monday has disappeared in marathon, the only news is at 21:15, we do not know how long the war will continue, we all want our victory to come as soon as possible, but the longer we live in a stressful situation, the longer we will be to see the horrors of a war of horrors these are not human bombardments by russian terrorists, the worse and worse will be the impact on the state of our health minister i welcome you to the first channel of public broadcasting thank you for visiting us today i congratulate you i wish you all good health thank you to each other already more than a year how

is the full-scale invasion of russia in ukraine going on and at the beginning of this invasion the message was voiced that unfortunately the state of health of ukrainians will deteriorate and at the end of last year the sociological rating group conducted a study and 32% of the respondents said that feel a little worse, 21% of respondents in general feel significantly worse if you count it as more than half of the population . so, the first question for you is what are the consequences of the year of the great war for the health of ukrainians and for the health care system in general, and to what extent these numbers have been voiced by me correspond to reality. thank you for the question, and when we talk about the war, we can talk about direct losses and the direct impact of the war on the health and life of ukrainians, as well as indirect ones. unfortunately, 2022 is not the year

when people thought about preventive medical reviews about screening programs about immunoprophylaxis programs, because now everyone has safety on the agenda, safety of one's own without the pc of one's loved ones, and after that, there are health issues and possibly some alarming symptoms that a person feels, whether to go to the doctor or not to miss or detect this or that disease at an early stage, and unfortunately, this is what going to the doctor is not a priority today for certain reasons, or in june of last year, after five months of war, you said that 5 months of war led to that we ukrainians have aged by at least 10 years, that is, the diseases that used to occur in us at the age of 60 will now be among people from 45-50 years old after the year of the war . how much do we

age in this? younger and what used to be 60-65 is now 45:50 and we do not know how long the war will continue, we all want our victory to come as soon as possible, but the longer we live in a stressful situation, the longer we will see the horrors of the war of horrors. this is not attacks on people by russian terrorists will get worse and worse, but the impact on our health and that is why i urge everyone who has this opportunity not to postpone visits to the doctor for preventive examinations and screening programs, but to find time now to rebuild ukraine healthy ukrainians well, all the more so it can be done according to the place of stay yes well we but we understand all the conditions people live who are now somewhere near the front line there are problems with the territories before russia is trying to establish

the occupation regime, there are problems with the de-occupied territories, or the indirect influence of the ukrainians was already felt when we were talking, and in the summer there was a fuel crisis, well, for cars, along with inflation , everything became more expensive. it was getting more expensive to leave a remote settlement to the nearest district center. there will be hospitals . where can you get this examination? it has become many times more expensive for those who do not have their own transport but cannot get there in order to carry out a diagnosis, only when they have it. we go to the doctor, this is a problem and this is the indirect effect of the war on the state of health of ukrainians, we see the same thing, and now even after paying off the prescriptions from the program, the available medicines did everything that it worked during the martial law, but we see a smaller number of appeals and payment of prescriptions is one of the reasons why many people left the country, at the same time, many people cannot travel to pay the prescription, and now we are developing a number of measures to bring medicines from the program, medicines are available

through various mobile mechanisms pharmacies through the help of paramedics, nurses who work in remote settlements, that they had supplies, they could fill out these prescriptions , by the way , according to the medicine. positions sometimes reveal one or another problem , what kind of position is it? well, for example, recently there was a problem in the global shortage, not for ukraine, but in the global insufficient number of drugs on the global market, these are the so-called thrombolytics of the group, when a drug is administered that dissolves blood clots, which helps to prevent complications in heart attacks and strokes, and unfortunately there were none in the world. quotas

of delivery to us, now there is no such problem , at the beginning of january , problems with access to oncological drugs periodically arose, these issues were also closed - everyone at different political levels got involved , accelerated the delivery of drugs to ukraine on at the beginning of the war, there were problems with hormone replacement drugs and insulins, operational measures were also taken . well, i would say in manual mode in order to react quickly to it. and yes, in principle , the range of drugs is sufficient both in the bird network and in medical institutions. yes, plus a large number of drugs have arrived from his humanitarian aid and distributed in the regions in order to give them to people who need them in general, what is the situation with health care institutions throughout ukraine and where is the best situation here

