will try to deliver those two chef andres and get for the answers on this questions, but it does point i think we will transfer to the next panel. i want to excuse chef andres and thank him for his testimony and his good work. god bless you. please stay safe. i know we are operating some pretty dangerous areas, and we just appreciate the work that you and your organizations are doing for people that we care about very deeply. and i think you present the presence of the united states and a very favorable way, and we appreciate that as well. thank you. >> thank you. >> we are going to recess just for a moment

>> mr. walsh has an extensive career working in areas of conflict. he has previously served as

director in south sudan and in tanzania. we also have mr. edward graham, vice president of operations. he earned the samaritan's purse and after a long career with the united states army, i want to thank him for his service to our country. witnesses will be un-muted so we can swear you in. would you all please raise your right hands? d swear or affirm that the testimony you're about to give is the truth, whole truth and nothing that the truth, so help you god? >> swear. >> i do. >> i do. >> let the record show that the witnesses have answered in the affirmative. without objection, your statements will be made part of the record. you are now recognized for your testimony. thank you.

>> thank you, chairman. ranking member and distinguished members of the subcommittee, thank you or organizing this committee. speaking from ukraine while serving with doctors without borders, we have been operating in over 70 countries in the world. where in line with universal medical ethics. these principles not only formed the core of our identity but are our production. -- protection. as you are aware, it has escalated in late february 2022. millington -- civilians have

been injured and killed, destroyed buildings damaged. in ukraine, they have an advanced health care system and a highly trained work force these health-care workers are asking force license of this is very to continue to care for their patients. the system is supplemented by work with organizations and volunteers to play a significant role. we have expanded artwork in ukraine -- expended our work in you rain. -- we have expanded our work in ukraine. we work with a lot -- we work alongside ukrainian doctors and nurses. we support services for survivors of sexual violence with medical and mental health care, mobile mental clinics in open areas where shelling is

dangerous and in rural areas where health has been interrupted with conflict. we only have means to move large numbers safely across the distance of the country from east to west. these move patients from overburden hospitals that are close to active conflict to hospitals away from fighting and where there's more capacity for patient care. we have conducted over 24 journeys by train and have assisted over 600 patients and their caregivers. most patients are civilians heavily wounded by rockets used indiscriminately in populated areas. an additional 78 infants into others were also evacuated from an orphanage using this system.

also, the strike on the reservation, hundreds of civilians were waiting and safer areas and we evacuated patients only two days before. the aftermath of the attack, we transferred 11 people to hospitals west of the country. most of them were children, the youngest being eight years old. with humanitarian law, they're taking access -- access to care and services. humanitarian a much -- must be allowed to reach them. accessing health care will be a continued challenge in the coming months. those with chronic diseases need access to medications and therapies. what we can provide hospitals

with training and materials, the initial medical act that saves a person's life is only a step to recovery. physical and psychological treatment. while continuing to support the medical needs of people affected by this crisis, it is important that this happens in addition to a not at the expense of other vulnerable people around the world. impact of the war on ukraine -- patients from the crisis. malnutrition, measles and pediatric hospitals. so overwhelmed that there were not enough beds. we are reaching our we are doing our best to battle

malnutrition in nigeria. >> thank you, mr. stokes. >> thank you for convening this hearing on the humanitarian consequences of the war in ukraine. i represent a humanitarian organization providing aid in

ukraine, supporting refugees in europe and welcoming refugees in the u.s.. we operate in over 40 countries, giving us a global perspective on the crises this conflict has unleashed. ukrainians are feeling the war's impact most directly. thousands have been killed or injured and millions more have lost their jobs, their homes and their hope. nearly 14 million have been displaced, including two thirds of all children. these are worst in the south and east, where hundreds of thousands are trapped mist fighting. 1.4 lack running water. western and central ukraine are comparatively calm and we are seeing more returnees than refugees. but missile strikes over the weekend remind us stability is precarious. already over 200 health-care facilities have been attacked. over 1800 schools have been damaged or destroyed, and 90% of ukrainians could fall below the poverty line nearly 60 million

ukrainians need humanitarian assistance, but insecurity and access challenges are limiting the response. the war has spread the fastest moving refugee crisis since the second world war. despite the inspiring welcome, they are showing strain, especially on ukraine's closest neighbors. in poland, and moldova, which is hosting the most ukrainians per capita. the u.n. refugee response 80% underfunded and donors including the u.s. have channeled most funding to you and agencies. all in tears, local government and by the sector resources are filling gaps, -- filling gaps. in just 100 days, the crisis has gone global. ukraine and russia are supporters of the world's grain.

