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URN Daily: Crises leave Ukraine with half EU nurse staffing levels, UN panel says strikes on grid could spark nuclear disaster

Today's Contents

Just The Facts:

  • Germany allocates €77.6 million for Ukraine's energy infrastructure recovery
  • DFC to issue $40 million loan portfolio guarantee to Ukraine's Bank Lviv to support local businesses
  • UN experts demand Russia halt strikes on Ukraine's energy grid due to nuclear risk
  • Gazprom plans for no more gas transit via Ukraine as of 2025, source says
  • EIB-funded upgrade of infectious disease department in Ukraine's Zhytomyr region completed

Reporter's Notepad:

  • Berezan Port looks far afield for investors

Here's What They Think:

  • The Defense Post: Ukraine's global strategy weakens Russia's influence, capabilities
  • Le Monde: Europe's 'most determined' countries must boost support to Ukraine amid potential US withdrawal

Sober Second Thought:

  • Covid and war left Ukraine with 1.1 nurses per doctor - less than half EU average, study shows

The Rebuilder's Social:

  • Ukrainian tech companies raise complaints with Defense Minister Rustem Umerov, Naftogaz launches a 4,200-meter well, AEQUO advised EBRD on €40 million loan, and more.

Dear subscribers,

We wrote yesterday about a surge in shares of South Korean companies on optimism over their participation in the reconstruction of Ukraine. Indeed, we've been writing a fair bit over the past year or so about preparations for an outsized South Korean involvement in the reconstruction, such as here, here, here and here.

So it wasn't a big surprise when Jon Queen, CEO of Ukraine's Berezan Port, told URN Daily yesterday that he'd just wrapped up a fund-raising trip to South Korea to back his company's $800 million megaproject.

The Berezan Port project, which envisions a reorientation Westward of Ukrainian logistics infrastructure with a focal point on a logistics hub near the city of Mykolaiv on the Black Sea, could be backed, at least partially, by South Korean capital.

Mr Queen says URN Daily subscribers will be the first with the details - the names of the South Korean backers and other information - likely in the next day or two.

In the meantime, URN Daily is preparing a full story on the project - which Queen says would mark a transition, infrastructure-wise, between the Ukraine of Soviet times and the Ukraine of the "build back better" sort touted by the European Union and other Western allies.

The project in Mr Queen's words:

"We're talking about a hub with sea, land, air and rail capabilities, and next to that is going to be a large tax-advantaged industrial zone. It will be one of the Black Sea's deepest ports. We're talking about a 20 meter depth, which allows us to serve the capesize vessels for this port to play an integral future role in the Black Sea region, shipping and transit world, and also in the large-scale production and shipment of agricultural, industrial products and oil products."

Germany allocates €77.6 million for Ukraine's energy infrastructure recovery

The Energy Community said it has received a €77.6 million grant from Germany's economy ministry for its Ukraine Energy Support Fund which provides funding for repairs of Ukraine's critical energy infrastructure damaged by Russian attacks.

The contribution will allow the Fund to procure essential spare parts and equipment for energy companies impacted by the war, including those in renewable energy generation, with 30% of the additional funds allocated to promoting clean energy solutions, the Energy Community, an organization formed in 2006 to integrate energy markets of the European Union and its neighbors, said in a press release on Tuesday.

"Ukraine's civilian energy infrastructure continues to be the target of massive Russian air strikes," Germany's Federal Minister for Economic Affairs Robert Habeck said. "A collapse of the energy supply during the third winter of war would have catastrophic consequences for the Ukrainian economy and population. Our support for Ukraine is therefore more important than ever."

Germany's total contributions to the fund since its establishment in 2022 amount to €387.2 million, making the country the largest single donor. With the latest donation, total pledges to the Fund have reached €894 million, as per the statement.

The Fund, administrated by the Energy Community Secretariat, was established in agreement with the European Commission and Ukraine's Energy Ministry.

DFC to issue $40 million loan portfolio guarantee to Ukraine's Bank Lviv to support local businesses

The US International Development Finance Corporation (DFC) has agreed to issue a $40 million loan portfolio guarantee to Ukraine's Bank Lviv to support lending to local businesses, the Ukrainian bank said in a press release on Tuesday.

The funding, provided by the United States Agency for International Development (USAID) will enable Bank Lviv to offer Ukrainian businesses access to financing under favorable terms and minimal collateral requirements, as per the statement.

This initiative offers support to entrepreneurs pursuing investment projects by facilitating loans with partial collateral coverage, according to the lender. It also aids Ukraine's importers and exporters by enabling them to replenish working capital with minimal collateral requirements, Bank Lviv said.

DFC has already extended $35 million in loan portfolio guarantees to Bank Lviv to support Ukrainian small and medium-sized enterprises (SMEs), according to its website.