to say there are two directions, yes, we see significant damage and destruction, we see that more than 1,200 institutions were damaged. and recently, the prosecutor's office and the security service of ukraine directly identified a gunner in kherson who directed fire at the hospital, and we have this fact again after all, they handed it over to international prosecutors so that they could clearly see the violation of the geneva convention, which clearly says that during hostilities , there are houses with red crosses and hospitals . does not affect in the same way as medical evacuation cars, yes, a loud target , and we see that there is destruction there. now, about 200 hospitals have already been restored in the center for primary medical care, and in some settlements they have been built from scratch because they were completely destroyed. it was possible, but there are still a large number of damaged

hospitals. we can't even begin to restore them, because they are constantly under fire and this affects the availability of medical care at the same time, wherever it is possible, the health care system of hospitals is being modernized, a large number of institutions were modernized, innovative equipment was supplied, both with the funds of the state budget, the funds of the national health service of ukraine were saved, and a large number of international partners supplied us with expensive equipment, including angiographs that help us with vascular pathology also remove thrombus from blood vessels in addition to farts for strokes, computer tomography, and now there will be supplies of linear accelerating artificial anesthesia devices in anesthesiological equipment pulmonary ventilation, that is, changes are taking place, institutions are being modernized, if it were not for the war, there would be something to brag about. and so we see that somewhere

we manage to develop a little better, but we understand the large amount of resources that we need in order to completely restore what was damaged and destroyed after our victories what is the situation in the de-occupied territories, has the health care system there fully worked and am i there at all, who and what to work on, again, in each region, it's different, when we talk about the kyiv region the zhytomyr chernihiv hospital was fully operational and everything is working when we talk about the kherson region. we can’t say what worked, everything is starting to work as the current situation allows , because all the hospitals in the city of kherson can’t be started now, because they are constantly exposed and come under fire and we launched the number of health care facilities and the number of medical workers that is necessary for a specific situation, and we additionally

help with field teams on rotating shifts in kherson, for example, they come neurosurgeons from odesa in the settlements of the kherson region, field teams of the center of disaster medicine of the ministry of health work, which travel through all settlements, and well, how is such a rural dispensary, a large number of partners help red plants, or international organizations and ukrainian public organizations, which also travel around the villages and provide both social support and the first medical aid in the first diagnostic procedures that can be carried out on the spot in order to then tell the person that you need to go further if you need to be hospitalized, yes, well, let’s say we are talking about the kherson region , there are medical workers there to work there, we all left there, not everyone left, they continue to work and continued to work in the eye and they continue to work under shelling, for which a big thank you to the medical workers or are they in the number of those

who were not, but not the number of people who continue to live now or have returned to kherson, so it can be said with a stretch, but the number of doctors is adequate for that situation what is there in case of some critical situation, if we see that there are gaps , the health care departments of the regional military administrations report to us, and through the mechanism that was launched last year, we can send any employee from another hospital on a business trip with the preservation of wages territories of our country , it is clear that people fleeing the war were forced to move, some inside ukraine to safer regions , some went abroad. and did this internal and external migration of ukrainians lead to

the lack of medical personnel, in particular, referring to the example of junior medical personnel, nurses, paramedics, mostly women. is there a shortage? if so, then this situation is the most critical, so the shortage is still felt the closer to the front line or where there is shelling, speaking in ukraine as a whole. yes we see a decrease in the number of medical workers, we monitor the number of workers who left their workplace and left ukraine , but this number is not critical for our health care system, because a large number of medical workers she moved from those territories where russia is now trying to establish an occupation regime and works calmly in health care facilities in safer territories, the burden on those who stayed um who didn't leave probably increased well, you have to compare how where uh and yes the burden on family doctors really increased, and especially in the first months of the war, when a large number of people

came by transit to certain settlements . kropyvnytskyi then moved further to the west of our country and the question is how they all went to the family doctor, they did not renew the declarations, but from the first days of the war, the ministry of health issued an order that if a person applies without a declaration, the doctor has the right to form a referral and write a prescription to provide him with all the necessary medical care. yes, this is signing without signing the declaration. yes, this led to additional burdens on the doctor, but everyone understood that this additional burden cannot be compared with that the burden where the doctor remains in the territory under constant shelling in the warehouse, we have a smaller number of people who we provide medical care, but it is much worse working conditions and it is like this , well, if the health care system could hold its own and continue