food prices are skyrocketing everywhere. in somalia, which depends on russia and ukraine grain for 92% of its grain, food prices have surged 40% to 100%. the cost of malia tradition -- malnutrition treatment has soared. water trucking costs have doubled. human depends on ukraine for nearly half of its wheat. it imports 80% of its grain from ukraine. the u.n. warns 47 million more people will experience acute hunger this year, adding to last year's record. with all eyes on ukraine, we also appeal for other crises globally. we applaud congress for allocating over $4 billion in

humanitarian funding and we urge the u.s. to build on that eared first, while only an end to the fighting will end the suffering in ukraine, the u.s. should prioritize diplomatic efforts, including documenting denial of access. encourage the government of ukraine to remove areas to cash-based aid, which is vital to meet needs and it gives ukrainians agency and supporting local markets. and invest in protection services to meet the unique needs of women, children, the elderly and disabled. second, to show solidarity with host communities in europe, u.s. should, together with other donors, increase funding to host countries before private and local funding decreases. -- regular lies the status of

ukrainian refugees in the u.s.. the u.s. should commit additional funds to humanitarian context most depended on ukrainian and russian imports. there should be clear guidance. open ukraine's black seaports, with the countries most affected at the center. aid is not enough. there must be accountability. the dynamics of death, destruction, just placement and denial of access are driving misery. this is not unique to ukraine. the u.s. should showing respect to international law and support mechanisms to monitor violations and all conflict settings. the war in ukraine should -- not set a new president for it. thank you. >> thank you.

we want to welcome mr. walsh, you are recognized. >> thank you very much. thank you for the opportunity to testify on the current crisis in ukraine that continues to put 7.5 million children at risk. i am calling from kyiv today. we work with local, national partners to provide cash, water, food, medicine and hygiene kits, establish safe spaces for children, and deliver bunk kits to the front line. i wanted to open up with a real-life story of my experience in ukraine. on the fifth of april, we visited a southern port city. most important link, their children's hospital, that reported airflight around the

grounds. i saw an ambulance, large cars and a minivan destroyed. blown out windows of properties, the blood outside the emergency departments. the hospital -- sorry. the hospital is in a residential area and not a single military target insight. there were reports of fatalities, i remember the stories of two girls. both in the operating theater at the time of the attack. one a 15-year-old girl who was having shrapnel removed, and the second, a six-year-old girl having a bullet removed from her arm from a previous attack. and one of these missiles or rockets from the attacks hit the operating theater. tragically, the girls received further injuries in that attack which put them into intensive care. their lives were now in severe

danger. however, a wonderful medical director who i met told us on that day that the girls were unlikely to survive the night. however, five days later we had a call from the doctor informing us that by some miraculous reason they did survive, but with life-changing injuries and trauma that will remain for the rest of their lives.

these are only two stories of the 7.5 million children affected by the war in ukraine. on average children have been , killed or injured every day since the start of the escalation. a child has become refugee of almost every second. there have been over 9500 civilian 9500 civilian casualties with over 272 children killed and a further 439 injured. then need for these children must be at the heart of any response. we therefore call on the u.s. government in the following three ways. one, help better protect children in ukraine. continue to condemn all attacks on schools and hospitals, schools need to be a safe space and cannot be used by the military. prioritize child protection, mental health, psychosocial support and inclusive safe education. recognize the specific risks that phase separating unaccompanied children and support the call for no intercountry adoption at this time. number two, champion our needs to access the most vulnerable children including those living past the contact lens. number three, enter all accountability mechanisms have dedicated child rights expertise and that all mechanisms are coordinated, including with the office of the prosecutor general. airstrikes and explosions which claim children's lives, millions

of children have lost relatives, their families ripped apart. parents have had to make difficult decisions -- should they flee or remain? the level of violence and trauma cannot be underestimated. one of our psychologists described children arriving in one of our child friendly spaces as being in a state of catatonic. their drawings are so filled with civilians running from tanks, bombs, and crying women. at least 1939 schools have been damaged and destroyed since the 24th of february. one in every ten schools have come under attack this year was destroyed. not only does this keep children from safe, quality education, but also increases protection risks, cuts off children from a sense of normalcy and interrupts other services such as nutrition and immunization. thousands of children have been separated and are now unaccompanied, exposing them to new threats including sexual violence, trafficking, or exploitation. these children may not be

orphans but rather have gotten separated. they may have been sent across the border for safety, a brutal decision for any parent to make. while we are aware of the health of psychological needs of millions of children across ukraine, we cannot reach tens of thousands of children pass this contact line. this is due to the unpredictability of the conflict, unexploded ordnance and lack of assurance of safety. areas in need are undergoing intense military action and shelling families are trapped , unable to leave. that might be an elderly grandmother or sick family member. some simply cannot afford to leave. we must be able to get access to these families. further, as guaranteed by international law, families who want to leave must be allowed. unfortunately we continue to hear of families who have been caught up in shelling or denied exit in such areas. attacks that target or cause harm to families on the move are prohibited under international law.

save the children have been impressed by the momentum of accountability across ukraine. internationally recognizes watershed moment. several mechanisms have been initiated and deployed including the u.s. supported atrocity crimes advisor group and the conflict observatory. while we recognize such proactive action, we reiterate our call for the inclusion of child rights expertise to ensure that collective preservation and analysis of evidence is in line with the best interests of the child. to conclude, at times of -- at times the conflict feels relentless and it's hard to picture a safe and secure future for millions of children. however, the last three months i have watched us scale up to over 100 staff in the country, supporting over 20 ukraine new partners and their staff all working together to protect children. we think the u.s. government for their support and continue to call for you to work with us so that we can continue to deliver a principal humanitarian

response to save the children and families across ukraine. i thank you for your attention. >> thank you, mr. walsh. we welcome mr. graham. you are recognized for five minutes for your testimony. mr. graham: i thank you for this opportunity. i'm going to focus on little more on the agility of ngos, especially faith-based ngos and one of the advantages i think we often have with the local church and some of these countries and how we operate. those are our partners. one to be clear up front samaritan's purse is not a humanitarian aid organization, we are a christian leave organization that uses the resources entrusted to us by god to meet the immediate needs of those who are suffering due to man-made conflict or natural disasters, including diseases. we love and serve everyone that has a need without discrimination. we do this because we love our neighbor, just as scripture commands us to do. we meet immediate needs of the suffering and then we hope that our work reflects the love of

christ in the work that we do. we want them to know that god loves them so much he sent his only son jesus christ to die on cross for them. we give it to those people out of his hands. with that, samaritan's purse has several aviation assets, medical assets, hospitals that we are able to deploy around the world at a moment's notice. we have been very gifted with expeditionary capabilities that allow us to serve quickly. in late february when the war began, i was personally traveling abroad but that's when the conflict started and i redirected our vice president of international projects to go to ukraine and start assessing what the need was. immediately, samaritan's purse deployed a tier 3 surgical hospital and began to set up and treat patients but we set up

clinics. that time the russian bear was coming and everything was going to collapse. we saw, the world saw, the chef did a good job trying to get out. when i went to the board this is second week of work a car line was 14 kilometers long. there was chaos at the border. so we started work in moldova, romania, poland treating the refugees helping been also , working medically inside ukraine, serving them. but we were able to set quickly and do a lot with the assessment because of our church network and were fortunate to have that. but eventually the war started to change and we saw some focus change and we knew that future is going to be a huge issue, just as the chef said, but further east, where the fighting is. while in ukraine, i saw the church housing, feeding and providing medical supplies to the displaced. i am proud of so many churches transporting housing, feeding, providing limited medical

support but spiritual support. they are living at the new testament, the story of the good samaritan. the church also allows us to get into areas serving especially with our food program i will talk about further in to areas and some i can't talk about for safety reasons, but it is an unbelievable network. after about three weeks, we sell the war changing. that's when i went to the baptist union pentecostal union. these are church partners with us for a long time especially , through one of our ministries, operation christmas child. with that we are over in 120 for in country serving with trained staff and volunteers. so when conflict happens in one of these countries we respond quickly. in ukraine alone 3300 churches , that participate in this program. our sister organization worked in ukraine for years as well. when we went to these baptist union pentecostal union to set up a reverse flow of our logistic needs we sent about , 600,000 shoeboxes gift filled shoebox operation christmas

child last year alone. that is already the logistics we need for these large feeding programs. we have treated over 12,000, about 12,500 patients in our medical sites and field hospital. 157 surgeries, 5900 tons of food distributed across two countries. 1.4 million assisted. we fly our cargo plane out of north carolina every week since the conflict started, that's 520 tons of relief supplies, nonfood items. we had to rent a 747 cargo plane because the need was so great. so it doesn't fly back empty, we started working with the canadian government and we are flying refugees out of poland to canada, where they are being served alongside one of our affiliate offices in canada, and being placed and work with the church therefore -- there for

support. we do not rely on government grants so there is no waiting on government grants. god trusts us to help those in desperate need. one of the reasons samaritan's purse is able to respond to ukraine again was the established church network i talked about. when i was in ukraine during the second week of the war i met the , head of the baptist pentecostal union, and they started working with us. i'm fortunate and blessed to have that relationship. but it is not ours. it is something god has given to us. the food pipeline will continue to morph and change. we will work with those teams and churches to feed further east, that's where many of our teams are set up, and ambulance relay system where they're getting people with the burn and blast injuries, getting them out of country, to those hospitals where we saw a great need. i don't think most ukrainians know that the u.s. is helping

with humanitarian -- they know the legal aid and they would ask for more. what they see is the ngo's and the church and that's who we partner with. they see the church working of loving their neighbors and serving those in most need. so i don't come to the government asking for anything and any resources i would just ask that you continue to encourage the generosity of the american citizens to donate to faith-based organizations that are agile, can move quickly just as the chef talked about. just think if the u.s. wasn't benevolent and that the american people didn't give, what the response in ukraine would look like right now. it would be disastrous. i think it is the generosity of the american people that has responded immediately and helped to love their neighbor in time of crisis. i appreciate the time, i look forward to your questions. >> thank you, mr. graham. i want to thank all our witnesses for their statements.

