Report from Ukraine – Between War and Resilience

Unbroken Center, ©La Chaine de l’Espoir

First Mission in Ukraine with Olivier, Director of Operations

We arrived on July 21 from Rzeszów, Poland. With the airspace closed, the journey continued by car: a ten-hour drive, with a first night in Lviv. This slow and complex logistics already says much about the war: entering Ukraine is to share, even for a moment, the daily constraints of an entire country.

The context is heavy. On the night of the 21st, Kyiv was hit by a massive attack: over 420 drones and around twenty missiles, some hitting a daycare, a metro station, and residential areas. Ten days later, a new wave caused up to 18 deaths and more than 150 injuries. Our mission took place between these two assaults, like a fragile parenthesis. During our stay, a few nighttime alerts were enough to remind us of the constant underlying anxiety weighing on residents.

Kyiv: a tense but vibrant capital

What struck me was the calm of Ukrainians. Everywhere, the war is present: interrupted nights, sudden awakenings, worry for loved ones. Many are sleep-deprived, yet no one complains. This silent dignity commands respect.

And yet, life goes on. In Lviv, restaurants and bars remain lively until curfew. In Kyiv, families stroll in parks, and young people linger outdoors in the evenings. An almost festive vitality, as if a collective refusal to fully succumb to war. This strength is rooted in history. Since 1991, civil society has continuously resisted. In 2014, the Maidan was a decisive rupture: Ukrainians rose against a pro-Russian president who had reneged on his promise to sign the association agreement with the European Union—a sovereign act and an irrevocable choice for Europe.

Civic engagement remains: the demonstrations

This spirit endures. During my mission, the population—a highly mobilized youth—took to the streets to oppose a plan to bring the anti-corruption body under government control. Massive and determined mobilization forced the measure to be withdrawn. Even in war, democracy is lived daily here, both in the streets and within institutions.

Maidan: memory and grief

Today, Maidan is also a place of mourning. On one of the lawns, thousands of small blue-and-yellow flags have been planted, tightly packed. Each bears the photo of a soldier fallen in combat.
I stop in front of these faces, sometimes so young they could be my own children. Behind each flag is a life cut short, a grieving family, an interrupted story. This field of bright colors has become a symbolic cemetery: a silent tribute to the price Ukraine pays every day for its independence.

Maidan Memorial, ©La Chaine de l’Espoir

Exemplary Ukrainian colleagues

In Kyiv, I met the local team of La Chaîne de l’Espoir. Their dedication gives our work a particular dimension: it is not only about external assistance but a shared struggle.

Polina, a pediatric surgeon, left Canada to return in the early days of the war. Mykhailo, an orthopedic surgeon, travels to Kharkiv every weekend, near the front line, to operate with his colleagues. For over three years, he has not taken a vacation. Their energy and determination embody the mission better than any speech. La Chaîne de l’Espoir lives through them.

Institutional meetings in Kyiv

Our days were also filled with numerous meetings: Ministry of Health, Expertise France, AFD, French Embassy, OCHA, and the manager of the Humanitarian Fund for Ukraine. These encounters are essential for strengthening partnerships and preparing new projects.

Deputy Minister of Health and Anouchka Finker, ©La Chaine de l’Espoir

A healthcare system weakened by war

Discussions confirmed that the war exposes the flaws of an already fragile hospital system. Three major challenges emerge:

  • Infections: Patients often arrive too late, after prolonged tourniquet use, without proper antibiotics. Wounds become infected, often with multi-resistant strains; many amputations could have been avoided. Observations from evaluations conducted by La Chaîne de l’Espoir are being incorporated into our projects.

  • Avoidable amputations: Too many patients lose limbs due to delayed stabilization or transfer to specialized hospitals.

  • Biomedical equipment: In many hospitals, essential equipment remains unused due to lack of maintenance, spare parts, or trained technicians. This paradox—available but unusable equipment—is a system Achilles’ heel. We address it by training local staff and restoring vital equipment.

Damage Control training, ©La Chaine de l’Espoir

Return to Lviv: Damage Control and reconstruction

In Lviv, we visited the Husome center, where six surgeons undergo intensive Damage Control training. One day of theory, followed by one day of practice. Under anesthesia, pigs are used following strict ethical protocols. Surgeons must diagnose and stabilize injuries to the bladder, liver, lungs, and heart.

Damage Control teaches how to stabilize a patient and buy time before transfer to a better-equipped hospital. These trainings, designed by Professor François Pons—a volunteer surgeon with La Chaîne de l’Espoir, former military, and former director of the Val-de-Grâce School—are now in high demand. Their impact is immediate on the ground: they save lives. To date, nearly 270 Ukrainian surgeons have been trained by La Chaîne de l’Espoir in this method, significantly strengthening surgical capacities in wartime.

