1. Background and justification for the project 

Even before the war, there was a gap in eastern Ukraine between poor, backward rural populations and rich, modern, high-tech cities. The war widened this economic and social gap. Younger people have fled the rural areas close to the combat zones, towards Europe or the cities of the West. What remains are mainly elderly people who, despite the danger of being close to the front line, remain attached to their land and refuse to be evacuated to the west. The rural populations living close to the combat zones in the Kharkiv, Donetsk and Zaporijia regions are particularly suffering from the devastation caused by more than two and a half years of war. The daily bombardments have destroyed civilian infrastructures (schools, hospitals, houses), as well as energy structures (water, gas and electricity) and communication routes (destroyed bridges, mined and/or damaged roads). These rural populations are thus deprived of access to medical care and are living in a critical humanitarian situation. With no means of transport and very few economic resources, the vulnerable elderly and/or disabled living in these half-ruined villages cannot get to the hospitals in the neighbouring towns that are still operational.
For these reasons, our mobile clinics are primarily aimed at this vulnerable rural population. The Kharkiv Health Cluster (led by the WHO), in which we participate, encourages us to fill this humanitarian "gap", while of course complying with safety protocols (our members are trained in first aid and follow a mine risk education course offered by Handicap International in Kharkiv). We don't knock on people's doors at random, but the civil authorities (gromadas) provide us with a list of vulnerable people to consult in each village. In order to prevent mine-related incidents, our medical unit is accompanied for the first consultations in a village by a local social worker delegated by the local civil administration. The latter gives us official authorisation to pass through the checkpoints and warns us of the dangerous nature of the terrain before each mission. The mission is cancelled if there is the slightest doubt about the safety of our team. Dignitas provides all its staff with first aid kits, helmets and bullet-proof waistcoats and sends its staff on regular training sessions organised by experts from PUI, HI, MDM and RCC.

2. Concept and objective 

The aim is to safeguard the health and access to healthcare of the Ukrainian population by setting up mobile medical clinics in de-occupied rural areas of the Kharkiv region. Operationally, the clinics consist of 2 mobile units, providing advanced consultations for 1 general practitioner, 4 specialists (2 surgeons and 2 cardiologists) and a nurse. 
Currently in place:2 mobile clinics are already operating 6 days a week in the de-occupied rural areas of the Kharkiv region. It offers:- Regular home care (monthly): consultations, electrocardiogram, dressings, medication, etc. - Transferring patients to the nearest functional hospital when their condition requires consultation with a specialist for a more in-depth diagnosis or hospitalisation. - Emergency evacuation in the event of an advance by the Russian army or increased bombing. 
Future objectives:We are aiming to set up 1 to 3 other mobile clinics, depending on the funding obtained. This project may be extended to the Sumy and Zaporijjia oblast depending on needs and available funds.