now i will yield five minutes to myself for some questions. ms. catanzano, you had a very good perspective on the cascading effects, not just what is going on within the borders of ukraine, but also you talked about the cascading effects beyond the borders. our committee as well, myself included, have visited somalia, yemen, a lot of the places you cited, especially north africa, where you cited the absence of ukrainian wheat and supplies would have a devastating impact. i also want to ask you about the border countries. our subcommittee spent time in moldova, romania and poland, and i realize now that moldova is one of the poorer countries in europe and yet it was

heartwarming to see the way those people who didn't have two nickles to rub together were welcoming refugees into their own homes. do you have any visibility on how those countries, and those people who are also showing tremendous, tremendous hospitality and kindness to the refugee population, and i'm talking principally poland, romania matilda -- and moldova. do you have any visibility in terms of what their need might be? i noticed that unlike afghanistan or other parts of the world where the committee has visited where there are large refugee camps, that's not the situation in these neighboring countries. these refugees have been taken in in large part into private homes. but i'm not sure how sustainable

that might be in the long-term. i think it's heroic but i'm not so sure, you know, that it's the most efficacious way to deal with the problem. so do you have any visibility on the situation in those neighboring countries and what we might be doing to ease their burden? ms. catanzano: thank you, chairman and thank you for that question. we are operating in poland and moldova as well, and i can absolutely endorse your perspective that it has been heroic and inspiring to see the welcome that these countries and the citizens have offered to displaced ukrainians. i can also your perspective that there are strains and stresses on these communities, these cities and countries, even the disproportionate burden that ukraine's nearest neighbors are bearing in this response.

like you said, this isn't a camp based response. this is members of the community welcoming ukrainians into their homes and into their lives, thinking was going to be for a few weeks, and here we are 100 days later. i think that spirit of generosity and welcome is still there, but in the case of poland, for instance some of the , subsidies the government was able to provide early on to those hosting refugees, you know, they are running out. there was the housing crisis in large polish cities before february, and now you can imagine the strain when the population of cities have swelled by 15% or 20%. it is making it even more difficult that we are reaching the summer season of the generosity of airbnb or vacation rentals that are opened up up to ukrainian families, those owners , they need that income. so we're going to see some of those housing stocks decline.

similarly in moldova, while not the sheer number that poland is it's hosting the highest number , per capita and it has the lowest gdp on the continent. and it's not just the numbers they are housing now, but looking around corners and wondering what's going to happen in the conflict itself. that's going to be where the civilian violation of ukrainians move quickly. so we've seen inflation, we see overwhelming need at reception centers within moldova. i think we have to bear in mind while there's been an overwhelming amount of support for inside ukraine, for the countries that are hosting the ukrainians they are not seeing , the same level of support. i mentioned in my opening statement the response plan for , the neighbors is only, is 80% underfunded, and a lot of those funds are being channeled or almost all of those funds are being channeled through you in agencies -- through u.n.

agencies, which makes the response less dynamic and nimble than it could be. the chef highlighted some of those challenges in his testimony earlier. so we are worried. we are pushing both for more funding for refugee response but we're also pushing for more diplomacy to enhance the burden sharing across europe. the european union did invoke the temporary protective directive at the start of this crisis for the first time, but it is up to the member states to implement it and to think about the scope with which they will implement it. so there is great disparity right now amongst the different european countries, but what kind of access to refugees have to support and services. so that really affects secondary movement and keeps many ukrainians in the countries of first refuge, which means that burden stays on moldova and poland. so i appreciate that question

and hope that we can continue to look inside ukraine, but also look across the border, look throughout europe, and as you said at the start about the cascading crises globally. rep. lynch: thank you, that was very helpful. i now recognize the gentleman from wisconsin, mr. grossman, for five minutes for his questions, thank you. mr. grothman, you may have to unmute. rep. grothman: a question for mr. graham and the other people can weigh in as well. percentagewise, 100% would be adequately fed. percentagewise, how much food is available in ukraine compared to what would be considered adequate?

mr. graham: to give a percentage i think it's different in different places. if you're looking at central parts of ukraine, and going back to the border towards poland, life is somewhat going on as normal, but they may not have access to the food they normally eat. the concern probably towards the fighting, food networks are challenging. there you are saying, you're looking at 50% maybe looking at looking at, to give a number -- a number from my team. the nutritional value you need to get to women, children especially those women that are pregnant. it's that good, quality food and programming that you need access to and getting it there. so that's one of the bigger challenges that we are seeing there and getting food. like the chef said we're trying , to buy locally as well. you're looking at about i think 35 million metric tons in the silos but with the force been blown up and closed they can't

get that stuff out or they can't internally ship things into the country well in and around the fighting. it's all been talked about there would be massive issues in africa because most of the food that supports come some out of the sahara so will looking at years down the road the challenge. in truth of the country along the fighting errors you're looking at 50% what is needed. rep. grothman: ok. from your expanse, would it be more helpful for the u.s. government agencies to provide direct assistance to the ngos position of the country or u.n. agencies? >> the u.n. is an organization has a lot of capacity. it is a huge bureaucratic system it is loaded with and has to build resource kit. there's also a soft internally and to work with the they don't

hire locally within ukraine. i can't, i'm not in, i kept all the challenges but i know when you look at ngos, we work directly a partner with the church. my team is not seeing much of the u.n. >>

ok. i give you kind of a different question i always wonder about it. when i i look i think of countries the size of big discussion worker ukraine has a second lowest birthrate of all of those countries. how does that affect your mission or what's going on in ukraine. this low birth rate. well, especially in time of competent were we see a lot of children and allow displaced children there's a safeguarding children. were concern with children crossing the border to make sure they're going with their parents or the book one, a family member and many are going without their fathers. that's a whole nother challenge. you are also look at the -- are when her hospital for set up i was there one of first patient we treated was a pregnant woman that that that felt her child kick in the last couple days as she was linked it we were able to let her be able to see her child and art become listen to a heartbeat. we delivered children. there's a whole lot of needs when it comes that within the feeding of children, we talk about for you here in this country and i notice a huge issue right now, i can imagine

being a mother but imagine being a mother in this war zone and what they're going through and that's what he meant you need is so great. it's also the reason operation christmas child is such a big program there because there are so many children. they want, the church is what this ministry to come into work and serve alongside them. you bring up a great point and we appreciate you highlighting that i think some of these other ngos could highlight the needs piercing with the children especially with safeguarding. ok here does anybody else want to address that? that's ok. we'll give you another question that. i'm glad you're working through the churches. could you describe the role of church in ukraine? could you address may be other european countries, the role of ukraine as little different.

>> ukraine is probably the most church country in europe with that aspect. i will not speak directly with the baptist union unit of pentecost can get the orthodox church as well and resource been split away from the russian orthodox. but the church is active, alive, hungry, one store. when i was there before we even call i was there the start of the second week of the war they were the ones housing and feeding and building these individuals from the train stations to the border and when one group would come out another one would come into the church. they are being the hands and feet of jesus of the thing i can living at the story of the good samaritans. that might not be true in every country in europe but within your the church is unbelievable, i'm sorry, within ukraine. >> thank you. the time of the gentleman has expired. i did know that mr. walsh might have a response to the question for you are free to answer if you wish, mr. walsh. >> thank you so much. really great questions. thank you, chairman. the issue of safeguarding is one of the highest priorities on save the children and his partners both within ukraine in neighboring countries. we've set up a network for unaccompanied separated children in poland, in romania to our partners in moldova and lithuania. to work together as one to ensure that if children are identified as unaccompanied that there quickly identified and save the children really

prioritizes identification of the parents or their wider family to try to reunite them as soon as possible. you notice that i did in my testimony talk about the request for a document save the children is grateful for solidarity from across the world from people who feel that what the need to adopt these children. that are unaccompanied. but more often than not these are children with parents and very early on in the conflict save the children ask for a moratorium for neighboring countries to not allow adoption. because whilst many people go with the intent to try to support children, there are also those that may have other alternative reasons for trying to adopt children. so that's why we're really trying to put emphasis on the

best interests of the child, which is with their family. >> that's a great point. the chair now recognizes that the single should jump from georgia mr. johnson for five minutes for thank you, mr. chairman. >> thank you to the witnesses on both panels who have testified today and also thank you for your work on the ground in this humanitarian crisis. ms. catanzano, in a report released last month the international rescue committee wrote that the war in ukraine has highlighted the failure of the international community to anticipate and respond to crises and fulfill basic needs, of communities in crisis. can you elaborate further about what irc meant i that? >> i'm happy to respond to the question.