to provide medical care by mutual aid to each other i will not say that everything is perfect, everything is smooth, the eu has its own cases, but we all react to these cases together, and in general, is there any provision for an allowance for doctors, well , medical personnel who work in the front-line territories, that is, see here about the front-line territories, we made separate packages for the medical guarantee program , because we understand that there are several issues here , uh, they do not have the same number of patients as before. a reduction in wages, so we fixed them there with the so-called combat package, which provides for the maintenance of funding at the level of 2021 so that they can be ready to respond to what challenges we separately kept the salary package for those hospitals that continue to work

in the occupied territories, we all continue to charge them salaries and , if possible, transfer them to cards so that people remember and know that ukraine is with them, ukraine will fight to the end to expel the russians from the territory of our country. we will also do this about health. i would like to talk to ukrainians from the streets. according to who estimates , currently one in four people in ukraine is at risk of serious mental illnesses. mental health is becoming the main issue. the problem of health care in ukraine is the statement of the special advisor at the world health organization, michel kozachka, on what will we do with the mental health of ukrainians and what is being done already, we are already doing it, so we understand that war really has a significant impact on the psycho-emotional state of everyone people, even if we do not recognize this. this does not mean that it does not affect us and the first months of the war, if we remember everything was seen live on the air

, the movement of the column of heavy weapons from russian terrorists, the shots of destruction residential buildings, rocket attacks were all broadcasted, and even a person who was very la not in the place where the rocket attacks were flying, they saw all of this and were already worried, as were the people who lived next to the destruction, we count somewhere on the figure of 15 million plus or minus which every fourth in which in which there will be changes in the psycho-emotional state. but in order to cope with this challenge, we have already conducted an audit of the existing system that we have for psychological support and an audit of the resources that we have implicitly identified problems that we have there are also these point problems, now the maximum effort should be directed at what works , well, for example, the problem is that psychology is psychological changes, it is not only a medical problem. in medicine, it is already

psychiatry, and when we say about the fact that we do not detect changes in the psycho-emotional state in the early stages, and then we already see the consequence of the psychiatric illness that is present, which treats this. so we have to look somewhere where the person went and where adequate help was not provided in order to work it all out and we in medicine have a flagship project, we have started to retrain family doctors on the problems of e.e. vozov such detection of changes in the psycho-emotional state, a program such as mhgab shows key changes to vozov methods that every family doctor should know so that when communicating with a person who has asked for a consultation , always with another question to the doctor , he should detect changes in the psycho-emotional state and recommend either exercises for self -help or referral to a narrow

specialist who will already help specifically cope with this or that issue, you now recommended to contact if people feel that the psyche is disturbed, now the family doctor , first of all, there is a hotline where you can talk to professional psychologists who can then tell you where the closest person to the person's place of residence is a psychologist who provides psychological help for free the vitality centers that we take care of the ministry of social policy will continue to develop . the ministry of education is retraining its psychologists who are in the education system near schools so that they can also work with injury received as a result of the war is another topic i would like to talk about reforming the medical system, however, a statement on the fact that the ministry of health is starting the next stage of medical reform

, however, there is the issue of reforming such systems that operate in health care, which as for me, it is more timely to reform the system of medical and social expert commissions , military medical commissions of the lkk, etc., which is being done now so that we do not see more posts on social networks about what people who suffered as a result of the war received mutilation, servicemen who were injured, that they go through the nine circles of hell in order to stand in a kilometer-long line for several hours, get a certificate , then get a conclusion, and a conclusion . it is not always objective. has been developed since soviet times, it is necessary to divide the issue in the lc e-e military medical commissions and medical and social expert commissions, there is such a social expert commission there is a global reform and

it is related to changing in general the disability system in ukraine, what is it related to? the first stage is the launch of a full-fledged rehabilitation system in the field of health care, as declared by the best countries in the world, this rehabilitation is not focused on the fact that a person has been somewhere, recovered, received treatment there, and on his return and resocialization of a person to know and understand the pathology, physical rehabilitation does everything possible so that a person comes and is physically active and employed in accordance with his functional capabilities in ukraine was launched as a new system rehabilitation was facilitated by the law on a separate law of ukraine on rehabilitation in the field of health care and a number of normative legal acts, there is an order from the president of ukraine to launch a new rehabilitation system in the country , and we have already done, well, a large part of what should have been done, and it is no longer

only on paper well, first any reform and changes are prepared on paper, it is already in practice now we are scaling everything up so that the rehabilitation system works everywhere and in the amount that our country needs, after that in all health care institutions multidisciplinary rehabilitation teams are working, and they will implement the international classifier of functioning, which we have already adapted in ukraine, and we are waiting for the launch of the electronic module on rehabilitation. may lose four blocks and the dominal rehabilitation plan shows that we can return it and we will try to return as much as possible.

for a person to be socially active and to be employed after that, this individual rehabilitation plan is picked up by the social service and talks about an individual rehabilitation plan in education , that is, it is necessary to retrain a rebellious person in other things and in employment and potentially in care and support if this is required for each specific of a person and directly a person who gets into the system , he is no longer running around with pieces of paper, he is already the system itself. it works. so a person is caught at every stage because the electronic module and certain services are provided and in the final stage the disability will already be established only for those people who cannot be helped by the rehabilitation system because there are certain diseases and injuries that, unfortunately, we cannot help medicine in its current state of development and thus the disability will already be established and certain supporting mechanisms , either payments or payments for certain social problems, means of rehabilitation

already now, it is not necessary to wait until a person is diagnosed with disability today, and protest and zery auxiliary means of rehabilitation are provided immediately by multidisciplinary teams, this is already a stage of reform right in the hospital regarding vlk there is a more complicated process , but we help we help the ministry of defense because it is the military part of the medical service in the armed forces of ukraine and now we have taken part of vlk in our civilian institutions those who are in hospital treatment have received a mandate the prime minister and we combine where there is a hospital where a person is staying and we see that she can get a disability in the existing fertility system, then we will do everything so that vlk and msek are done right in the institution at the patient's bedside, he will not need to leave the institution in order to run around the offices to go somewhere to the regional center , because there are no regional centers, there are simply different

cases, why all this is happening, we thoroughly understood, helped to understand these problems, the ministry of defense has attached mine number and now everything is digitized , the number of outpatients in the vlk will be increased. i think that this will also solve the problem. how long do we have to wait in order to record it all? somewhere in a month or two, there is an opportunity to increase the number of outpatients, there is a need, we are ready to give away our facilities, do it here , just come, a military specialist from the seal, who will then this reference was attached, therefore, we are completely open and are only waiting for administrative documents from the e medical forces of the armed forces, this system was questioned for decades, don't be afraid that the system will interfere so much that you won't be able to reform it , look at the ultimate goal in the system. this is an interested person who is ready to come to that

system, then she will eat two problems in msecs firstly, they give disability to those to whom they should not give, secondly, they do not give to those to whom they should, well, with those problems, there was another problem, and they do everything in order not to mobilize someone. but i say that they give to those who do not need to give, that is well, there is no such problem, it’s just that someone is pursuing some final goal, and that’s it. our task is to make sure that this final goal does not exist in order for it not to exist. so, we start rehabilitation, we start multidisciplinary teams, the electronic module of the medical center, and why are you not here? there is something to deceive, because at the end you are not interested , in the end, what can ukrainians expect from the health care sector in the 23rd year? to go back to pre-war life, and then there will be our own problems. but we will be like united ukrainians with them. we are now proud

of the whole world. let's solve them. there will be discussions and political discussions and criticism. but this will be a movement forward and it will be. - is a huge how moving forward is not the way we used to stomp in place. now we simply do not have the right to do this. thank you, mr. minister , and i want to thank all the medical workers who continue to work under extremely difficult conditions, continue to save the lives of ukrainians, the lives of children, and the lives of our servicemen and bring them back to a normal life. thank you for this time . thank you. events, we understand that in such conditions you have to work no less hard than the medical workers, we confidently go to victory, so