Russia's attack on Ukraine has led to one of the largest humanitarian crises in Europe since World War II. It hit the residents of social care facilities with particular force.

 

Train journeys lasted 30 or even 40 hours. For seniors and people with disabilities evacuated from places such as Kharkiv, Zaporizhzhia, Kramatorsk, or Mariupol, the multi-day trip drastically increased disorientation. The sounds of sirens and explosions triggered states of psychosis, aggression, or catatonia. Many, struggling with intellectual disabilities, did not understand why they had to leave their homes.

 

The need for evacuation was a direct result of Russia's attacks on civilian infrastructure. According to the Ukrainian Ombudsman, Russians completely or partially destroyed 26 care facilities, including in Kherson and Bakhmut. Before the outbreak of the war, nearly 38,000 people stayed in 245 such centers. By the beginning of 2024, about 4,500 of them had been evacuated – the majority went to safer oblasts of the country, and nearly a thousand abroad. Not all residents could be saved.

 

Mass relocation to western Ukraine led to overcrowding in local centers and a deterioration of living conditions for residents. The war also halted the state reform of the care system's deinstitutionalization – forced, mass relocation meant that patients returned to large, closed institutions.

 

The burden of improving conditions in overcrowded centers – such as the one in the village of Zaklad in the Lviv oblast – largely fell on non-governmental organizations. In the first days of August 2022, nearly 100 men and boys with intellectual disabilities were placed there.

 

The facility, which currently provides permanent care for about 60 people, is located in the monumental building of the former Institute for Orphans and the Poor, founded in 1843 by Count Stanisław Skarbek. High maintenance costs of the building, which required renovations from the very beginning, make the future operation of the facility in this location uncertain. Its survival has been facilitated by international aid – organizations such as SmartAID and the CORE Foundation have financed renovations, the purchase of equipment, and even the opening of an on-site bakery. However, the staff continues to fight to keep the center running.

 

A significant portion of those evacuated to the Lviv oblast are patients over 60 with dementia. They suffer from orientation and memory disorders: they forget their own names, do not know where they come from or where they are. Destroyed medical records and the lack of relatives often make it impossible to reconstruct their pre-hospitalization and treatment history.

The evacuation of the most vulnerable exposed the state's organizational shortcomings. In its 2022 report, the UN Committee on the Rights of Persons with Disabilities assessed that in the first phase of the war, Ukraine did not give appropriate priority to the evacuation of these people from combat zones. There was a lack of logistical support and the capacity to transport assistive equipment, such as wheelchairs.

 

This problem is systemic and persists to this day. A study by the HelpAge organization, conducted in the summer of 2024, shows that 35% of surveyed seniors in collective centers were unaware of available evacuation services. Nearly 30% of respondents also stated that they did not receive the necessary medical care during the evacuation.

 

The material was produced for Smartaid.

