“What happened in Lviv this morning, is nothing new, just as it was in other parts of the country, but it’s a strong reminder that this country is in war and the medical needs are increasing,” said Dr Jarno Habicht, representative of the World Health Organization (WHO) in Ukraine.

Now in its fourth week, the war in Ukraine has seen 44 attacks on healthcare throughout the country, including on buildings and a warehouse, patients, staff and supply chains, resulting in 12 confirmed deaths, according to WHO data.

Push for access

Despite the dangers, the UN and its partners have continued to push for humanitarian access.

“On deliveries, we have up to 100 metric tonnes made available for Ukraine,” Dr Habicht said, speaking from Lviv, adding that “at least one-third” had been dispatched to healthcare facilities, including in the capital Kyiv.

Mariupol, Sumy, ‘extremely dire’

Underscoring the deadly danger to civilians unable to escape Russian bombardment, the UN refugee agency (UNHCR) described the situation in cities such as Mariupol and Sumy as “extremely dire, with residents facing critical and potentially fatal shortages of food, water and medicine”.

That assessment followed the bombing of a theatre in Mariupol on Wednesday, targeted despite clearly visible lettering daubed on the ground outside the building, indicating that “Children” were sheltering inside.

In the country’s eastern regions, or oblasts, needs “are becoming even more urgent”, said UNHCR spokesperson Matthew Saltmarsh. “More than 200,000 people are now without access to water across several localities in Donetsk oblast, while the constant shelling in Luhansk region has destroyed 80 per cent of some localities, leaving 97,800 families without power.”

In Odessa, UNHCR reported that the authorities have appealed for support for general food assistance to cover the needs of 450,000 people in the city, as well as medicine.

“As of 17 March, a permanent consultation point for protection, legal, and social matters is functioning at the Odessa railway station where 600 to 800 individuals transit daily on their way from Mykolaiv, to the western oblasts of Ukraine,” the agency reported.

More than 3.2 million refugees

According to UNHCR, more than 3.2 million people have now fled Ukraine, and millions more are internally displaced, some of the 13 million hardest-hit by the war.

Those who have left Ukraine have found shelter in Poland, Slovakia, Hungary, Romania, Moldova, Russia and to a much lesser extent, Belarus. Ninety per cent are women and children and 162,000 are third-country nationals.

“They don’t have a plan when they arrive,” said Mr. Saltmarsh. “So many of those in the first phase might have had friends, diaspora networks, contacts, a relative to whom they could go and stay with initially, and then make a plan from there. That’s been less the case recently.”

To counter the risk of exploitation of these vulnerable new arrivals, UNHCR and UNICEF have set up safe spaces known as “Blue Dots” in six countries: Czech Republic, Hungary, Moldova, Poland, Romania and Slovakia.

Safe zones to repel traffickers

These facilities are “one-stop-shops, and safe spaces which provide a minimum set of protection services for children, families and others with specific needs, in support of

existing services and government efforts,” UNHCR explained.

Also providing help to victims of the conflict, UN migration agency IOM said that last year it identified and assisted over 1,000 victims of trafficking.

IOM spokesperson Paul Dillon added that a telephone hotline that the agency set up in the last nine days has so far received more than 10,000 phone calls, more than half of which were related to trafficking concerns.

IOM: Web of protection

“We’re working with our many partners on the ground to ensure that these protective messages and these efforts that are being made at the border to inform people are then structured in a coherent manner”, he said.

“Not just for the people who are coming across the borders, but for border guards and for volunteers working at these border points in reception centres and indeed for IOM staff on the ground.”

OCHA appeal for safe passage agreements

With a solid agreement on continued and safe humanitarian access still proving elusive, Jens Laerke from the UN Office for the Coordination of Humanitarian Affairs (OCHA) urged both sides to the armed conflict “to agree with each other a mechanism of the modalities, standard operating procedures into actually minute detail how such safe passages - either for movement of humanitarian supplies, or on the other hand, for evacuation of civilians - how that can be established”.

In a statement issued later on Friday, UN Crisis Coordinator, Amin Awad  said the United Nations and partners had completed “the first convoy of urgent humanitarian aid to the city of Sumy in the northeast, one of the most war-affected areas of the country.

“We hope this is the first of many shipments delivered to the people trapped by fighting”, he added.

The 130 metric tons of essential aid includes medical supplies, bottled water, ready-to-eat meals and canned food that will directly help some 35,000 people, the crisis coordinator continued.

In addition to these items, the convoy brought equipment to repair water systems to help some 50,000 civilians in need.

“We count on the continued cooperation of all parties as the United Nations and our humanitarian partners scale up our relief operation to respond to the grave humanitarian crisis caused by this war”, said Mr. Awad.

“We are here to help the most vulnerable civilians caught in the fighting, wherever they are in Ukraine. We need unhindered and sustained humanitarian access to do so.”

The crisis coordinator said that safe passage for the humanitarian convoy "followed successful dialogue with and notification sent to the Ministries of Defense of Ukraine and of the Russian Federation, which was coordinated by the Office for the Coordination of Humanitarian Affairs (OCHA)."

Unprecedented challenges

The crisis coordinator and other senior officials briefed Member States via videolink on Friday, regarding the humanitarian situation in Ukraine and neighbouring countries where millions have fled as refugees. The meeting was chaired by UN relief chief, Martin Griffiths.

Speaking from Ukraine, Mr. Awad warned that the war has created unprecedented humanitarian challenges that continue to rise.

Humanitarian hubs

He said the UN along with humanitarian partners, were on the ground operating from 17 locations, grouped into 10 hubs.

However, Mr. Awad stressed that we need to do more, and further safe humanitarian access from the Russian military as the offensive continues, is essential.

From Lviv, Resident and Humanitarian Coordinator for the UN in Ukraine, Osnat Lubrani, said the UN was working on a joint response to integrate long-term development needs with the immediate humanitarian response.

She noted that water and sanitation facilities have either been partially or totally destroyed in much of Ukraine, with dramatic and immediate impacts on civilian life for the long-term.