Dnipro: improving continuity of care for prisoners of war through coordination

The ICRC has been working with health-care services for those deprived of liberty in Ukraine for many years, to improve conditions and provide support where needed.

Those deprived of liberty include soldiers in captivity as prisoners of war, who are generally held in places of internment, and detainees, who are those that have been judicially charged with a crime and are held in places of detention. There are times when each may be held in the same facility in separate areas. Regardless of the reason for being deprived of liberty, all have a right to medical treatment.

For internment or detention facilities in front-line regions, organizing medical care can be more challenging. People may need to be relocated or evacuated and, in some cases, referred to specialized health-care facilities. At the same time, treatment that has already begun needs to continue without interruption.

The first such meeting to discuss these challenges was held in Dnipro last year. Some of the solutions agreed on at that meeting have already resulted in practical changes.

One example was the opening of an X-ray department at Penal Institution No. 4, which began operating at the end of 2025. X-ray examinations can now be carried out on site, without transporting patients to another health-care facility.

One of the key questions discussed at the recent meeting was very practical: what happens when a prisoner of war needs medical care that cannot be provided at the place of internment?

Participants discussed the patient pathway — where medical staff should turn when specialized treatment is needed, how a patient can receive care at Ministry of Health or Ministry of Justice facilities, and how to ensure continuity of any needed treatment until the prisoner of war is repatriated.

For Hanna Ostakhova, Head of the Dnipropetrovsk and Donetsk Regional Branch of the State Criminal and Executive Service Health Centre of the Ministry of Justice of Ukraine, working together as different institutions to find joint solutions is vital.

“It is important that, as a result of such meetings, we not only find practical solutions, but are also able to address them at the regulatory level,” she explains.
Throughout the year, we speak to each other frequently and resolve issues. But I would also like us to make progress on the legal side — so that the ways of resolving these issues are documented.”

For internment or detention facilities in front-line regions, medical care needs to remain accessible even when people have to be relocated or evacuated.

At the same time, some medical procedures can, where appropriate, be performed directly at detention facilities.

“We have qualified doctors who work both in our facilities and in city hospitals. If a doctor can perform a necessary minor surgical procedure directly at the facility…This would allow us to provide care in a more timely manner,” says Tymoshenko.

This is not about replacing specialized hospitals. Where care can be safely provided closer to the place of detention, it can reduce waiting and transportation times.

Participants also discussed the treatment of prisoners of war with tuberculosis.

Some patients currently need to be referred to other cities for treatment. Such transportation requires additional time and resources, so attendees also considered the possibility of organizing appropriate medical care in Dnipro.

“If a unit for treating prisoners of war with tuberculosis is established in Dnipro, it will significantly reduce transportation time. Treatment can begin sooner, and its effectiveness will be higher,” Ostakhova says.

Timely detection and treatment of infectious diseases are important first and foremost for the patients themselves. They also matter for medical staff and others who may come into contact with them.

Last year’s meeting in Dnipro showed that regular dialogue can lead to concrete changes. 

This year, participants identified the next steps: improving the patient pathway, strengthening access to specialized care, working specifically on tuberculosis treatment, strengthening the transmission of information, and establishing the necessary processes within the regulatory framework.

The next step is to work towards turning these agreements into sustainable mechanisms — so that medical staff know where to turn, patients do not lose time because of organizational difficulties, and treatment that has already begun is not interrupted.

Ultimately, that is the result of such coordination: decisions made around one table helping people receive the medical care they need, and under international humanitarian law, have a right to, in a timely manner.