The initial $15 million loan guarantee program, announced in late 2022, has been fully utilized, enabling nearly 500 new loans for Ukrainian businesses. In 2023, DFC committed an additional $20 million guarantee, expected to finance over 200 micro, small, and medium-sized enterprises over the next five years.

Bank Lviv is one of the biggest commercial banks in western Ukraine and it focuses on lending to SMEs.

UN experts demand Russia halt strikes on Ukraine's energy grid due to nuclear risk

Russia launched attacks on Ukraine's electricity system on Nov. 17, risking a nuclear disaster that must be avoided at all costs, a group of UN experts said, calling on the Russian government to immediately end attacks on energy infrastructure.

"The latest large-scale Russian missile attack on Ukraine’s electricity system on 17 November has led to further significant damage to electric substations that are essential to the operation of Ukraine’s nuclear power plants," the group of experts said in a press release published by the UN on Monday.

The group — 12 expert special rapporteurs and executives in the UN Human Rights Council — reminded Russia that the International Criminal Court issued arrest warrants in June for Russian officials Sergei Kuzhugetovich Shoigu and Valery Vasilyevich Gerasimov, in relation to earlier strikes on Ukraine's power plants and substations.

They further cited allegations that staff at the Zaporizhzhia nuclear plant has been subjected to arbitrary detention, enforced disappearance, and torture by Russian forces.

"Having reportedly lost two-thirds of its power generation capacity, further damage to Ukraine’s electricity system could lead to an electricity blackout which would increase the risk of operating nuclear reactors losing access to the grid for powering their safety systems," the UN experts said, adding: "Such an event could lead to a nuclear disaster potentially more severe than the 2011 Fukushima Daiichi accident or even the 1986 Chornobyl disaster."

In October, unnamed sources including senior Ukrainian officials told the Financial Times that Kyiv and Moscow are in preliminary talks to halt attacks on each other's energy infrastructure. However, during the first week of November, Russia launched attacks on energy infrastructure in Ukraine's southern region of Mykolaiv, the region's Governor Vitaly Kim said via the Telegram messaging app.

Later in November, Russia's attacks hit three thermal plants owned by DTEK, Ukraine's largest private power producer, according to a Reuters report, citing unnamed industry sources.

Gazprom plans for no more gas transit via Ukraine as of 2025, source says

Gazprom's internal plans for next year outline a base-case scenario with no more gas flows to Europe through Ukraine after Dec. 31, when Russia's gas transit deal with Ukraine is set to expire, Reuters reported, citing an unnamed source familiar with the matter.

Ukraine has said it wants to halt the transit deal, which generates up to $1 billion annually in transit fees for Kyiv, potentially ending gas flows from Siberia to central Europe after more than 50 years. Moscow has, however, implied it was open to the idea for the gas flows to continue via the route.

Gazprom's internal plans are yet to be approved by the company's top management, the source said, adding Russian gas exports to Europe, excluding ex-Soviet countries, and Turkey, are expected to fall by a fifth in 2025 to just below 39 billion cubic meters, from more than 49 bcm expected this year due to the end of the Ukraine transit deal.

That covers supplies to Turkey via the TurkStream and Blue Stream pipelines and excludes exports to China, which are expected to reach 38 bcm in 2025.

Russia shipped about 15 bcm of gas via Ukraine in 2023, representing only 8% of peak Russian gas flows to Europe through routes in 2018-2019, according to Reuters.

Before the full-scale invasion of Ukraine in 2022, Russia was Europe's number one natural gas supplier but has since lost most of its European customers.

EIB-funded upgrade of infectious disease department in Ukraine's Zhytomyr region completed

A European Investment Bank (EIB)-funded modernization of a pediatric infectious disease department in Ukraine's northwestern Zhytomyr region has been finalized, the EIB said.

The infectious disease department at the Zhytomyr Regional Tuberculosis Dispensary in the Guiva village has been equipped with advanced medical and diagnostic equipment. The overhaul of the department which was opened on Tuesday also included significant energy efficiency upgrades, the EIB stated on Tuesday.

The upgrade, with a cost of around €736,000, was carried out through the Ukraine Recovery Programme, a joint initiative of the European Union and the EIB, aimed at helping Ukrainian municipalities rebuild social infrastructure, according to a press release.

The Ukraine Recovery Programme is implemented in partnership with Ukraine's Ministry for Development of Communities and Territories, the Ministry of Finance, and the local authorities, with technical assistance from the United Nations Development Programme (UNDP) in Ukraine.

The EIB noted that a total of 13 recovery projects in the Zhytomyr region are supported through two EIB recovery programs: the Ukraine Early Recovery Programme and the Ukraine Recovery Programme.

The lender also said that its third initiative, the Ukraine Recovery Programme III, will offer more cities the chance to apply for small-scale reconstruction projects in sectors including education, healthcare, heating, public housing, and water and wastewater systems. A call for proposals is expected to be announced soon by the Ministry for Communities and Territories Development, as per the statement.