when we work around the world, we are seeing that we've been in these places in some cases 20 or 25 years. these are emergencies. these are not events that happen overnight and we are providing services so many years later. as i mentioned i believe in my statement, it's wonderful to see the outpouring of support to the crisis inside ukraine and to see the funding level so high. but it's also disheartening to look across rest of the world and see funding levels so low . while the response in ukraine is funded almost 3/4 of the way only three months into this crisis, the rest of the world is looking at you manage and response plans that are funded less than 20%. these are places with communities and people wish is

people, which is only being exacerbated by the knock on effects of this war and with the grain shortages and other shortages as well as fertilizer prices. so we need sustained diplomatic attention. we need sustained funding across the border. what we realize is it's very difficult to keep the international donor community focused on more than one crisis at a time. from august of last year to february, all eyes are on afghanistan. we have all moved on to having eyes on ukraine. it's important that we are able to walk and chew gum when it comes to these crises around the world. the u.s. is a very generous donor and and i really applaud congress for the emergency supplemental and the foresight to allocate funding not just for inside ukraine, but insecurity impacts around the world. but i'll be there is one that needs to be to both combine emergencies assistance with forward looking to a rethink the impact will be worse and combine it with resiliency and future oriented development of program that makes agricultural system stronger, more drought resistant

and more shock resistant for communities around the world that are really struggling and only going to get worse over the course of this year as the grain shortage, the fuel shortage and the fertilizer shortage make life harder across the board. >> why is it that the international community has responded so differently to the crisis in ukraine as opposed to the ongoing conflicts across the world that require international humanitarian assistance? >> sir,

i can only speculate to begin to answer that question, but i do think a lot of it is driven by news cycles in the media and what's on the cover of the "new york times" or the "washington post" i think it has a lot to do with understanding the dynamics of the conflict and the dynamics of the crisis. i think that the further away a crisis happening and less understandable it is to citizens of donor countries, the harder it is to rally attention and funding. distance and complexity is the enemy of action. i think what we're seeing unfold in ukraine,'s very simply to people. it was an invasion of one sovereign country into another, and impact is playing out in front of our tv screens and our social media feeds every day. so i do think that drives a lot of the attention, a lot of the action. the shock and the disbelief that something like that could happen and in the 21st century in the heart of europe. but i don't think that gives us license to look away from populations that have been suffering longer, suffering party suffering, suffering for a long time, and increasingly

suffering as a result of this crisis. so i do think it has to do with the shock of it happening in europe, with the fact is playing out on our tv and social media feeds, and the fact it's a little bit more understandable perhaps to the average citizen than what is happening in a car place across the world. but i think it's incumbent upon us to overcome that and figure how to get to the medic and funny attention on those most in need according to humanitarian assistance. >> thank you so much. my time has expired. >> the gentleman yields back, thank you. the chair now recognizes the generally from north carolina ms. foxx for her questions. >> thank you very much, mr. chairman, and i want to compliment you on this hearing. it's one of the better hearings i believe we've had in this committee and others. i'm very sorry that this committee, that this hearing wasn't held in prime time last night because i think it is, one, again very, very important for the american people to hear what is being said by these witnesses today.

and i want to thank particularly major graham for being here with us today. samaritan's purse is in my district and very, very proud of the work samaritan's purse does year after year after year as i have known -- >> ms. foxx, you might be muted, i'm sorry. >> i didn't mute myself. ok. maybe you can stop my clock for a second. i am very proud -- >> of course course. we -- go ahead, i'm sorry. >> that's ok. i'm very proud samaritan's purse is in my district, and i've known the graham family for a long time. i appreciate very much the

comments that major graham brought up about samaritan's purse and the ability for samaritan's purse to go in and work with the churches and the baptist union. i have often heard, i heard on 9/11 that the baptists men with were the most effective people in new york city on 9/11. and i am very, very grateful to hear that is continuing. i am also concerned about the issue being brought up about the u.n. and it being such a bureaucratic organization. i would like to ask major graham, what lessons can the federal government take from how your organization, and i may fif , if i have time i will ask the others, responded to the attack on ukraine and what things could we know and learn from this that you all have learned? >> yes, ma'am.

congresswoman, it is great to see you today. i think one of biggest lessons , well, world was wrong on what they felt was can happen with the russian invasion. they thought = they wer going to wipe right through and we woul they thought they were going to wipe right through and we would ca diff ukraine and it would all be russia. we were wrong and that's great. but war changes and it changes quickly. i learned that in special operations. it is fluid. things on the ground change. as an ngo, as a faith-based organization we had to be agile and be able to change to the needs on the ground. when we first got there the assumption and distilled is a huge need, medically but without talking massive surges and trauma. some of the did happen but it quickly turned to food and that's always going to be the case in war and conflict is food. but we have to be able to pivot quickly and that was brought up before, you have to be able to do more than one thing. you have to be able to walk and chew gum. we had to do the all of the world with various projects but even in ukraine as multiple ways to be able to serve and work through the church.

the church and each church union has different capacities, different opportunities to serve , different logistic nodes. we have to be able to plug-in and reinforce and hammer down and reinforce action that is working. when we started seeing these node notes get food into areas that are beyond the conflict zone on the other side where there is huge problems and you're not getting much and not hearing the press because it's on the other side of the russian line, we know this food pipeline is working. we are watching and tracking them where they're going. we reinforce that and get that church and those nodes more food , more equipment, more resources. you have to be able to be quick. i am not at the point of the god is ever going to tell me to be in the u.n. but it is a beast. just like in the middle east. i was in the u.s. army for years, it is hard to shift a a mood. that's why i stayed in special operations. resources. allow it to respond quicker in

the time of crisis. do that here as well. when you take away bureaucratic red tape, things speed up. oversight and watch and understand you to track where the money goes, those are good things. you owe accountability to the taxpayer. find those nonprofits and ngos that are working to have reliable reputations and other parts of the world that have access and hammer down. >> thank you. i want to say that governor david beasley comes to our prayer breakfast almost every thursday morning and he brings to our attention the need for all over the world. mr. walsh, quick question for you that you won't be able to answer on there, i think, but i would like for you to get an answer to us later. i have a county in my district that is that a very close relationship with ukraine for many, many years and the churches there, we have had some people in the county who were in the midst of adoptions of children who were approved to come to the united states to ashe county.

and those adoptions were stopped , and we have people asking us what can they do to finalize those adoptions. there are people who want to take children in. so if you could give us information, give the staff, the committee information on how we might connect those people again and what is being done to reunite children with their families, that would be interesting i think for the whole committee to know. but if you could give us information on contact people that we could get to for these people who are desperate to complete those adoptions. but if you want to say anything about how you are reuniting families and the chairman would allow that, i think would be interesting for the whole committee to hear. >> of course. mr. walsh, you may proceed. >> thank you very much, and

thank you, ms. foxx, for your question. our hearts go out and we welcome and we are so grateful for the solidarity of the american people who have genuine adoption applications with children in ukraine. but right now when martial law is in place and the normal protection systems and safeguard systems you normally find in a country are stressed or are being repurposed for the war effort, there is a lot of confusion and maybe things are not working as they should be. plus, we are in an unprecedented time with the children on the move. the response is urban, transient , about migration. separated children in an emergency are extremely vulnerable to trafficking, exploitation, and every effort must take to safeguard some , to put safeguards in place to

keep children from abuse. so what save the children strategy is through our networks and throughout our partners across the country and neighboring countries is identify these unaccompanied children. and we're doing a fairly good job at that. however, we need the government support which were getting plus additional partners to come on board to ensure we safeguard children. once you identify children unaccompanied, there is a set process that we follow, that follows all safeguarding rules and procedures, that we do not rush to, not any child. most processes and procedures must be met. only once they are met, then we try to reach out to the family, extended family, look at the status, local partners, and local authorities to help with any reunification process, and we have been doing this for many years in many countries. so far, over 4000 children in south sudan reunited with their families, and the joy sing a

children to the mother's arms, who hasn't seen the child in 18 months and may be lost of the members due to war, it is amazing. >> thank you, mr. chairman. i yield back. >> the gentlelady yields back.

>> the chair now recognizes the distinguished member from california for five minutes, welcome. >> thank you mister chairman and distinguished member. i want to follow up a little bit about the ranking member's comment. i have a family in northern california and they're in the process before the war of adopting a ukrainian child. that child is now stuck in germany and where having a hard time facilitating getting her to her adopted family. so i'd like to follow up with the member comments, and then our ability to comprehend the consistency i think as a species and a society what's happening in ukraine just being overwhelmed with what seems like a daily impactful things happening around the world but as i listen to this discussion i think mister chairman of our trips and my trips to syria and dealing with children in the refugee camps there in jordan and following up with that and how this pattern is repeating itself. it seems like either an indiscriminate or purposeful psychological tool, weapon of mister putin to go after the most vulnerable members of what he perceives as his enemies and particularly children, having met with those families and kids who have walked for miles to get to safety. mister stokes, the psychological impacts, behavioral health needs

, how are we dealing with that in the near term but how do we look at this ongoing? we know the impacts to the neuroscience and cognitive development. i can't imagine the impact this will have and as we are seeing with the syrian refugees and what appears to be a deliberate psychological, i can't describe it, weapon to demoralize countries by doing this damage that will last for generations . -- generations. what do you see happening? what are you able to provide in the near term and what can we talk about in the long term and unfortunately as long as this person is in power it seems like this is clearly a pattern that he doesn't care about and for some reason that our ability to concentrate and have a global response to this as a weapon of war is also a problem but first and foremost tell me what you're able to do right now to help with kids. almost 300 kids have lost their lives in ukraine, almost 500

have been seriously wounded. two out of 3, 5 million ukrainian kids have been forced to move out of their homes. those impacts are significant in the near term right now, but also long-term devastation. >> thank you for that question. i can share the experience that we have seen by moving families from the east to the west here in the western part of the country, men, women, children, i would say two particular groups are affected, the children, but also the elderly. these people have been uprooted from their homes and their towns in the east and they're coming here to the relative safety of the west. mental health is a major issue and we've seen that and the patients that we're treating, the patients we are transporting. they've seen some terrible things. and some of them have been living underground in bunkers and shelters for weeks and

