UKRAINE 2019 UNHCR PARTICIPATRY ASSESSMENT came home my daughter asked me to buy her a gun – she said she would go and kill the persons who shoot.” Conflict-affected woman in Svitlodarsk When asked about how they coped, some women mentioned doing Pilates or yoga, which have become popular but remain costly. They suggested establishing a place where yoga and Pilates were available for their community free of charge. Persons living with HIV said they had needs for professional psychosocial support. Health care In many communities along the contact line, residents said there is no ambulance service, or that ambulances lack fuel. Ambulances do not come after dark due to risks of shelling. The only hospital in Avdiivka is half-destroyed. It is also used as military hospital. The town cannot afford repairs. Residents believe that the repeated shelling of the hospital is linked to the fact that it also serves the military. Some participants mentioned that they had requested medical assistance from military doctors and they all had been assisted. Participants in Avdiivka complained about poor health care, lack of specialized doctors and medical services. There, they cannot access ultrasound services and dental x-rays. Many doctors have left the area and only few have stayed, mostly older physicians. Furthermore, there is no cardiologist or endocrinologist and there are few dentists and pediatricians. Therefore, participants mentioned that they have to go to Kramatorsk (one bus per day; long hours of travel and expensive; need to stay overnight) or to Kostiantynivka (more buses but still expensive). Subsidized public transportation was a suggestion. There is no maternity hospital in Stanytsia Luhanska and the raion hospital lacks key specialists in gynecology, anesthesiology, speech therapy and pediatricians. Women forced to go to Bilovodsk district hospital (70 km from Stanytsia Luhanska) or to Lysychansk to deliver babies. As a result, people have to spend long hours and their scarce funds on transportation. Women feel compelled to use medical facilities in Luhansk NGCA as the distance between Stanytsia Luhanska and Luhansk is 20 km. They said they can receive free medical assistance in NGCA. People living with HIV mentioned that they do not have free access to medical services. They said they are often refused treatment when their status is disclosed and that there is violation of confidentiality of patients. Medical staff do not have skills to work with people living with HIV. This gap leads to poor quality of medical services. Lack of access to medical care was mentioned by participants in Pervomaiske, Sviatohirsk and Chermalyk. People must travel to larger cities with hospitals and specialized doctors. Participants recommended to create mobile visits of doctors to specific settlements. Livelihoods In cities and towns, such as Mariupol and Pokrovsk, many IDPs stated they had been successful in finding jobs or self-employment opportunities. However, in other towns and rural areas, especially close to the contact line, participants said that the lack of job opportunities was a major concern. Many people from Avdiivka used to work in Donetsk. However, employment availability there has reduced significantly. It was suggested to establish an additional checkpoint connecting Avdiivka directly to Donetsk for commuters from Avdiivka with simplified crossing procedure. However, others opposed this idea as they noted the need to obtain official labour records to receive pensions in the future. Records from Donetsk-based enterprises in NGCA will not be accepted by the Ukrainian authorities. People complained about age discrimination on the job market. They said there were no employment opportunities for persons over the age of forty. Due to limited opportunities, people believe that jobs are given to people who have the right connections. Many coalmines have closed, which has reduced the number of employment opportunities near the contact line, therefore, people are engaging in odd jobs or seasonal work. In Sviatohirsk, participants mentioned the absence of employment opportunities and discrimination against IDPs. Some participants complained that employers refused to consider employing IDPs. 17