Battling to protect their patients: how health workers from three Ukrainian hospitals have adapted to working in wartime

“We have not lost hope, we do not give up, we support each other.”

The war in Ukraine has forced Ukrainian health workers to adopt new roles and ways of working and to draw on their ingenuity and dedication to protect and treat their patients.

Infectious disease specialist Olha has returned from treating patients in COVID-19 disease hot spots to a health-care facility in central Ukraine.

It was the plight of a young man caught in blast shockwaves that convinced her to give up her private practice and dedicate herself to those who need her the most. “He lay in the woods for about 3 days. After he was brought in, he didn’t speak for another 3, hiding in his hospital bed with a blanket over his head. We carried out an electrocardiogram, which showed the young man had had a heart attack. The cardiologists couldn’t believe the diagnosis, repeating ‘How is this possible? He is only 22 years old’”.

When Olha advertised her services as an infectious disease specialist on social media, she started receiving up to 150 messages a day for diagnosis and treatment advice for a range of diseases. Some of those contacting her have already fled their homes and moved to central Ukraine, but others are still based in places badly affected by hostilities and cut off from health-care services. She helps them, in person and remotely, interviewing them on the phone and referring them on to other specialists where possible.  

“We have many displaced people coming to the hospital, who have fled from places such as Mariupol, Kharkiv and Chernihiv. I am trying as hard as I can to help them, whatever their condition. The most common cases I see are young children. In bomb shelters, people breathe in fungal spores and if they have chronic illnesses these often get worse. Sometimes, they arrive with protracted illnesses, such as pneumonia, kidney infections and severe allergic reactions. I accept everyone.”

Lidiya is the chief operating officer of a Kyiv hospital. In peacetime, the hospital ran 18 external clinics, but since the hostilities began, all resources have been concentrated in the hospital. Although many staff based in heavily bombarded areas around Kyiv had to evacuate, a core workforce stayed.

“Mostly we’re treating people who are sick with regular illnesses, strokes and heart attacks and those needing acute surgery. They are stabilized here, and then evacuated elsewhere for intensive care and further scheduled operations. Adults and children have also been taken abroad by volunteer organizations for rehabilitation in Italy.”

The switch to emergency work means that some hospitals no longer offer routine services, and those that do have seen a fall in demand.

“People now try as much as possible to go to shelters immediately when the air raid siren goes off, so attending routine consultations is extremely rare, although we have had cases over the last 2 weeks of people coming to us with children for planned vaccinations, because they are worried about their future health.”

To provide continued medical services for those with chronic conditions or new acute symptoms, a website has been created through which patients can connect to a doctor for advice. A chat group, including many long-term patients who have since relocated to other parts of Ukraine has also been set up and currently has over 35 000 members.

Despite the many challenges, staff and volunteers in the hospital are working together and providing moral support to one another. “The staff continue to hold the defence and to work on. Even some of the staff who left want to return and get back to work,” says Lidiya.

Another hospital in Kyiv has been treating adults and children with cardiovascular diseases and despite the Russian military offensive, the whole team has stayed to continue to provide round the clock care. They have switched from conducting planned operations to providing 1 or 2 emergency operations a day.

“All of us, as a team, have gone into emergency mode to be able to provide assistance when needed,” says Andriy, an anaesthetist/resuscitator. “Because movement in the city is difficult, we decided to be here when needed — we almost live here now. At the moment we have around 80% of the number of staff we used to have and are getting by thanks to the assistance of so many organizations and volunteers.”

WHO is working closely with Ukraine’s Ministry of Health and authorities to identify gaps and needs in the country’s health system and is swiftly responding to them. WHO has opened an operations hub in Poland, developed a pipeline of trauma supplies to many Ukrainian cities, and sent more than 100 metric tonnes of medical equipment over the border, to health facilities across the country. To support beleaguered health workers in Ukraine, WHO is also working with partners to organize emergency medical teams and trauma management support.