By Elizabeth Piper KHARKIV, Ukraine (Reuters) -Playing outdoors with his friend, Ukrainian teenager Nazar was badly injured when an explosive device blew up under his feet. Despite his phone being shattered by the blast from what was apparently a discarded munition, he called an ambulance and spent months in hospital where he underwent multiple surgeries and doctors managed to save his leg. Now at home in the eastern village of Nikopol, 130 km (80 miles) south of Kharkiv city and about half that distance from the frontline of Russia's war against Ukraine, the young teen and his mother rely on overseas aid to pay for his care. "They gave us crutches, a walking frame and also a computer tablet ... But mostly it was financial aid," Yevheniia Mostova, Nazar's mother, said in mid-May of the help she received from aid group the International Rescue Committee. That money is running low, however, after U.S. President Donald Trump ordered a pause in foreign aid in January and froze operations at the U.S. Agency for International Development. "We do not know what to do next," Mostova, 36, told Reuters in Nikopol, a village of small, single-storey homes, surrounded by tidy vegetable gardens. IRC's support was central to Nazar's mental recovery too, she said, after her traumatised son spent weeks unable to communicate. She now worries about paying for Nazar's painkillers and medical creams for his leg following several skin grafts. Groups like IRC that relied on U.S. funding are reeling. Other leading donors, including Britain, are also paring back humanitarian aid as they seek savings to boost defence spending. The impact of these changes on Ukraine is particularly acute. Ukraine was by far the biggest recipient of USAID funds after Russia launched its full-scale invasion in February 2022. According to the agency's now-defunct website, it has provided Ukraine with $2.6 billion in humanitarian aid, $5 billion in development assistance and has paid $30 billion directly into Ukraine's budget since. That has all but stopped. U.S. support had been used to pay salaries of teachers and emergency workers, as well as helping Ukrainians displaced internally and overseas, de-mining and support for local media. The cuts coincide with Trump's lurch towards Russia in the war, leaving Ukraine more exposed than at any time since the early days of the full-scale invasion. Reuters spoke to eight non-governmental groups providing humanitarian services to Ukrainians, from medical aid to evacuations, as the war with Russia grinds into its fourth year. They detailed the turmoil caused by Washington's abrupt withdrawal, and cuts in funds from other countries. Two groups had laid off staff, some employees had taken salary cuts, one group has shut its Kyiv office while another is cutting back operations across Ukraine. All are downsizing significantly as funding slows. "The reduction in U.S. assistance ... has already had a critical impact on our organisation," said Dmytro Sherembei, co-founder of the 100% LIFE group, the largest patient-led organisation in Ukraine for health conditions such as HIV. Ukraine is vulnerable, "not only due to ongoing epidemics of HIV, tuberculosis, and hepatitis, but also because it is a country under active military attack ... financial support is not only vital - it is the only way to save lives," he said. EUROPE HASN'T FILLED THE GAP The Trump administration froze and then cut billions of dollars of foreign aid after taking office on January 20 to align with his "America First" policies. Ukrainian President Volodymyr Zelenskiy appealed to European allies for help, but far from stepping up to fill the gap, they have also cut back humanitarian aid funding. After Trump called for Europe to shoulder more of the burden in NATO, alliance leaders backed the big increase in defence spending that he had demanded - pushing governments to hunt for savings in other areas, such as foreign aid. Britain plans to cut its aid budget to 0.3% of gross national income from 0.5% by 2027. Germany, another of the biggest donors of humanitarian aid to Ukraine, will cut its overall aid budget by almost 10% this year. "NGOs are competing for the same small pots of money available in Ukraine," said Alain Homsy, IRC's Ukraine country director in Kyiv. With frontlines stretching more than 1,000 km, and millions of Ukrainians living under the daily threat of Russian drone, missile and artillery fire, the needs are vast. U.S. funding covered around 30% of coordinated humanitarian funding plans in Ukraine in 2022, 2023 and 2024, says ACAPS, an independent project that analyses global humanitarian activity. By the end of 2024, there were 39 active USAID programmes in Ukraine, with a total budget of $4.28 billion. Just three months later, in late March 2025, only about $1.27 billion of the awards remained active, ACAPS said. Similarly, aid from Europe is declining, from 6.2 billion euros ($7.3 billion) in 2022 to 4.1 billion euros in 2023 and about 3 billion last year, according to Taro Nishikawa, project lead for the Ukraine Support Tracker at the Kiel Institute think-tank. BESIEGED VILLAGES In the village of Morozivka, occupied by Russian forces for almost seven months before being retaken by Ukraine, the oldest among some 400 residents rely on free medicine from IRC. Its mobile doctors come around once a month, bringing medications for ailments including high blood pressure and diabetes. Svitlana Basova, a 56-year-old social worker, could not access treatment during the Russian occupation. More recently, she's had regular check-ups after her joint surgery. "They treat people well, they help us, (give us) medicines and also they help psychologically," she said. The village's nurse, Yuliia Samiha, 34, says the medical support is crucial. "We don't even have a pharmacy," she said. IRC is now reviewing how to allocate its funds. Britain recently halved the budget of a project with IRC and partners to support Ukrainians with job training and safety services, said Homsy. A UK foreign ministry spokesperson said there would be "no let-up" in support for Ukraine, but acknowledged there would be an impact on specific programmes after a recent government spending review. A German government official said Ukraine was a priority, and a fall in overall aid did not necessarily mean funding for Ukraine would fall. The U.S. State Department did not immediately respond to a request for comment. For people in Samiha's small village, the idea of losing the help is hard to contemplate. The nearest hospital is some 20 km away and few of the elderly have access to private cars or any kind of regular public transport. "There are not many other options," she said. (Additional reporting by Olena Harmash in Kyiv and Thomas Escritt in Berlin; Editing by Mike Collett-White and Ros Russell)
