Chapter 5Humanitarian and medical assistance
5.1United Nations High Commissioner for Refugees (UNHCR) statistics indicate that 6 739 400 refugees from Ukraine had been recorded globally as of 19 August 2024.
5.2International law requires all parties to a conflict to heed obligations under humanitarian law, that is, to protect people affected by conflict while minimising the ‘human, social, economic, and environmental cost of armed conflict.’ A submission from the Australian Red Cross noted that the Australian Government has called on both Russia and Ukraine to respect international humanitarian law.
5.3The government’s condemnation of the Russian invasion on 22 February 2022 was accompanied by moves to deploy officials to eastern Poland and Romania to assist Australians seeking to leave Ukraine.
5.4Australia’s contributions towards humanitarian relief for affected Ukrainians are set out below.
Australia’s humanitarian response
5.5A submission from the Department of Foreign Affairs and Trade (DFAT) stated that humanitarian assistance is included in Australia’s broader response packages and indicated that Australia has to date contributed a total of $85 million in humanitarian assistance for Ukraine. A series of ministerial announcements over the course of the war to date describe specific commitments within this total, including:
23 February 2022: all Ukrainian nationals in Australia at the time on a visa due to expire within 30 days would be given an automatic six-month extension. Outstanding visa applications from Ukrainian citizens, numbering approximately 430 at the time, would be fast-tracked.
28 February 2022: a $3 million contribution to NATO’s Trust Fund for Ukraine to include provision of medical supplies.
11 March 2022: a further six-month extension for visas held by Ukrainian nationals which were due to expire by 30 June 2022. The government also highlighted its funding to trusted humanitarian partners.
20 March 2022: a $30 million commitment in emergency humanitarian assistance focused on protecting women, children the elderly and disabled people in Ukraine.
28 March 2022: a joint humanitarian partnership with the UK including two chartered flights carrying hygiene kits, solar lights, blankets, heaters, shelters and other basic necessities, departing 29 March 2022 for Poland, from where the UNHCR would distribute to refugees in Ukraine and Moldova.
27 April 2022: confirmation that a total of $65 million had been given in humanitarian assistance to date, as well as 70 000 tonnes of thermal coal to support Ukraine’s energy needs.
26 June 2023: $10 million to the United Nations Office for the Coordination of Humanitarian Affairs, which manages the Ukrainian Humanitarian Fund, to help provide shelter, health services, clean water and sanitation.
31 May 2023: a total of $31 million committed towards Ukraine’s energy and humanitarian needs, of which $10 million went towards emergency humanitarian funding to the UN Office for Coordination of Humanitarian Affairs.
5.6On 14 June 2024, government ministers confirmed the $85 million in humanitarian assistance figure as cited in evidence from DFAT and provided a broad indication of how the money had been allocated:
On humanitarian assistance, since February 2022 Australia has provided a total of $85 million; $63 million of that has flowed through United Nations agencies, and of the balance of $22 million, $10 million has flowed through Australian NGOs through the Australian humanitarian partnership, $10 million has gone through the Red Cross movement and $2 million has gone to the emergency action alliance.
5.7The submission provided by DFAT also stated that Australian humanitarian support in Ukraine is focused on pronouncedly at-risk groups such as women, children, elderly people and people with disabilities.
Additional support required
5.8The committee sought views on the effectiveness of Australia’s humanitarian contributions. Aspen Medical, an Australian-owned global provider of healthcare solutions and the only commercial organisation in the world classified as an emergency medical team by the World Health Organisation, stated that Australia’s approach of distributing assistance through donations to international organisations could be reviewed to channel aid through Australian providers:
Whilst Australia's monetary contributions to Ukraine are commendable, these contributions are often not recognised. The funds are distributed amongst many international organisations, which themselves receive significant recognition for their contributions. We would offer that the Australian government consider tied funding for Australian government grants to Australian providers. This approach would ensure constant recognition of Australia's commitment, reaffirm Australia's value to Ukrainians, enhance Australia's international standing and influence, and grow and support Australia's sovereign capability.
5.9Feedback from Ukrainian diaspora groups in Australia, such as the community peak body Australian Federation of Ukrainian Organisations (AFUO), suggested that the Australian Government’s humanitarian assistance—like its military and diplomatic assistance—appears ‘siloed and sporadic’.