St Pantelimon Hospital and the memory of heroes

At St Pantelimon Hospital, the corridors are adorned with portraits of doctors, including Dr. Stéphane Romano, a French volunteer surgeon with La Chaîne de l’Espoir. His commitment alongside local medical staff has earned him the status of a true hero. His photo reminds us of the impact a single doctor can have.

St Pantelimon is also one of the largest medical facilities in western Ukraine, with the country’s largest intensive care unit (nearly 100 beds), a 700 m² state-of-the-art sterilization unit, and a cutting-edge transplant center capable of complex procedures thanks to an immunogenetics lab and advanced technologies. A pillar of Ukraine’s health system, marked by war yet looking toward the future.

Unbroken: reconstruction after injury

Finally, we visited the Unbroken center, a showcase of Ukrainian resilience. Next-generation prosthetics, exoskeletons, medical robotics: everything supports rehabilitation. Patients, often very young, relearn to walk, live, and rebuild themselves. The contrast is striking: on one hand, avoidable amputations due to delayed care; on the other, innovation giving hope.

Conclusion

Three priorities emerge from this mission:

  1. Train surgeons in Damage Control to save more lives.

  2. Provide faster, better care to prevent infections and unnecessary amputations.

  3. Strengthen biomedical capacities by training technicians to restore hospital equipment.

Beyond projects, I retain the image of a dignified and resilient people, and of my Ukrainian colleagues who fight every day, not only to save lives but to defend the future of their country.

Anouchka Finker

Anouchka Finker - CEO @ La Chaine de l'Espoir | LinkedInAnouchka Finker has been CEO of La Chaîne de l’Espoir since 2019. She has over twenty years of international experience in strategic management and partnership development in multicultural environments, both in the private and humanitarian sectors.

As head of La Chaîne de l’Espoir, she leads the work of a 240-staff international medical organization active in around twenty countries. The NGO focuses on improving access to healthcare for the most vulnerable populations, especially children and women, while sustainably strengthening health systems, with particular attention to surgery. She works closely with local partners to provide lasting solutions and meet needs in crisis contexts.

La Chaîne de l’Espoir 

I invite you to read these interviews and articles published in the edition :

A host of challenges for the humanitarian sector.

© WHO In February 2025, before the ceasefire broke down, Palestinians displaced in southern Gaza were returning en masse to the north of the enclave.

In this editorial, I seek to name and understand the upheavals currently underway.

This article is neither exhaustive nor definitive. Its aim is to explore new situations in order to adapt the humanitarian response. It draws on numerous sources.
As we did before with our series of articles “humanitarian questions”, I invite you to join the debate by sending us your testimonies, analyses, and perspectives at contact@defishumanitaires.com

Challenges converging.
A change of era.

We are experiencing a decisive shift in the political and geopolitical era—some even call it civilizational. Whatever one thinks, populism is advancing globally in various forms, accompanying the collapse of the international order established after the Second World War.

This includes the rise and assertion of power by Russia, China, Turkey, and the Global South in all its diversity. As Giuliano da Empoli said, “Trump is not a historical accident or a fit of madness—we are tipping into a new world.” What is this new world, and what will be the role and place of humanitarian action within it?

BRICS meeting in Kazan, Russia, from 22 to 24 October 2024

Aid funding in decline!

The funding of international humanitarian aid is a reliable indicator of trends and the priorities of UN member states. And funding is collapsing—no one knows when or how it will stabilize. It’s easy and somewhat fair to blame the abrupt freeze on all aid by the Trump administration and the dismantling of USAID.

However, many European countries were ahead of the United States with massive budget cuts—in the UK, Germany, France, the Netherlands, Belgium, and almost everywhere else to varying degrees, with the exception of the European Union.

Official Development Assistance (ODA), OECD

The reasons vary depending on whether we’re talking about humanitarian aid or development assistance, which fall under Official Development Assistance (ODA). Beyond doubts about aid effectiveness and the rising call for productive investments, the primary reason today is the priority placed on security in the face of the serious risk of the war in Ukraine spreading across Europe. The second reason lies in the state of public finances, national debt, and ongoing tariff wars. Defending one’s freedom, independence, and sovereignty has become a vital priority in the face of mounting threats.

With what consequences?

What will be the human and political consequences of dwindling humanitarian funding? According to OCHA, in 2025, 305.1 million people will require humanitarian aid, but only 189.5 million have been targeted across 72 countries to receive assistance estimated at $47.4 billion.

