The current crisis between Russia and Georgia comes after several years of deterioration of relations between the countries. Given the disintegration of the health care systems and poor water and sanitation, there is a strong need for emergency life-saving interventions. The quality and availability of public medical care in Tskhinvali region deteriorated during the war. Policy making is affected during periods of political violence: by conflicting approaches by different agencies, by parallel health systems organised during the war, and by conflicts between international funding agencies and national policy makers; Operational capabilities of the health sector are difficult to establish. In Shida Qartli, policy making capacity, health workers' morale, and mechanisms for resolving conflict seem to have been negatively affected by the conflict and its aftermath.