Lviv, Ukraine – January 2023. A woman stands under an umbrella amidst fresh graves at the military section of the Lychakiv Cemetery (Mars Field). At this stage of the war, the rows of burials honoring fallen Ukrainian soldiers had begun to mark the landscape of the city.
Lviv, Ukraine – December 2025. A passerby walks past a sea of Ukrainian flags at the same military cemetery, illustrating the staggering human cost of the ongoing war. Over three years later, the burial ground has expanded significantly, filling the horizon with tributes to the fallen.
Worshippers attend a service inside the Holy Trinity Church in central Kharkiv, Ukraine, on December 7, 2025. Amidst frequent power outages that leave the interior in semi-darkness.
Kyiv, Sophia Square. The monument to Bohdan Khmelnytsky is enclosed in a protective sarcophagus to save it from bombardment. Beside the dark structure stands a Christmas tree decorated with doves of peace, marking the second winter of the full-scale invasion.
A driver stands beside her car on Khreshchatyk Street near Maidan Nezalezhnosti in Kyiv, Ukraine, at 9:00 AM on December 3, 2025. Following a city initiative launched in late 2025 to honor the victims of the Russian invasion, traffic on the capital's main thoroughfare comes to a complete halt every morning. Traffic lights turn red and a metronome broadcasts the passing seconds over loudspeakers, transforming the bustling city center into a temporary memorial of collective grief and respect.
Kyiv, Ukraine. Inside the logistics center of the Serhiy Prytula Charity Foundation. A volunteer assembles tactical first aid kits (IFAKs) for soldiers on the front lines. The window is barricaded with sandbags for protection. The text on her hoodie reads: "Time heals, pain will pass."
Lviv, Ukraine. The historic St. George's Cathedral during the war. Statues are wrapped in protective materials and sandbags are piled at the entrance to shield the UNESCO heritage site from potential Russian missile strikes.
Igor from Drohobych and Oleg from Polyana are soldiers who ended up in the hospital of Drohobych not because of their wounds but because of other health problems (high blood pressure and stomach problems).
Valentyna Yakievska Pusieva, 84, rests at a shelter following her evacuation from the Donetsk region on September 8, 2022. She arrived accompanied by her husband, Sergey Andreevich, who remains paralyzed and unable to speak after suffering a stroke. Ms. Pusieva is a survivor of two wars; she lost an arm and a leg to a shell explosion at the age of four during World War II.
Chernihiv, Ukraine Date: December 3, 2025 Caption: Vitalij (34) holds his newborn son just hours after his birth at a maternity center in Chernihiv, Ukraine. While his wife Katerina (32) rests, a mobile phone charges from a power bank nearby—a ubiquitous necessity due to rolling blackouts caused by targeted Russian attacks on Ukraine's energy infrastructure. For this family, their first child represents a new generation born into a reality of war, where moments of intimacy coexist with the logistical struggle for light and warmth.
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Children gaze into the colorful window of a candy shop in the historic center of Lviv, Ukraine, in 2024. Despite the ongoing Russian invasion, the western city remains a hub of relative safety and tourism, where residents and displaced persons attempt to maintain a semblance of normalcy and preserve childhood joy amidst the conflict
A student in a festive dress walks past a projection screen during a celebration at the Hlynska Special School in the Sumy region, Ukraine, on December 6, 2025. Volunteers from Lviv traveled to the facility, located near the Russian border, to deliver gifts to the children. The graphic on the screen depicts a Ukrainian soldier standing alongside Saint Nicholas, symbolizing the merging of religious tradition with military reality. Following calendar reforms in Ukraine, the beloved children's holiday now coincides with the Day of the Armed Forces.
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Vitia Shcherbak, 27, arranges a collection of his sketches on his bed at the Zaklad branch of the Hruszkiv Psychoneurological Residential Institution. An orphan originally from Kharkiv, Shcherbak was evacuated to this facility after enduring eight months sheltering underground with other residents to survive the initial invasion.
Mrs. Alexandra lived in one of the bombed-out flat blocks near the airport in Hostomel. Today she lives with a friend of her younger son who is fighting at the front. She comes under the destroyed building to get her cat, which keeps running away and returning home. Mrs. Alexandra's older son was killed in the Donbass. He was an officer.
Luba Aleksandrovna shakes a carpet outside the apartment building where she lives in Chernihiv, Ukraine. Behind her stands a section of the same residential block that was bombed by Russian forces on 3 March 2022 at 12:15 p.m. during the siege. The airstrike destroyed the apartment building and nearby infrastructure including a grocery store, a pharmacy, and a cardiology dispensary. According to investigations, the attack was carried out using a FAB-500 aerial bomb. The explosion killed 47 people and injured 18 others
Vitia takes part in a workshop on making a traditional Ukrainian Christmas decoration called a didukh. A didukh, crafted from rye, wheat or oats, symbolizes ancestors, prosperity and the harvest, and is traditionally placed in a position of honor in the home during the Christmas season.
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A young woman sits in contemplation at Independence Square (Maidan Nezalezhnosti) in Kyiv, Ukraine, in August 2024. The lawn behind her has been transformed into a makeshift memorial, filled with thousands of small flags placed by relatives to honor soldiers killed since the start of the Russian invasion.