GENEVA — The United Nations is appealing for $4.2 billion to support war-affected communities in Ukraine, as well as Ukrainian refugees and host communities in the wider region, as Russia steps up its bombing campaign in the blistering cold weather to inflict maximum pressure on the Ukrainian government and its people.

“Next month we are entering a third year of full-blown war and occupation,” said Martin Griffiths, undersecretary-general for humanitarian affairs and emergency relief coordinator. He noted that while the war started 10 years ago in eastern Ukraine, “the escalation in 2022 rushed in a whole new level of death, destruction and despair and, of course [the] outflow of refugees.”

U.N. agencies report at least 10,000 civilians, including more than 560 children, have been killed and more than 18,500 injured since Russia invaded Ukraine on Feb. 24, 2022.

They report more than 4 million Ukrainians are internally displaced and some 6.3 million people have fled as refugees, most to neighboring European countries.

Griffiths said 14.6 million people — “a staggering 40 percent of the Ukrainian population” —will need aid this year, in addition to the millions of refugees living in 11 countries in the region.

Among those in desperate need, he said, are 3.3 million people who live in front-line communities in the east and south where the war goes on under relentless bombardment.

“Now that is really a shockingly high number even these days,” said Griffiths. “No place in Ukraine is untouched by the war … add to that the harsh winter, which is sweeping across Ukraine and ratcheting up people’s need for lifesaving support — heating, proper shelter, warmer clothes, and sufficient calorie intake because of the winter.”

He noted that people in small front-line towns and villages in Donetsk and Kharkiv have exhausted their meager resources and are relying on aid for survival.

“Families live in damaged houses with no piped water, gas, or electricity in the freezing cold. Constant bombardments force older people to spend their days in basements.

Children — terrified, traumatized — have lived the last three years under these circumstances trapped indoors and many, many of them with no schooling,” he said.

The United Nations aims to support 8.5 million of the most vulnerable people inside Ukraine and 2.3 million refugees and the communities hosting them in the region.

“The total displacement today is about 10 million people if you add the almost 4 million estimated people who are displaced inside Ukraine and the over 6 million estimated to be refugees worldwide,” said Filippo Grandi, U.N. high commissioner for refugees.

“So, we are over 10 million people not in their homes, which remains, by the way, the largest displacement crisis in the world.”

Grandi said most of the refugees fled Ukraine in the first few months of the war, but the outflow of people slowed dramatically when they realized that it was safe to remain in Ukraine.

He said the refugee situation is very fluid in that people often leave and then go back to Ukraine, which is quite unusual in most refugee situations.

The International Organization for Migration estimates some 900,000 refugees have returned to Ukraine.

Grandi said it is important to understand that the pendular movement is possible in Ukraine and not possible in other refugee situations “because these people are not fleeing from their government. They are fleeing from the occupation and the invasion and the Russian bombing.”

“They are still refugees. That is how we call them because they flee war, but they are not refugees from their government,” he said.

The UNHCR reports the majority of refugees plan to remain in their current host countries and will require continued support to meet their basic needs, including education for children, physical and mental health care, skills, and language training, as well as protection.

According to a UNHCR survey, 62 percent of the refugee populations are women and girls, and 36 percent are children. The survey said, “This age and gender composition, together with the high number of single-parent families, highlights the heightened risk of gender-based violence.”

Speaking at the joint launch of the U.N.’s multibillion-dollar humanitarian and refugee response plan for Ukraine, Denise Brown, humanitarian coordinator for Ukraine, told donors that the U.N. responds to every bombing incident that occurs — big or small.

Within days of the incident, she said, “We bring psycho-social support. We bring immediate supplies to people whose doors and windows have been completely destroyed by massive explosions.”

Weeks after a bombing takes place, she said the U.N. begins work on rebuilding the damaged homes, removing the rubble and, in many cases, supporting small businesses in reopening.

“The war is not over. The suffering is not over. We continue to require your support,” she said, warning, “If the funding is not coming, we will have to dismantle the humanitarian system.”

In appealing for continued donor support, Iryna Vereshchuk, deputy prime minister of Ukraine, spoke about the resilience of her people and their determination to fight on until the war was won.

“The enemy counts on our being exhausted because the enemy knows that they cannot win militarily. They really count that sooner or later our civilians will get exhausted, and we cannot allow this to happen.

“We have to keep supporting civilians. We have to keep supporting IDPs who move within Ukraine and people of Ukraine who move outside, running from the war by withstanding and resisting evil and oppression,” she said.

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