A number of nations have pledged support and willingness to welcome a share of the estimated 4.2 million refugees fleeing the war in Ukraine. A Harvard humanitarian aid expert applauded the efforts but said the goal should be to help these people quickly return home and start to rebuild after hostilities have ended, not resettle in foreign nations.

“The best thing that can happen to them is a cease-fire and some resolution so there’s not active conflict. The next thing after that is repatriation as soon as possible,” said Michael VanRooyen, the J. Stephen Bohan Professor of Emergency Medicine at Harvard Medical School and director of the Harvard Humanitarian Initiative. “There’s nothing like going back home.”

He offered the caveat that any resettlement plans would need to be redrawn if Russia decides to employ nuclear or chemical weapons. Barring that, VanRooyen said during an online event in April sponsored by The Studio of Harvard T.H. Chan School of Public Health that the toughest challenge facing Ukrainians would be rebuilding from the widespread destruction of buildings and infrastructure.

“I would be most afraid of something like Chechnya happening [in Ukraine], just an absolute smashing of every facility, every structure, every civilian institution. That level of blunt warfare is far more damaging and likely compared to say, chemical and nuclear weapons,” said VanRooyen, who is also a professor of global health and population at the Harvard Chan School. “The disruptive nature of war cannot be overstated. War is the great de-developer. It takes a developed nation, like Syria for example, and completely decimates it.”

VanRooyen also discussed the challenges facing relief workers handling the sudden flood of people fleeing Russia’s invasion, saying that their immediate needs are basic. Most are arriving in relatively good health and landing in nations with well-functioning health care systems and robust social safety nets. Their major health needs are mainly medicines and other care for chronic illnesses like diabetes and heart conditions. Beyond that, they need food, money, and access to the internet, so they can keep in touch with family, friends, and extended social networks as well as access bank accounts and other resources.