Canada is failing Ukrainians displaced by Russian invasion, former head of Doctors Without Borders says

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Ottawa needs to do more to help Ukrainian refugees navigate the complexities of paperwork and logistics to come to Canada, the former head of Doctors Without Borders says, lest it reprise past blunders.

“We know the failures in Afghanistan of not living up to our promises. And we cannot repeat history,” said Joanne Liu, a Montreal emergency physician who returned recently from three weeks in Ukraine, where she was struck by the warm reception to her Canadian passport.

Many in the country remember early Canadian promises to stand by Ukraine, making Canada “a place of promise, a place of hope,” Dr. Liu said. “We have to live up to our promise,” she added, pointing to bureaucratic obstacles Ukrainians must navigate before coming to Canada.

“We absolutely need to lift the red tape. For people who are seeking to come here, it’s not good enough to just say, ‘Well, we have extended the hours of our consulates.’ ”

For example, Ukrainians need better linguistic support to complete paperwork in an unfamiliar language, she said. “You have to facilitate it. That means you should staff better, you should have people who speak the language.”

In early March, the Canadian government said it was creating a telephone hotline as “a dedicated service channel for Ukraine immigration inquiries.” That line offers service in French and English only, and suggests anyone who speaks another language write in using a web form. The Globe and Mail called the number six times on Friday, but was not able to reach anyone. When The Globe selected an option for callers “regarding the situation in Ukraine,” the hotline hung up each time.

Global Affairs Canada referred questions to Immigration, Refugees and Citizenship Canada, which did not immediately respond to a request for comment on Friday.

Canada has offered measures to streamline entry for people from Ukraine, waiving some fees, exempting some people from biometric requirements and allowing Ukrainians to stay in the country for up to three years on a free visitor visa. The Canadian government has sent arms to Ukraine and promised $245-million in humanitarian support. Ottawa has approved more than 40,000 applicants seeking to come under a Canada-Ukraine authorization for emergency travel program. Far more are waiting; 120,000 have applied.

It’s not clear how many have arrived in Canada.

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Nearly 4.8 million people have fled the war in Ukraine, where fighting has killed thousands and left many badly injured.

Dr. Liu arrived in Ukraine in the last week of March as part of an emergency response team. She travelled to eastern parts of the country, where Doctors Without Borders has used a specially equipped train to evacuate people from areas that have seen fierce fighting. The rolling medical facility, a modern-day echo of hospital trains used in the Second World War and earlier conflicts, has allowed doctors to reach into the country’s disputed Donbas region.

Doctors Without Borders has used the train, which has modified sleeper cars as patient rooms, to transport about 300 people to safety in western Ukraine, Dr. Liu said. Ukrainian Railways has begun operating its trains at slow speeds to limit injuries in case they are struck by Russian forces, she added.

Russian attacks have already hit more than 80 hospitals in Ukraine, an average of one or two for every day of the war. Doctors Without Borders is currently preparing a second train that will offer intensive care to patients on the move.

Hospitals in Ukraine have coped remarkably well with those injured by the war, Dr. Liu said.

But problems have arisen from the general evacuation of broad areas of the country, particularly in eastern regions where Russian forces are expected to mount a major new offensive after retreating from their failed attempt to take Kyiv.

Since fighting-age men cannot leave Ukraine, most of those who flee are women and children. Their ranks include medical workers. The most pressing need in Ukraine at the moment is for operating theatre nurses, Dr. Liu said. “Most of the nurses are women, and they are evacuating with their kids,” she said. “It’s really hard to do surgery without an OT nurse.”

Another problem lies in providing proper care for people with chronic conditions. “They’re short on insulin, they’re short on thyroid medicine,” Dr. Liu said. For many fleeing Mariupol, a city subjected to a lengthy Russian siege, “that was the first thing they were asking us for,” she said. “If they didn’t have physical injuries from blasts” – Russian forces have shelled evacuation convoys, injuring entire families – “they were asking for chronic disease medicine.”

Those who have made it to safety encounter new burdens. People fleeing danger tend to be propelled by adrenalin with a focus on their destination. “But once you settle somewhere, all of a sudden things emerge and mental trauma catches up on you,” Dr. Liu said. She worries about anxiety attacks and posttraumatic stress disorder among refugees.

Even those staying in parts of the country far from conflict experience constant stress from air-raid sirens. Dr. Liu herself heard four sirens a night. “So we couldn’t sleep,” she said.

For those still in Ukraine, she said, “you don’t feel safe anywhere.”

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