UNHCR Global Trends Report 2024, 9 October 2024.

However, in 2024, of a $49.6 billion budget, only $21.2 billion was raised—just 43% of the required amount! What will 2025 look like with ODA in free fall?

Among these at-risk populations were 122.6 million forcibly displaced people as of June 2024. Recall: 51.23 million in 2013, 89.27 million in 2021—and the numbers are expected to continue rising. Will we abandon internally displaced people and refugees? What will be the human, migratory, and political fallout from such disengagement?

For instance, in the Democratic Republic of Congo, insufficient funding forced the shutdown of a severe malnutrition treatment program for 220,000 children under 5.

UNICEF DRC Dubourthoumieu

2024 was the deadliest year for humanitarians, with 281 killed—63% in Gaza and the West Bank, mostly nationals. Will we now say to humanitarians: “Take the risks, you’re on your own”?

As a French citizen, I am personally convinced
that we must prepare for a possible expansion of the war in Ukraine in order to contain it—and thus secure peace. And if this does not prevent war from being imposed on us, then we must declare it, fight it, and win it.

What I fail to understand is this: in a world where military budgets total $2.4 trillion, and banking sector profits stand at $1.1 trillion, how is it not possible to find $47 billion to save lives, stabilize countries, and revive development and trade that benefit everyone?

Short-sighted selfishness will catch up with us—and cost even more!

Ukraine and the return of war.

Since February 24, 2022, the war in Ukraine has shattered the principle of inviolable borders and shown that war is once again a conceivable means of resolving conflict. It has killed and wounded hundreds of thousands of Ukrainians, displaced millions, and destroyed much of the country and its infrastructure—not to mention Russian losses. The war consumes enormous resources, yet they remain insufficient from Ukraine’s allies.

I’m not convinced we truly grasp the risks and consequences of a potential expansion of this conflict to other frontline countries in Europe—and possibly to us through a domino effect! Let’s be clear-eyed: Vladimir Putin has declared a long-term war against us, supported, tolerated, or ignored by many Global South nations. And if Donald Trump chooses to end U.S. support for Ukraine, the risk of war in Europe would only grow. European countries, however, are not yet prepared for such a scenario. Let’s hope it never comes to pass and that a ceasefire, then a settlement, brings this war to an end.

Yet even if full-scale war isn’t certain, it’s entirely possible. Some experts believe it has already begun—through cyberattacks, propaganda, disinformation, rearmament, and a mobilization of public will. How will humanitarian actors respond to this threat? What could they do if war comes to Europe? What would happen to humanitarian principles of humanity, impartiality, and independence in such a scenario?

And what about Europe?

Among the world’s top three humanitarian donors, along with the U.S. and Germany (which has slashed much of its aid budget), the European Union remains. At the recent European Humanitarian Forum (EHF) on May 19–20 in Brussels, the European Commission appeared to reassure humanitarian actors—yet never addressed the “elephant in the room”: shrinking budgets.

The agenda was technically sound: ongoing crises, cooperation, coordination, humanitarian diplomacy, the nexus, national actors, climate impact. But it deliberately avoided tackling the decline in ODA and its consequences for humanitarian work. Business as usual! Nevertheless, voices such as VOICE on these issues, UNRWA on Gaza, and informal hallway conversations raised the alarm.

Ursula von der Leyen confirmed the DG ECHO humanitarian budget of €2.5 billion, including the emergency aid reserve (€580 million), in line with the 2021–2027 Multiannual Financial Framework (€11.569 trillion).

This framework is truly strategic, and discussions are beginning for the 2028–2035 cycle.

Here lies the decisive issue! Given the budgetary constraints of EU member states, will the Commission’s budget be sufficient—and how will it be allocated?

Former EU Humanitarian Commissioner Janez Lenarčič rightly emphasized the need for assertive humanitarian diplomacy to preserve humanitarian space, which must now address the question of funding—without which, access to at-risk populations is impossible.

The current Commissioner, Hadja Lahbib, set out a roadmap: We must focus on two areas: first, increase funding, broaden the donor base, and work more efficiently. Second, we must reduce humanitarian needs, often caused by conflict and climate crises.

UNRIC. During the session on the Middle East, attended by Hadja Lahbib, European Commissioner, and Philippe Lazzarini, Director of UNRWA, at the European Humanitarian Forum on 20 May 2025 in Brussels.