5.10Aspen Medical added that Australia’s assistance had made a tangible impact in Ukraine’s war effort. However, representatives observed, future Australian commitments could be even more impactful if they recognise Ukraine’s long-term needs:
The casualty rate in Ukraine is severe. International estimates suggest over 30,000 soldier and 10,000 civilian deaths and another 20,000 civilian injured. As the Australian government considers the next steps in its contribution and turns its gaze to the future, our national assistance could be directed towards reinforcing and growing comprehensive prosthetic and rehabilitation programs, perhaps even establishing an initiative inside these programs in partnership with the Ukrainian Ministry of Health, the First Medical Union and the UNBROKEN program and perhaps joining with our allies.
5.11Aspen Medical also suggested the Australian Government could contribute by assisting Ukraine’s mental health program, which is in significant need of support.
5.12It is important to note in this context that the requirement for humanitarian assistance in Ukraine is only growing. DFAT’s submission estimated that some 14.6 million Ukrainians need humanitarian assistance midway through 2024, with almost four million internally displaced and more than six million living abroad as refugees. As Russian strikes continue to affect critical civilian infrastructure such as schools and medical facilities, the UN Office for the Coordination of Humanitarian Affairs estimates that another US$3.1 billion is need in humanitarian aid.
5.13A submission from the Australian Red Cross presented a sobering statistic suggesting that only 20 per cent of the US$3.1 billion needed has been funded to date. The submission expressed concern about the widening gap between the humanitarian needs on the ground in Ukraine and the resources available. After ‘two years of intense conflict and competing humanitarian and domestic priorities, funds and solidarity are waning.’
5.14Caritas Australia, the international aid agency of the Catholic Church in Australia, similarly highlighted the growing effect the war has had on vulnerable groups, particularly children:
According to the Humanitarian Needs Overview (HNO) in 2023, approximately 5.3 million children and teachers of preschool and secondary school age in Ukraine have been negatively affected by the war, with 4.8 million children in need of immediate educational support, including 480,000 (10%) children with disabilities and special educational needs.
According to UNICEF, 2.2 million children need protection services, and 2.8 million are internally displaced. In some regions close to conflict zones (Donetsk, Zaporizhzhia, Kherson regions), during the 2023/2024 school year, children have not attended school in person for any day, significantly impacting the level of formal education and the acquisition of social skills.
5.15As well as providing essential services, Caritas’ partner agencies are working hard to address post-traumatic stress disorder in Ukrainian children.
5.16World Vision Australia urged Australia and the world to do more to address humanitarian needs urgently, including mental health, to avoid catastrophic consequences in the future.
5.17Ukrainian diaspora organisations in Australia have been fundraising since the conflict began to help address shortages including those in the humanitarian field, such as for medical evacuation. AFUO confirmed that people have received tax deductions for donations towards humanitarian assistance like shelters, ambulances and medical evacuation, but called on the government to explore with Treasury whether donations of medical equipment could be facilitated:
We have many companies that have approached us and said that they want to support and help Ukraine but, at this point, they only have the ability to make a financial contribution, a financial donation. If we could explore with Treasury the possibility of donations in kind, such as medical equipment—there's a company in Queensland that develops skin grafting and has been providing hospitals in Ukraine with a lot of support, and I'm sure other things could come from these discussions if we were to create a mechanism whereby donations could be made in kind with equipment or manufactured goods—I think it could go much further and provide more aid.
5.18Other non-government entities have also stepped up to help the Ukrainian people, working with the Australian Government to assist. For example, the committee noted the work being done by Minderoo Foundation, which has contributed around $20 million to humanitarian aid in Ukraine. Projects supported include:
Advancing food security through Ukraine's crucial agricultural industry: Includes partnerships to de mine agricultural land, chartering of a bulk carrier vessel for humanitarian grain shipments from Ukraine to Africa and scaling up temporary grain storage in wake of Russian attacks on storage facilities.
Supporting young children and families: Minderoo Foundation funding has supported thousands of Ukrainian children and their families in providing shelter and early childhood development service delivery hubs, equipping and training educators to support children with trauma and enabling displaced children to integrate into new communities. Minderoo also collaborated with the Olena Zelenska Foundation for the construction of large foster families who have lost their homes from the war.
Provision and transport of 169 large generators from Australia: These generators were provided to the Ukrainian State Emergency Service for their 'Points of Invincibility'. These shelters provide warmth, food and water for Ukrainians impacted by power and heating outages.
5.19Minderoo Foundation urged the Australian Government to provide further humanitarian relief to Ukraine without delay, as well as to focus on what will be needed in the reconstruction phase.
5.20Aspen Medical suggested that that Australia’s humanitarian assistance could be improved with better coordination, through ‘some form of national coordination centre that wasn’t just coordinating for government but helped coordinate those private efforts.’
5.21CARE Australia urged the Australian Government to do more in the humanitarian sphere, particularly through Australian NGOs:
[T]he Australian government should further consider launching a multiyear humanitarian and resilience package for Ukraine. We note that of the $1 billion in Australian aid to Ukraine, military assistance exceeds humanitarian aid at a scale of almost 10 to one. We also note that, of the $120 million provided in humanitarian aid, only $10 million has been provided directly to Australian NGOs operating inside the country.
5.22Preparatory work for the reconstruction of Ukraine, the committee heard, is already underway. Minderoo Foundation cited estimates of $486 billion being required to build Ukraine’s post-war prosperity. Dr Andrew Forrest, who founded Minderoo in 2001, has led investment into Ukraine’s future with ‘$500 million seed funding to the Ukraine Development Fund to catalyse further private funding.’ The initiative will focus post-war reconstruction on the following areas:
This fund will focus on green energy and digital infrastructure. Once conditions are met, including the end of hostilities and corruption is addressed (in line with reforms towards a cashless economy), the fund will rapidly deploy capital to supercharge the reconstruction of Ukraine.
5.23The committee sought views on the possibility of offering ‘deductible gift recipient’ (DGR) status, essentially a tax concession, to people offering funding for reconstruction in Ukraine, however, more evidence is required on this before an effective assessment can be made.
5.24The committee also asked the Australian Red Cross whether investment into reconstruction is better spent meeting needs which exist on the ground today—such as the work Baltic nations are doing to rebuild medical facilities destroyed in the conflict—or on post-conflict needs. Ms Yvette Zegenhagen, Executive Director of External Engagement at the Australian Red Cross, replied:
I think the answer is we need to consider both. This is a spectrum of needs. There are obviously, as you've identified, immediate humanitarian needs that need to be met, including for reconstruction, but they cannot be at the exclusion of longer-term needs as well. It is about, again, being able to have a short, medium and long-term view of what needs exist and what are likely to exist into the future and how funding can be most effectively distributed to meet those needs. I wouldn't be advocating for one over the other.
Supporting displaced Ukrainians
5.25The crisis led to an influx of Ukrainian nationals arriving in Australia on tourist visas, desperate for safety. The Australian Government acted quickly to welcome displaced Ukrainian people into the country, offering the opportunity for people to transition onto humanitarian visas.
5.26The process was further simplified as need grew. Mr Adam Miljenovic, Chair of the Ukraine Crisis and Humanitarian Assistance Council and Vice-President of Ukrainian Community of Queensland Inc and a former RAAF officer, stated:
A number of barriers to obtaining visas were lowered and processing increased to around the clock, and the mechanism of obtaining a visitor visa, with the promise of a subsequent humanitarian visa, was an evolution of the mechanism used for the Afghanistan evacuees previously.
5.27Members of the Ukrainian-Australian diaspora welcomed the protection Australia offered to displaced Ukrainians and did what they could to support the new arrivals:
We all felt a sense of pride in the Government of Australia stepping up to accept Ukrainian refugees from the war by awarding them Humanitarian visas early in 2022.
5.28Mr Miljenovic outlined cooperation between Ukrainian diaspora organisations and the Department of Home Affairs, noting the government’s proactivity:
A WebEx meeting was being held between the Minister and various community leaders quite literally at the moment when the ground and air invasions commenced. Minister Hawke's office was directly approachable for resolving the numerous issues that were communicated to us from community members, such as persons without valid travel or ID documents, children travelling with only one parent, and the lack of visa medical checks preventing visas.
5.29While the rapidly evolving situation and resultant reduction in due diligence were necessary, Mr Miljenovic noted that unintended consequences nonetheless occurred:
Whilst I am loathe to criticise the mechanism, as Minister Hawke's intent was to ensure that people could bring their family and friends safely to Australia, the reduction of due diligence checks lead to a number of situations we witnessed where the crisis and low barrier to entry was being exploited for profit or other non-humanitarian migration, such as church groups sponsoring dozens of applications, individuals offering letters of invitation for a fee, human trafficking, sham relationships visas, dual-national Ukrainians that were residents of other nations, or migration agents charging exorbitant fees for processing visitor visas.
Reviewing Australia’s approach to visas
5.30Humanitarian visas granted with the outbreak of war are valid for three years. Visa holders have:
work rights;
study rights (but not access to Commonwealth Support Places or the Higher Education Loan Program)
access to Medicare;
access to Centrelink Special Benefits;
access to the Humanitarian Settlement Program; and
childcare subsidies.
5.31As the war stretches into its third year, visas are due to expire. AFUO representatives stated that the question of how these visas will be processed is of great concern to the Ukrainian community.
