A surgery of a soldier wounded near Mariinka in summer 2016 Photo from the Facebook page of Sergiy Ryzhenko, the Head doctor of the Mechnikov Hospital
After more than two years of the war in the east of Ukraine, which is still officially called the Anti-Terrorist Operation, walking on the streets of Kyiv, Lviv or Odesa, one would not notice that there is a war in this country. However, there is a place in peaceful Dnipro (formerly known as Dnipropetrovsk) where the feeling of war is still very real.
The city is located 250 kilometers from the frontline. In early 2014, there were fears that war would also come to the eastern city of Dnipro, as it had been threatened along with Donetsk and Luhansk. Thankfully, war did not come to Dnipro, and the city has become only more united.
The heroic 2014
The Mechnikov Clinical Regional Hospital became a center of volunteer movement of Dnipro, and its doctors heroically responded to the first hits of this war. Many wounded soldiers have gone directly to this hospital.
The effects of war hit the Dnipro hospital in spring 2014.
“It happened on May 10. There were three injured. They had quite serious bullets wounds. We were told that an Anti-Terrorist Operation is being completed. The war has not been declared yet, but during these two years there were 560 wounded who came only through our department,” says Ihor Yovenko, Deputy head of the Department Of Intensive Treatment Of Polytrauma.
The hospital has experienced critical situations before, treating victims of a gas explosion, a train crash, and a terrorist attack.
But even these experienced doctors were shocked by the cases they began to see in 2014. That is what Yuriy Skrebets, Deputy medical chief doctor of the hospital, remembers from the first month of the war:
“Someone had a severed leg, it was attached by Scotch tape.Where could they put the leg? Well, they couldn’t leave it on the battlefield. But the person was alive. It was just terrible to see it. We were not used to this.”
Until nowadays, the hospital feels all the escalations, “boilers” (when the soldiers are locked in some area by the enemy) and calm periods.
The military volunteers in the Mechnikov Hospital found huge support from the civil volunteers who organized their headquarters in the hospital. They raised money, collected the essentials, and most importantly, bought medicine. Moreover, the headquarters helped people to find their missing relatives among soldiers.
“We did not know what would happen next. Before the soldiers from Ilovaisk arrived, we were outside the hospital all night, waiting. Then helicopters started to bring them,”
Olena Bohach, one of the volunteers who organized volunteers shifts to take care of the soldiers, told. She was in charge of selecting volunteers; back then she used to receive up to 300 calls a day from people who wanted to come and help.
The doctors of the hospital had to quickly adapt to the situation and learn the details of treating types of injuries they were not used to:
“We had to learn the details treating gunshot wounds on the run. In Ukraine, there has been no military surgery for a long time. There was a lot of information on it in English. Later, with the help of foreign colleagues, it was translated to Ukrainian and we learned to treat the injured soldiers. We also started to develop our own protocols and share it among colleagues who needed it,” says Igor Yovenko.
Common people, Dnipro entrepreneurs, the Oblast Council, and foreign funds also contributed resources to the hospital. Their help was crucial but not sufficient for wartime.
The long-lasting war as seen by the hospital
Over more than two years of war, the hospital has treated injuries of over 2,000 people. According to Yuriy Skrebets, 98.5% of them survived. Now, only soldiers with the most serious wounds are taken to the Mechnikov Hospital in Dnipro, as military medicine started to improve after 2014, and there is a network of mobile hospitals on the frontline. After treatment in the Mechnikov Hospital, soldiers go to military hospitals elsewhere to receive further rehabilitation.
In the worst moments of war, as well as in the calm periods, there have also been civilian patients at the hospital. The doctors manage to offer the same amount of care to everybody who comes to them. Ihor Yovenko says:
“We do not divide our patients. Sometimes we have very unusual cases. There were people who were hurt trying to commit suicide, there were people who violated the law, and we treat everybody according to common rules.
We see people who were wounded because of the war. I know for sure that some people who belong to the enemy’s camp were treated in our hospital. And even they were not questioned. They received the help they needed and continued their lives.
We had civilians who were injured in tragic situations. There was an old woman who saw her family die as their house was hit by a shell. There were people who were held in dungeons and tortured.
Our main task is medicine. Outside the hospital, we all hold our own opinions.”
The doctor Yuriy Skrebets already wanted to go to the front line in April 2014, as he realized where the situation was headed after Crimea’s annexation. However, because of his position in the hospital, he had been obliged to continue working. When the volunteer battalions were formed, he joined the medical battalion Hospitaliers, which was created within the Right Sector, and started to go to the East in his free time.
His opinions on Russia have always been clear:
“My father was born in a concentration camp. My grandfather used to sit in prison because of political motives. What is Russia? It is an artificially entity, many countries which were under the rule of the one big empire. This empire was a pure dictatorship.”
Yuriy experienced the war firsthand. He was hit twice: a neck wound and blast injury. He was awarded the Order for Courage.
When asked why he joined the Right Sector, he replied: “I did not choose it. It chose me. Dmytro [Yarosh] asked me and I did it.”
Dmytro Yarosh, the former leader of the Right Sector, also has been a patient of the Mechnikov Hospital. He spent about four months there in 2015. Yuriy describes him as an intelligent, moderate and prudent person, and recalls the Right Sector leader arrival to the hospital after a shell injury with sadness.
Talking about his own injuries, Yuriy becomes more pragmatic:
“Kyivoblenergo, Dniprooblenergo [energy companies] belong to [Ukrainian oligarch Rinat] Akhmetov. I paid for my shrapnel,” he says, showing a wound near his chin, “and broken teeth. I regularly pay for light, for gas, for energy supplies. And the mine that hit me was bought with this money. And then they bought another one which hit me in Avdiivka. I can’t complain. I bought the weapons which hit me myself. Several oblasts belong to Akhmetov. TV channels. The 34th [Dnipropetrovsk Oblast local channel] is choking with information how they [Akhmetov’s fund] helped one old lady to bury her husband, or someone else. They brought pearl barley and sugar to occupied territories. And everybody thanks them. Thank them for the weapons which are used. Or do you think it is Russia? Russia will not buy them. They have their own oligarchs.”
Yuriy, along with all the people I talked to in the hospital, initially did not realize how long the war would last. Even into its third year, they still do not receive needed support from the state for treating soldiers.
To survive with lack of means
Though state support was directed to military medicine from the start of the war, it doesn’t fully cover the needs of the Mechnikov hospital, which is in charge of treating the bulk of wounded soldiers from the frontline.
As Igor Yovenko tells, neither the number of employees nor their salaries have increased; only now they have more time sheets and a greater need for equipment.
“Despite the fact that the department was created to help six patients simultaneously, eight to ten people are always being treated here. All the intensive care units of the Mechnikov Hospital work like that,” says Ihor.
According to him, the equipment was kept in a good condition due to the efforts of the administration of the hospital, but adds that medical equipment needs to be updated:
“I do not think that somebody has a freezer at home which works for 10 years. And nobody uses a mobile phone for 10 years.”
During the last two years, the equipment stock has been partially replaced. According to Yuriy Skrebets, this is mostly thanks to the help of the Dnipropetrovsk Oblast authorities and volunteers.
There is state funding for building maintenance and salaries, but it does not extend much beyond this.
It is impossible to calculate how much the hospital needs for treating one soldier, as each one has different needs. Yuriy says that sometimes one soldier needs only one dose of a medication which costs 35-40 thousand UAH ($1,390-1,590).Recently, the Dnipropetrovsk Oblast Council allocated UAH 3 mn ($119,070) for wounded soldiers.
“3-4 months of antibiotics cost us UAH 3mn. Moreover, we cannot use these funds now because they have to go through the program for tender purchases Prozorro. After that, we should demonstrate that we will use this medication for the wounded. But what if the wounded will then need other medications? We change antibiotics once every two years,” explains Yuriy. But according to him, bureaucracy in the medicine field is not only a problem in Ukraine.
Here in the Mechnikov Hospital, another system exists to provide help to the soldiers:
“It is based on personal contacts and common understanding that we are not able to do this alone. Without any agreements, laws and decrees, we decide who will treat whom, where, and how,” says Yuriy.
Since the beginning of the war, the diaspora and friends of Ukraine from the USA, Italy, Lithuania, Latvia, Germany, Israel, the Vatican, and beyond have contributed their help to the hospital.
“The Center for Help to the Wounded, which was created independently, provided the soldiers with everything they needed,” says Yuriy.
Ihor Yovenko also recognizes that, if there was no help from volunteers, it would be impossible to carry out many tasks.