I fully support this—but we must reframe the European humanitarian issue within the broader challenges the EU faces: internal cohesion, the war in Ukraine and its potential expansion, trade wars with the U.S. and China, and weak, naïve governance amid a world reverting to jungle law. The Europe of nation-states cannot avoid a political aggiornamento (renewal) if it wishes to defend its very existence and role.

The UN in turmoil.

Donald Trump’s early decisions confirmed the decline of globalization and multilateralism, shaking the UN—which is being forced to adapt. Payment delays by the U.S., China, and others threaten a potential $1.1 billion deficit by year-end.

To mark the UN’s 80th anniversary, António Guterres launched the H80—or UN80—initiative in March 2025 to urgently reform the organization amid falling funding.

The UN must now cut costs, consolidate its agencies into four clusters—peace and security, humanitarian affairs, sustainable development, and human rights—reduce its workforce by 20%, and relocate to more affordable cities. This real austerity drive will have operational consequences yet to be fully grasped.

OCHA is contributing with its “Humanitarian Reset” led by Tom Fletcher, launched March 10 and based on a 10-point reform. In brief: prioritizing national actors, context-specific adaptation, prioritization planning, integrated reforms, joint advocacy, bold efficiency measures, field redeployment for emergencies, resource and service pooling, simplified clusters, and a more strategic, high-performing “integrated planning framework.”

Necessity dictates—but what are the consequences for aid and for national and international humanitarian actors who must prepare for these shocks?

While we now know OCHA’s “humanitarian reset,” what about NGOs in their diversity and coordination mechanisms? How will they come through this ordeal?

Humanitarian strengths and weaknesses.

Let’s begin with a brief—too brief—introspection of the humanitarian sector, which we too rarely undertake. But now is the time to dig deeper, both in its flaws and strengths, to reshape humanitarian action for this new world.

Humanitarians often see themselves as belonging to the “good” side, judging others from a perceived moral high ground. They also tend to see nations, empires, or ethnic communities through the lens of NGOs—a grave mistake.

Humanitarians view the world as one global humanity, which is true—but without sufficiently recognizing its diversity, which is both a richness and a source of differences.

Above all, humanitarian action is an existential act to aid any person or population in peril. This cross-border solidarity is more relevant than ever. Humanitarianism isn’t the answer to everything—but without it, what would be the daily fate of those in danger? Every day, around 550,000 humanitarians work to assist 190 million people—men, women, and children—who actively contribute to mutual aid as fellow human beings.

The greatest frustration and limitation of humanitarian work is the inability to help everyone in urgent need. Obstacles abound—from access denial to falling funding.

Crises abound—in the DRC, the Sahel, Yemen, Ukraine, Sudan, Haiti, and Gaza, the latter being the horrifying emblem of the unthinkable becoming routine.

Why did pediatrician Alaa Al-Najjar lose nine of her ten children—Yahya, Rakan, Eve, Jubran, Raslan, Rifan, Sidine, Louqman, and 7-month-old Sidra—in a single airstrike on May 24 in Khan Younis? Only her husband and one child survived. Why?

With its pogrom on October 7, 2023, and the abduction of 251 hostages, Hamas triggered a spiral of endless violence with Israel. As of April 30, 2025: 52,400 deaths (including combatants), 118,014 wounded. By the end of 2024, 87% of housing was damaged or destroyed, over 80% of businesses lost, and two-thirds of roads unusable! As if that weren’t enough, a full humanitarian blockade was imposed on March 2, 2025. Famine is now weaponized—violating international law.

To calm international outrage and limit aid diversion by Hamas or gangs, Israel bypassed competent humanitarian organizations in favor of an ad hoc body: the Humanitarian Foundation for Gaza. Its first distributions ended in chaos, death, and injury.

These ongoing destructions and the blockade seem aimed at the deportation of all or part of Gaza’s population. What do we call that? Is a political solution still possible? Let’s hope the upcoming meeting on Palestine at the UN General Assembly in New York (June 17–20), co-organized by France and Saudi Arabia, will answer that.

In conclusion.

As we publish issue 100 of the Défis Humanitaires online journal, current events reaffirm its value to the humanitarian community and its partners by:

  • Promoting humanitarian action

  • Analyzing the cause-effect link between geopolitics and humanitarianism

  • Documenting the major challenges ahead

Défis Humanitaires is read each month in dozens of countries by thousands of people whom we warmly greet here, with a wish to be useful to their work.

But we also need their support and participation to do more and better. To that end, we invite you to:

  • Fill out the journal’s feedback questionnaire

  • Share your thoughts on the journal

  • Support the journal with a donation via HelloAsso

Thank you for your attention, your loyalty, and your support.

Alain Boinet

I invite you to read the articles published in this issue: