Ubydul Haque wrestled with the difficulty of what he’d asked his colleagues in Ukraine: Collect data about the humanitarian crisis in their country while it unfolded around them. 

At times, they worked from bomb shelters, they told him. Sirens wailed overhead.

Haque is an assistant professor of biostatistics and epidemiology at The University of North Texas Health Science Center. When Russia attacked Ukraine in February, he knew the ensuing human suffering would eclipse local bandwidth to measure it. “When war is happening, nobody is interested in data,” he said. 

He also knew the data could illuminate the war’s impact and help people prioritize health care delivery in the country’s most beleaguered regions.

In late September, Haque and his colleagues at the Health Science Center and across the world published the first study attempting to quantify the war’s public health toll. They tallied injuries and deaths from direct attacks, described damage to an already struggling health care system, and measured rising cases of infectious disease in the wake of the largest war in Europe since the 1940s. 

The study found that, in the early months of the invasion, Russian attacks damaged 32 major hospitals across Ukraine, including maternity and cancer hospitals. More than 3,600 pharmacies closed. As health care delivery stalled, infectious diseases like HIV, tuberculosis and COVID-19 cases rose. Thousands of civilians died. 

“Any war that happens anywhere in the world, (it’s) the ordinary public who mostly suffer,” he said.

When Russia invaded Ukraine on Feb. 24, Haque didn’t expect the latter’s resistance to lead to prolonged war. But as days turned into weeks, he invited a cadre of colleagues, including students in his survey design class, to help him measure the scope.

Nearly 10 professors in Ukraine agreed to participate. To “blind” the data they collected, Haque didn’t initially share their identities. Some worked in the same university, but for months, they didn’t know who the other collaborators were.

The cohort gathered reports from local and international media — outlets like Al Jazeera, Reuters and the Kyiv Independent. When discrepancies arose, they conferred with the Ukrainian government. 

The totals are likely an undercount, said Uyen-Sa Nguyen, associate professor of biostatistics and epidemiology at the Health Science Center. A coauthor on the study, she knows how personal war can be.

“Even with trying to stay objective, and be scientific about it,” she said. “You can’t really remove the horror of war from the impact on humanity.”

Nguyen and her family fled Vietnam around the time Saigon, now Ho Chi Minh City, fell in 1975. She was 7 years old. She remembers hiding in the bomb shelter her dad built in the back yard, the sound of helicopters overhead. “It’s been 47 years,” she said. “And yet, and yet, sometimes, some of these memories will just last.”

Because the cohort in Fort Worth has garnered trust and credibility with researchers in Ukraine, ongoing studies are possible, Haque said. He and his colleagues have continued to collect data after the publication of the initial study. Next, they’re planning to design surveys to distribute to a representative sample of the population in Ukraine. 

One focus will be the war’s effects on sleep and mental health, according to Shanshan Wang, a Ph.D. student in epidemiology at the Health Science Center’s School of Public Health. She learned about the Ukraine study as a student in Haque’s survey design class last spring and joined as a coauthor. A person’s sleep quality, or lack thereof, can be an indicator of mental health, Wang said. 

As for Nguyen, she’s particularly interested in the long-term effects of war on women’s and children’s health. She hopes to study both in the coming months with Haque and their colleagues. 

But this week, she’s reflective. Her daughter is visiting for Thanksgiving, and they plan to talk about what Nguyen and her mom experienced during the Vietnam War, all those decades ago.

Three generations around a table, remembering. Giving thanks.

Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her at alexis.allison@fortworthreport.org or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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Alexis Allison

Alexis Allison covers health for the Fort Worth Report. When she can, she'll slip in an illustration or two. Allison is a former high school English teacher and hopes her journalism is likewise educational....