The assessment of the World Health Organisation suggests that access to, and the provision of, quality emergency and primary health care in hospitals and medical facilities in the Luhansk and Donetsk region has been severely impacted by the security situation, which has led to a deterioration and the insufficient provision of services due to the extreme lack of pharmaceuticals, consumables and human resources, as well as intermittent electricity and water supply. According to preliminary estimates, in Donetsk and Luhansk regions 15 hospitals have been damaged in the course of fighting, 20 medical institutions closed and 70% of the medical personnel have fled the area. Medications for patients in need of renal dialysis, vaccinations and antiretroviral treatment (ARV), as well as insulin dependents, patients with rare diseases and the disabled are currently provided through available local resources, which will soon run out. The incidence of tuberculosis may increase due to the risk of treatment interruption or inadequate treatment. It is increasing difficult to distribute some live-saving medications, such as ARV and insulin. These medications are bought through national tenders and delivered to regional centres first. In the current situation, with fighting concentrated in Luhansk and Donetsk, such treatment cannot be delivered even to smaller towns where fighting has stopped. People who are in institutions face particular difficulties. Institutions where older persons live were not evacuated from the eastern regions. Most of these homes had been in very poor condition with little equipment and resources. They are located off the main roads making deliveries difficult; they thus now face severe shortage of food, medicines and basic commodities. Furthermore, due to the constant stress experienced by the residents as a result of prolonged fighting and shelling, cases of heart attacks and strokes have become more frequent. More than 23% of all prisoners in Ukraine are held in the eastern regions. As of beginning of August, out of 36 penitentiary institutions, 28 were in territories controlled by the armed groups in the Luhansk and Donetsk regions. Due to the lack of food delivery, it has become a major challenge to feed the inmates. Some penitentiary institutions do not have sufficient supplies of ARV treatment. Since April 2014, due to the security situation and fighting, inmates could not be sent for treatment to the regional hospital of Donetsk. As a result of fighting, public infrastructure in the east has been severely damaged and its reconstruction will require significant time, human and financial resources. Availability of basic infrastructure and adequate living conditions is a determining factor for IDPs who plan to return home. In such towns as Kramatorsk, Slovyansk, the electricity and water supply have been fully restored. Nevertheless, as of 13 August, 76 towns and villages in the Donetsk region had limited or no electric power. Reconstruction of buildings damaged by shelling, particularly residential ones, will be required. For example, in Semenivka, a suburb of Slovyansk, 250 houses were completely destroyed by shelling; in Slovyansk, approximately 2000 buildings were damaged. On 12 August, the Confederation of Free Trade Unions of Ukraine reported that out of 93 mines (which provide a large proportion of the jobs available in the eastern regions), only 20 were fully functioning, 48 were semi-operational, 6 were flooded and others were closed and/or damaged. On 7 August, during a roundtable on access to education for children from the eastern regions, the Ministry of Education and Science reported that the buildings of at least 51 kindergartens and 102 schools in the Donetsk and Luhansk regions had been damaged. It is expected that in the districts where fighting has stopped, the school year will be postponed by a month and will start on 1 October. For the towns where the fighting is ongoing, alternative plans will be developed, most likely distance learning. It is also expected that with the beginning of the school year, problems will arise in other regions of Ukraine regarding education. Many IDPs have not registered officially with the 220 | P a g e