Abstract and Introduction
Abstract
People living with kidney disease are among the most vulnerable at times of natural or man-made disasters. In addition to their unpredictable course, armed conflicts impose a major threat given the disruption of infrastructure, sanitation and access to food, water and medical care. The ongoing war in Ukraine has once more demonstrated the importance of preparedness, organization, coordination and solidarity during disasters. People living with kidney disease face serious challenges given their dependence on life-sustaining treatment, irrespective of whether they remain in the war zone or are displaced internally or externally. This especially affects those requiring kidney replacement therapy, dialysis or transplantation, but also patients with other kidney diseases and the medical staff who care for them. Soon after the war started, the European Renal Association assigned a Renal Disaster Relief Task Force dedicated to support the people living with kidney disease and the nephrology community in Ukraine. This report summarizes the major challenges faced, actions taken and lessons learned by this task force. We anticipate that the experience will help to increase preparedness and mitigate the devastating effects of armed conflicts on the kidney community in the future and propose to establish an international collaboration to extend this effort to other parts of the world facing similar challenges.
Introduction
Natural or man-made disasters disrupt the functioning of a society and cause widespread human, material, economic and environmental losses.[1,2] Vulnerable people, especially the elderly, women, children, the frail and the chronically ill, are more severely affected during disasters. These groups should receive specific attention to increase their survival chances. Among these, patients in need of kidney replacement therapy (KRT) compose a small but particularly vulnerable group comprising <1% of the population.[3–5] Patients on KRT are mostly overlooked by the authorities, who are overwhelmed by the needs (i.e. security, housing, nutrition, communication, transportation, water and electricity) of the broader remaining population. Consequently, experts, national and international specialty societies, the World Health Organization (WHO) and non-governmental organizations (NGOs) must shoulder the responsibility for helping these patients. Furthermore, the patients themselves and their families should be prepared for various forms of disasters and, at times, be prepared to support each other.
Armed conflicts, wherever they occur, are a major threat to public health, disrupting infrastructure, sanitation and access to food, water and medical care. One of the major differences between armed conflicts and natural disasters is that in armed conflicts, the extent and the duration are not predictable. Conflicts may last for years, necessitating a sustainable relief plan.
In this report we aim to evaluate the interventions of the Renal Disaster Relief Task Force (RDRTF) of the European Renal Association (ERA) during the war in Ukraine and to make proposals for more effective renal relief and rescue strategies for similar future catastrophes.
Nephrol Dial Transplant. 2023;38(9):1960-1968. © 2023 Oxford University Press
