On any given day, women and girls are proportionally at greater risk of being subjected to sexual violence than men and boys. But when conflicts rage or wildfires spread unhindered – untangling social fabric, displacing people, erasing safety nets and cutting off access to health care – that risk to women and girls multiplies.
This is no news to Anna Langa. For years now, she has been providing medical treatment and supporting evacuations from war-torn Ukraine to her native Poland in her capacity as a nurse and paramedic for Humanosh, a Polish nongovernmental organization (NGO) that’s part of a network of more than 100 emergency medical teams in the WHO European Region.
These teams consist of more than 75 000 trained professionals from health care, civil protection, defence sectors, NGOs and academia – all of them following WHO’s recommendations on coordination and quality of care.
“There was this Ukrainian girl next to the front line. When we brought her medications, we could hear the sounds of war, but she kept on smiling. She never left my mind: Was she scared? Was she OK? Is there anyone she could turn to if something happened?” Anna says, and shares a photo of the two of them in the girl’s village, now in ruins.
“I want to be the kind of nurse I'd want to have by my bed if I were sick. Do you know what I mean?” Anna explains.
Anna Langa, a paramedic and nurse, together with a young girl, during a humanitarian mission of the Polish NGO Humanosh in Kharkiv Oblast, Ukraine, February 2024. Credit: Humanosh Foundation.
When we speak, Anna‘s preparing for a night shift at the emergency room of Warsaw’s University Hospital, where she works as a paediatric nurse. She admits that it’s not easy to spread knowledge about responses to sexual violence in emergencies.
But she is adamant: “We have to teach health workers how to speak with women, how to explain where help can be found, how to listen. We have to make sure we have procedures in place to respond adequately.”
“There may be another layer”
In the summer of 2026, Anna took part in training in Istanbul, Türkiye, on the clinical management of rape and intimate partner violence in humanitarian settings, facilitated by WHO/Europe, the Human Reproduction Programme and the International Planned Parenthood Federation.
Participants from 16 countries in the Region were there to strengthen health responses for survivors of violence and ensure emergency medical teams are equipped to respond.
“Having done the training, I realised that now I’d look at a girl like the one close to the front line through a different lens. Previously, my focus would have been on the immediate task: the patient’s medical condition. Today, I am more aware that there may be another layer. I now understand that vulnerability is not always visible. That’s the biggest change, having those ‘sensors’ switched on.”
Based on the latest available figures, sexual and reproductive health services remain severely constrained across Ukraine, with only 35% of facilities reporting full availability. The gaps are starkest for sexual violence care: clinical management of rape survivors, post-exposure prophylaxis and, especially, emergency contraception (unavailable in 21.7% of facilities) all fall below standard.
Bolstering responses in humanitarian settings
“We want every emergency medical team in the Region to have the capacity to deploy at least one trained health worker with the skills and experience to deliver care for survivors of rape and intimate partner violence and for this to be institutionalized as part of our routine emergency response”, says Melanie Hyde, WHO/Europe’s Technical Officer on Gender, Equality and Human Rights.
WHO’s minimum standards already incorporate sexual and gender-based violence considerations, including a requirement that all emergency medical teams receive awareness training.
“But standards are only the starting point. We need to turn awareness into skills so personnel can recognize vulnerabilities, respond appropriately and ensure survivors can access the care and support needed”, says Oleg Storozhenko, WHO/Europe’s Emergency Operations Team Lead.
Doing that across dozens of countries is a complex yet crucial undertaking.
“Most health providers are used to people being able to speak directly about their issues openly, but often that’s not possible for survivors – many blame themselves or fear the consequences of disclosing due to retaliation or systems that routinely fail them. What is heartbreaking is that some of the health impacts of violence can in fact be prevented if care is provided early. But even further down the line, health workers can still provide treatment and help survivors access other services”, Melanie adds.
According to Anna, survivor-centred care isn’t well understood, making education key.
“This violence is a blind spot among health workers and emergency responders, and I think it’s due to lack of knowledge – which saddens me. Every responder should know what clinical management of rape means”, Anna explains, as she talks of her newly gained sense of responsibility to educate others.
Staggering needs in Ukraine
The impacts of violence touch on almost every area of health: physical injuries, sexually transmitted infections and HIV, mental health conditions, unsafe abortion, the list goes on.
Ukraine is no exception. A number of United Nations agencies have in the past few years documented grave human rights violations, including sexual violence against women and girls, as well as against men and boys.
And when armed conflict shatters infrastructure and disrupts social services as it has in Ukraine, where war has raged since 2022, health care becomes a top priority.
“Now, I am more attentive to possible signs. During my missions into Ukraine, when I suspect someone has faced violence, I talk to them. I just need a few minutes to tell them I understand. Words like ‘I’m here if you need me’ can change a survivor’s life”, Anna concludes.