The Defense Post: Ukraine's global strategy weakens Russia's influence, capabilities

Ukraine's global campaign against Russia, including targeting Russian mercenaries in Africa and disrupting its operations in the Middle East, has led to the weakening of Russia's influence worldwide and forced it to fight on multiple fronts, providing Ukraine with critical military and diplomatic leverage as it defends its sovereignty, an associate research fellow at the London-based think tank Henry Jackson Society, David Kirichenko, wrote in an op-ed for The Defense Post.

Le Monde: Europe's 'most determined' countries must boost support to Ukraine amid potential US withdrawal

European countries that have been "most determined" to help Ukraine fight Russia, including France, the UK, Poland, and the Nordic and Baltic states, must further enhance their support to counter a potential withdrawal of the US from Ukraine, even without a broader European consensus, and demand a seat at the table once peace talks begin, Le Monde wrote in an editorial.

Covid, refugee surge and war left Ukraine with 1.1 nurses per doctor - less than half EU average, study shows

The Ukrainian health labour market has been facing significant challenges as a result of compounded effects of the Covid-19 pandemic, the ongoing Russian conflict, and migration pressures, which resulted in shortages in nursing shortages, according to a study by the World Health Organization.

The study found that, while the density of doctors in Ukraine — 40 per 10,000 population on September 2023 — is on par with EU countries' average of 39 per 10,000 in 2021, the country's density of nurses falls short, at 43.8 per 10,000 population in comparison to EU's average of 92 per 10,000. This shortage is also reflected in the nurse-to-doctor ratio, with Ukraine's ratio at 1.1, less than half of EU's ratio of 2.3.

The problem is also found among nursing graduates and entrants, as in 2023, Ukraine had nursing graduates of around 20 per 100,000 population, which is around 37% lower than the average of EU countries' average of 32 per 100,000 in 2020. However, data from Ukrainian MoH has shown that in 2023, the number of nursing school entrants in Ukraine (40 per 10,000 population) was similar to EU average (39 per 10,000).

Source: Ukraine data from MOH (2022); EU countries’ data (2020–21) from JDC, and from NHWA for countries with no data in JDC

The analysis relied on WHO's Health Labour Market Analysis (HLMA) framework, coupled with disaggregated data provided by the Ukrainian Ministry of Health (MoH) and the Health Service Ukraine (NHSU). The HLMA framework aims at identifying bottlenecks that result in human resources for health (HRH) shortages.

The sources for the data included the number of health workers between 2020 and 2023, disaggregated by gender, age, region, private or public health ownership, level of care, and geography; the number of health workers leaving the workforce during 2021, 2022, and the first nine months of 2023; the number of vacancies in health workers positions; and the number of health workers being produced annually.

Source: Ukrainian data from MoH (2023); EU countries’ data (2020) from JDC/NHWA

Another issue that WHO highlighted in its report is the significantly lower density of doctors and nurses in rural areas in Ukraine than in urban areas. The density of primary health care doctors in rural areas is half the density in urban areas, while the density of specialist doctors is 13 times lower in rural areas than urban areas. Moreover, the density of nurses in rural areas is a sixth of that in urban areas and the density of midwives is one ninth.

Source: NHSU data (September 2023)

WHO reported that the decline in doctors and nurses has been an overall trend since 2016, as nurses and doctors prefer to migrate abroad. However, the UN agency highlighted that the war has led to increased rates of international migration, adding that nurses in their new host countries are usually engaged in non-health professions.

The war with Russia has impacted Ukraine's overall health workforce, but the impact is felt most in areas directly affected by the conflict, WHO said. Additionally, the Russian invasion resulted in an evident increase in the emigration of doctors, nurses, and health professionals.

Finally, WHO's study found a sharp decline in the admissions of international students, which has greatly impacted the finances of medical education schools, while a significant decline in self-funded Ukrainian medical student enrollments has compounded the issue.

Among WHO's recommendations is strengthening the government's ability to finance health worker's education. Many medical schools are coming under financial pressure due to the drop in international and self-funded Ukrainian students. WHO recommended increasing government funding for medical schools and expanding budget-funded admissions to support medical schools.

The USAID Energy Security Project (ESP) posted that it "handed over 33 high-voltage power transformers to a local water supply company. This will significantly enhance the reliability of the power supply."

Ukraine's AEQUO law firm announced that it advised the European Bank for Reconstruction and Development (EBRD) on its new €40 million loan to Kormotech Group.

Naftogaz of Ukraine announced that it has launched a high-yield well launched at a new field with a daily flow rate 170,000 cubic meters of gas, and a depth of 4,202 meters.

Tech Force in UA, a coalition of Ukrainian technological manufacturers, met with Ukrainian Defense Minister Rustem Umerov to discuss key issues that, the group says, have driven 85% of its members to move abroad or consider moving abroad.

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