months. we have families shelled as they were evacuating mariupol. we have also treated and transported to safety across the country, so mental health clearly a big issue but also the social care that's needed. once they have been treated in hospitals and other parts of the west in western ukraine, they are then very vulnerable and left a sometimes to fend for themselves, and this is clearly a major issue. also we are seeing significant mental health needs and people -- and people who return from belorussia or who are taken from the north of kyiv was the russian troops were treating -- retreating. we've been organizing mental health care and we're trying to look at supporting survivors of torture who are coming back from neighboring countries and some

quite horrendous stories actually, so mental health will be quite an issue and it will be for the medium and long term in ukraine, absolutely. >> mister walsh, do you get the sense that they understand there is up world of support immediately, but in the long term, to help with these issues? >> i do, i really do and i think what's important as i mentioned and you mentioned about conflict cognitive behavior, we are providing bunker kits to go into the areas where children are in bunkers right now cowering from bombings and shelling and fighting, and these kits are designed to get the child for the one moment to be a child and rather than having to think about what's happening above ground and that's important for an early-stage intervention for mental health and psychosocial support. i have met children in counseling sessions, in mental health counseling sessions and

heard harrowing stories of what they have been exposed to, but they do connect very well to social media, so they are also aware of the international community and how much support is being received, but probably they hear more about the legal -- lethal aid, as mentioned by mr. graham, rather than the aid coming from the u.s. taxpayer, so i do think that they are there. >> thank you for all that you do, and all the panelists. i yield back. >> the gentleman yields back. as a courtesy to my friend the ranking member does he have any closing remarks or questions? if you have any closing or questions? >> no, i would just like to thank you for this hearing and i

would like to thank all the witnesses. i think it was very illuminating. we will see what we can do in the future to use these responses as we do what we can to craft american policy. not only to deal with the crisis in ukraine, but the crisis around the world, so i just like to thank the chairman for convening this subcommittee and thank all the witnesses for spending so much time with us this friday morning. >> thank you. in closing, i do want to just spend a little time with mister stokes. you know, doctors without borders has a central role to play within this conflict as you do in so many other instances. and i'm just wondering if there are sufficient support systems around your work and are there

gaps, are there things we are missing because there's as so many of you have pointed out, you really do need to be on the ground, boots on the ground and sometimes bureaucracy can get in the way of things. are there things that you would want this committee to know regarding your ability to deliver the relief and support that your intended to? >> thanks for the question, mr. chairman. i would say that the ukrainian environment when it comes to healthcare is one that's for the moment in terms of humanitarian access is permissive in the sense of the ministry of health of ukraine is supportive of our work and has under these exceptional circumstances authorized all foreign medical professionals to be able to clinically work here in ukraine , so we are sending in surgeons

and doctors into places that are 15 kilometers from the frontline and they're able to work more effectively with support from the ministry of health and local authorities. one of the issues we're seeing today is that in the east because of the insecurity and the shelling in civilian areas actually, a lot of the hospitals staff have had to leave because they're taking their families out and we are reduced to maybe 10%, 15% of the health staff left and some of the key hospitals. it is true that the population is also reduced, but the health service provision has been drastically reduced. this is why we and others have been moving patients out from saturated hospitals in the east out to the west, but now the west is also now reaching a crisis point. some of the hospitals basically

are at full capacity and looking at how they can move patients out of the country or to other parts of the country. so the general healthcare system here in ukraine has responded reasonably well. we have to admit that 99% of the response when it comes to healthcare is done by the ukrainians, not the international organizations. we add, perhaps, that extra 1%. and they are under huge pressure. the human resources issue, the issue of security around hospitals close to the front lines is coming to the fore, and we're only 100 days into this conflict and it's quite worrying to think what will lie ahead for the healthcare system and the hospitals, especially in the east, close to the front lines. >> right. that phase is something that we need to be thinking about right

now, when this conflict is eventually over. in closing, i just want to say how thankful i am, how grateful i am for really the full spectrum perspective that your selves and chef andres were able to offer the committee and we appreciate the way you have helped inform us in terms of the decision that we are going to have to make and continue to make regarding the situation in ukraine and other countries around the globe that are being impacted by this conflict. so we're really grateful for your expertise and your perspective. i want to thank you for your remarks. i want to commend my colleagues for their participation and some great questions. with that, without objection, all members will have five legislative days with within which to submit additional questions through the chair which will be forwarded to the witnesses for their response. i ask our witnesses to please respond as promptly as you are

are able, if you do receive further questions. this hearing is now adjourned.