The Volunteer Center still works in the Mechnikov Hospital. Its coordinator, Viktoriya Pavlova, is a doctor who works in another clinic, but she comes to volunteer in the Mechnikov Hospital almost every day since July 2014.
Volunteers, like an army of guardian angels, have taken care of the injured for a long time. Now, they have experienced a significant decrease in the number of volunteers. According to Viktoriya, the last wave of activity was seen in winter 2015, during the battles for Debaltseve. In Summer 2015, everything came to a halt.
Viktoriya says that, during these two years, she has changed. Often she faces old friends who do not understand her work. Now, the people around her are mostly soldiers, who became friends, or even like family to her. Some of them return to the Mechnikov Hospital a few times, and many died on the front line.
Now there are only three permanent volunteers in the hospital: Viktoriya, Oksana, and Olena. They explain the decrease in the number of volunteers as overall weariness of this war. They also recognize that there were moments they were going to quit themselves, as mentally they were too exhausted. However, they cannot do it because of the feeling of responsibility for the patients they care for.
“This whole time, from month to month, everybody thought that [the war] would end. It is scary to think that it has lasted three years already,” Viktoriya says.
Only recently the volunteers started to think of receiving some funding for their work.
The volunteers remain the first whom the doctors will go to for help: “It can be shavers, napkins or expensive medicine [for the soldiers],” Viktoriya explains. She says they have no trouble getting these things because they have developed a network of support over the past two years. The only problem is collecting the finances for it.
Even during the interview, Viktoriya answered calls and organized the delivery of water donated to the hospital by a company. While she took the calls, her colleagues continued the conversation, becoming very emotional talking about the soldiers.
Oksana quotes the Facebook post of a soldier who was describing how it is to come back from war to society which does not notice a real war is being fought: “They say, why do you disrupt our environment? But it’s okay, we will rehabilitate you…You will become normal like us, or go to war and we will sit and drink smoothies.”
Oksana goes on with her own thoughts:
“What should they be rehabilitated from? From not calling things by their real names? If there was understanding in our society and it was acknowledged that we are at war, maybe they would not need this rehabilitation.”
Ihor Yovenko recognizes that it has become mentally harder for him too:
“We often see men and women die, or receive crippling wounds. Common workers who should live peaceful lives, not be involved in a military conflict. It is an anomaly that in the 21st century there is a war in the center of Europe, and people are dying because of it.”
Even in Dnipro, the war can slightly be noticed outside the hospital. However, the question of why this city does not share the fate of Donetsk and Luhansk still remains unknown.
Breakdown of Russian plans in Dnipro
In Spring 2014, when pro-Russian protests were organized in Donetsk and Luhansk, there were similar attempts in Kharkiv, Dnipro, Odesa, and Zaporizhzhia, but they failed. In the summer of 2014 there were also rumors that Russian President Vladimir Putin was planning to attack Dnipro. But in the end, this did not happen.
Viktoriya thinks that the fear of 2014 helped people in Dnipro unite their efforts:
“Some people did not know where the occupants would stop. There was an understanding that everybody has to be mobilized.”
Yuriy Skrebets is confident if three to four thousand participants of the pro-Russian protests in Donetsk and Luhansk were suppressed, there would be no occupation there either.
However, in his opinion, Dnipro is free because for other reasons, as well:
“Zaporizhzian Kozaks and Hetmanate used to be here. Ukraine did not have its statehood for centuries. There was a short moment when Zaporizhzhian Kozaks had it. It was here. In Zaporizhzhia, Ukrainian statehood was preserved during the times of Bohdan Khmelnytsky. This is Ukraine.”
Nonetheless, Yuriy was prepared for Russian forces to move toward Dnipro. He says that the huge resistance in the city helped deter the aggressor.
Now Viktoriya recognizes that, after two years, people feel no fear being even 250 kilometers from war. However, another reason for becoming less active is that now certain obligations are expected from the state.
Yuriy also says that he does not feel the same emotions he felt at the beginning:
“A person should live, work effectively, and help others. The shock wears off after the first month. I do not feel the emotions which I was feeling after first 20-30 wounded.”
Despite his conclusion, it is hard to not notice emotions when he speaks about injured soldiers or remembers the time when Dmytro Yarosh was being treated in the hospital.
Outside of the hospital, the sun still shone. Busy people walked the streets. The doctors and volunteers of the Mechnikov Hospital continued their work too, pushing on through the never-ending need for funding and resources.