5.32The committee heard that many Ukrainian refugees in Australia deal with tremendous uncertainty, with no prospect of returning home safely and, because they are here on temporary humanitarian visas, no ability to lay down new roots. This situation causes great distress and heightens people’s sense of dislocation.
5.33As put by AFUO:
Now we're coming to a point where these displaced Ukrainians don't know if they will have to go back home. Some of them don't have a home to go back to. They don't know whether they will be deported. A real fear in our community is: 'Once the visa finishes, what will happen?' Seventy per cent are women and children. Children will have to be uprooted again. They're already experiencing significant psychological trauma. For children to be uprooted from school, where they've just settled in, and not knowing where to go or what to do—it's definitely causing a lot of mental health issues.
5.34This is further complicated by the fact that a change in government in Australia during this time led to a change in the humanitarian visa program. While there are currently approximately 11 400 Ukrainian nationals in Australia as a result of the conflict, their visa status is inconsistent:
Some of those people arrived on a humanitarian visa and have access to different levels of support from the Australian government. That humanitarian visa program was shut down and stopped once there was a change in government, so anyone that arrived after 31 July is on a different visa stream. We currently have a situation where we have some members of our community that are on one visa stream; others are on another visa stream. We have family members that are trying to have some sort of family reunification, and they are currently on different paths with different expiry dates and also, as I mentioned, different levels of support from the Australian Government.
5.35AFUO suggested that the four different visa classes Ukrainians in Australia are currently on need to be streamlined.
5.36Mr Miljenovic similarly called on the government to review the mechanisms and processes which were in place for managing the arrival of newly displaced persons following the Russian invasion of Ukraine.
5.37Dr Tanya Dus, a child and adolescent psychiatrist with Ukrainian heritage, also urged the government to extend existing visas and recognise the benefits of accepting refugees:
The longer the war drags on, the stronger will be the urge to place permanent roots here. If our parents’ generation of migrants is any indication, this would be a fruitful, mutually beneficial development for Australia. The many aid projects undertaken by children of refugees who settled in Australia 75 years ago attests to the fact that investing in educating refugee children benefits both the greater Australian community, as well as their “heritage communities”, in a broad cross-section of community needs, not least in the area of mental health.
5.38Dr Dus also pointed out that that Australia could benefit from the skills of Ukrainian medical professionals, who currently are unable to practice medicine in Australia:
I also encourage the government to consider fast-tracking the retraining for Ukrainian health professionals who have arrived in Australia as refugees. To embrace this opportunity would see trained Ukrainians serving the Australian community in areas of need, particularly in rural communities, while also addressing the health needs in the increasing refugee population. This has already been successfully pursued in Nova Scotia, Canada.
5.39AFUO has been assuring displaced Ukrainians on humanitarian visas in Australia that they are not going ‘to be deported and that the Australian government will support them’ but has called on the Australian Government to issue the same message and develop pathways to permanent residency.
Committee view
5.40The committee notes that evidence received on Australia’s humanitarian assistance reflected the same shortcomings in coordination identified elsewhere. The committee is therefore of the view that these identified shortcomings further underscore the need for coordination to be centralised in a single office within a government agency, which would work to bridge the gap, and facilitate cooperation, between government and non-government humanitarian assistance efforts.
5.41As with military assistance, the committee urges the Australian Government to work more closely with Australian non-government and industry bodies to maximise the impact and benefits of financial resources committed to assisting Ukraine.
5.42The committee is of the view that developing a long-term strategy for Australian humanitarian assistance to Ukraine would help to increase the effectiveness and reach of Australian assistance, and provide clearer pathways for Australians and Australian aid organisations to contribute to humanitarian aid for the people of Ukraine.
5.43The committee also acknowledges the issues raised about Ukrainian health professionals in Australia being unable to work in their profession while in Australia due to regulatory requirements around training and accreditation. Exploration by government agencies of whether it is possible to fast-track these processes for skilled medical professionals wishing to work in Australia would be welcomed by the committee.
5.44The committee recommends that the Australian Government, in line with recommendation 1, urgently develop a central point of contact for Australian aid and medical organisations seeking to provide assistance and aid to Ukraine.
5.45The committee recommends that the Australian Government urgently make new commitments for humanitarian assistance for Ukraine as part of a comprehensive, multi-year strategy.
5.46The committee recommends that the Australian Government prioritise using Australian non-government organisations and businesses to deliver Australian Government-funded aid, medical aid and humanitarian assistance to Ukraine wherever possible.
5.47The committee recommends that the Australian Government provide long-term certainty to Ukrainians already in Australia on temporary visas who wish to stay in Australia or are unable to safely return to Ukraine due to the ongoing war.
Senator Claire Chandler
Chair
Liberal Senator for Tasmania