The Moral Imperative for Supporting Ukraine
Whether the United States should continue to provide military and other aid to Ukraine has become highly contentious. The case for continued support for Ukraine has principally been grounded in U.S. strategic interests, most notably stopping Russia’s aggression on NATO’s eastern flank and deterring China’s threats to Taiwan. But there is an equally compelling moral reason for ongoing military and other aid: given Russia’s conduct in the war, and its history in Ukraine, it would be a mistake to ignore the existential stakes for Ukrainian society if Russia prevails.
The Ukrainian people themselves remain at grave risk of a steady expansion of Russia’s dehumanizing and gratuitous brutality and violence that could destroy Ukrainian democracy, institutions, national identity, culture, and the long-term health of the population. The United States has a stake in preventing these outcomes.
In September, I was in Ukraine along with a delegation of health, humanitarian, and human rights experts and faith representatives organized by MedGlobal, a medical aid group. The stories and insights I heard from health, government, and religious leaders revealed the grave risks of continued atrocities and dehumanizing and gratuitous violence that could destroy Ukrainian democracy, institutions, national identity, and culture.
Take the experience of Dr. Olena Yuzvak, who directs the primary care center in Hostomel, outside Kyiv, and her family. In the first days of the war, Russian troops shelled Hostomel, including Dr. Yuzvak’s home and the health center, one of the first of more than 1,000 health facilities Russia would attack. Two weeks later, Russian forces occupied the town, but she carried on seeking to care for the sick and wounded.
On March 22, 2022, soldiers entered her home. They accused Dr. Yuzvak’s husband of providing information to Ukrainian forces, shot him in the thigh and knee, and took him, Dr. Yuzvak, and their 23-year-old son, Dmytro, to a military base for interrogation. They aggressively questioned her, then placed a bag over her head so she couldn’t breathe. She remembers thinking that asphyxiation was a quick way to die. Just as she ran out of breath, they cut a hole in the bag.
She remained detained and couldn’t understand why, as she told soldiers she was a doctor who only cared for people. A day later, soldiers tied her to a lamppost, and finally blindfolded and drove her away in a tank. Soldiers removed the blindfold and ordered her to walk. It was surreal as she saw bodies scattered around, expecting at any moment to be shot in the back of the head. Finally, the troops released her, but not her husband and son.
A month later, her husband was released in a prisoner exchange after severe beatings and deprivation of medical care, almost costing him his leg. Eighteen months later, all she knows about Dmytro is that he is imprisoned somewhere in Russia, one of 20,000 civilians the Office of the Office of the Ukrainian Parliament Commissioner for Human Rights says are illegally detained in Russia.
Dr. Yuzvak’s experience was at the beginning of the war, but Putin’s wanton willingness to use terror against the population and to seek to destroy Ukrainian society has continued. On October 6, Russia launched a missile attack on the village of Hroza that killed 51 people attending a funeral. Ukrainians understand, too, that more suffering lies ahead. Emine Dzhaparova, first deputy minister of foreign affairs, told the delegation that Ukraine is anticipating renewed Russian attacks on the power grid as winter approaches. Putin’s less visible tactics include denying Ukrainians in occupied areas access to healthcare unless they obtain a Russian passport. I spoke to another mother seeking information about her son, a Ukrainian military physician, one of more than 500 military medics unlawfully incarcerated—a gross violation of the Geneva Conventions.
The delegation learned, too, of Russia’s determined efforts to erase national and ethnic identities in areas it controls. Leaders of Crimean Tatars told us, and the State Department confirmed, that Russia has imprisoned or disappeared Tatar political activists and journalists, and eviscerated Tatar culture and language. Most of the Crimean Tatar leaders we met were born in central Asia to parents who were among the 200,000 Stalin deported in 1944, only returning after Ukrainian independence in 1991. In other occupied regions, Russia is denying people healthcare unless they acquire a Russian passport. Only a handful of the Ukrainian children deported to Russia have returned.
Ukrainians have suffered enormous physical and psychological trauma from loss of so many families and friends in the war, displacement, and stresses from Russia’s repeated missile and drone attacks. Hard data on prevalence of mental health needs are not available, but everyone we spoke to referred to a widespread mental health crisis among Ukraine’s people. Yet, as of 2022, only slightly more than a quarter of the population had access to mental health services. Meeting the need for physical rehabilitation services for those wounded in the war, now and long into the future, is equally challenging. Officials and parliamentarians worry about the paucity of services for veterans, who have experienced the worst of the war. And despite its efforts to preserve health services and drug affordability, millions of people who are displaced or living near the front lack access.
Despite all the suffering and unmet needs, both of which are likely to increase, the delegation witnessed unity and commitment to resist Russia’s aggression and cope with its consequences. Dr. Yuzvak continues to direct her health center, now serving 5,000 additional people displaced from other parts of Ukraine. Like hundreds of other health facilities, the damage to the building was quickly repaired. Health reform begun in 2017 to move toward an expanded system of primary care is moving forward. Maternal mortality has not increased during the war; Dr. Valentyna Ginzburg, director of the Kyiv Health Department, said no women have died in childbirth in the city since the war began. Medical students spoke about their ongoing education. Though short of people to meet pastoral needs, religious leaders are committed to help people in need.
Ukrainians’ stance and fight for survival warrants ongoing U.S. support. The phrase “existential threat” is thrown around freely nowadays, but for Ukrainians, the threats of continued Russian terror and their existence as a people is real. The United States and its European partners and international organizations have so far contributed generously to help Ukraine respond militarily to Russia’s aggressive war while also addressing Ukrainians’ humanitarian and health needs. Sustained—and indeed expanded—support by the United States and its partners remains indispensable to enable Ukraine to keep up the fight and fill painful gaps in services the war has brought.
Leonard Rubenstein is a senior associate with the CSIS Global Health Policy Center, distinguished professor of the practice at the Johns Hopkins Bloomberg School of Public Health, and author of Perilous Medicine: The Struggle to Protect Health Care from the Violence of War (Columbia University Press, 2021).