Help Wanted or War Ambulances

How long does it take for an ambulance to get to the frontline villages? What help can the firstaid points provide and why are military medics treating civilians?

Hromadske journalists went to see what civilian medical care is like in the frontline villages, whilst healthcare reform is being widely discussed in Kyiv.

The plight of the village paramedics. They’ve had no new equipment for 9 years.
- I’ve never refused anyone in medical aid.

Galya comes to us from her house. It’s easy to find, there is an old ‘Moskvich’ car  flipped on its side in the middle of the yard. This woman lives in Vidrodzhennya village which is at the Svitlodarsk Arc. We finally caught her at home: she had been treating someone in Bakhmut for a while.

Galyna has been working as a paramedic in the village of Vidrodzhennya and Roty for eight years. She has around 200 patients. When she goes for treatment, people get their medical care in the nearby village of Myronivskyi, which is 10 km away. There is no public transport to get there. So people have to pay for a taxi. It’s mainly elderly people living off pensions who are left here, so they can’t afford it.

‘We have no medical equipment, only a tonometer and glucometer. We haven’t received any equipment for 9 years’, Galya shows us the first-aid point where she is sees her patients.

It is dark and cold here, although very clean. There is no central heating or hot water. The village council bought an electric heater, which she brings here every day from home, so no one can steal it. There is a examination table covered with a warm blanket, an old table and a few medicine cabinets. In the corner of the room there is long broken air purifier.

‘We have to work in these conditions. I wish everything was better. I wish we had flu medicine, at least. But where can we get it from?’ complains the paramedic.

If someone in Vidrodzhennya or Roty needs first-aid, they call an ambulance from Bakhmut. It takes no less than an hour to get here, because the roads are damaged by the military equipment. Sometimes the ambulance arrives too late.

This is typical for villages on the frontline. In the neighboring Luhansk region, according to the Ministry of Health, residents of three frontline districts (Popasna, Novoaidarsk, Stanytsya Luhanska) have problems with the access to medical services. There is a lack of doctors, many of them were forced to leave because of the hostilities.
‘Donetsk military and civil administration has no information on the medical care in the villages on the frontline’. That’s the response we received to our request.

The hospital on the frontline: how to survive on 900 thousand UAH instead of the 3 million that is really needed?

International organizations help deal with the problems the state can’t solve. They provide hospitals with medicines and equipment.

Yana is from Horlivka. Since the war began, she has been working for the International Committee of the Red Cross in Slovyansk. We met on a day when her team was transporting medicine and cabinets to the Svitlodarsk hospital and dispensary. They headed out from office as early as possible because the road to the town is totally damaged.

‘We help dispensaries treat five chronic diseases. We provide family doctors with the medicines need’, says Yana.

These five diseases are; hypertension, diabetes, asthma, chronic pulmonary disease and coronary heart disease.

‘In war time the attention is usually focused on military medicine, treating the wounded, all the rest just goes on in the background. But there is myriad of chronic diseases, which affect a large percentage of the population. These people always need medicine which they can’t afford’, says Yana.

Currently, about 300,000 people in the frontline zone benefit from the International Committee of the Red Cross’ program. ‘The support is significant’, doctors say. At the same time, they don’t keep silent about state underfunding.

‘This year we asked for $113,000 worth of medicine, reagents and other necessary items. But we only received $34,000 thousand from the state budget’, says Genadii Gurzhyi, chief doctor of Svitlodarsk hospital, where the Red Cross team have just arrived.

This medical institution was severely damaged by shelling in 2014-2015, but doctors continued working in the damaged buildings. The hospital serves not only the town, but also the surrounding villages up to the border with the Luhansk region. Part of the hospital, which is now used by the military, was repaired at public expense. International organizations are helping to repair the rest of it. Operating rooms have already been repaired, and they will be able to perform surgery there soon.

‘If international organizations did not help us, there would be no hope’, says the chief doctor.

Military medic-volunteers also help civilians.

The normal ambulance does stop here. Seeing as we are always here, we help civilians. People often come to us with prescriptions and ask for the medicines they can’t afford..

Yuliya is a volunteer for ASAP Rescue team. They are paramedics who evacuate the wounded from the battlefield. The organization exists on donations from Ukrainians. Besides the Armed Forces (their primary goal), paramedics provide medical care to civilians from the villagers on the frontline every day. We caught them in Kurdyumivka, near Horlivka. They come here once a week.

Once the ASAP Rescue car arrives at the first aid point, people start coming. Most of them are pensioners and woman with young children. The line is usually long, but Yuliya carefully examines each patient – checks their heart, measures blood pressure, examines the symptoms. No one leaves without medicine, which she looks for carefully inside the big box they brought. 
Despite the fact that Tanya works in the Kurdyumivka dispensary, she is also patient. She has the flu. Here, the woman receive the necessary medicines and a sedative. Sedatives are in high demand here. It was relatively quiet before the latest round of shelling began. Kurdyumivka is quite close to Mayorsk, which is the last village before the non-controlled territory.

‘One guy was killed because of the recent shelling in Kurdyumivka and the ambulance didn’t arrive’, says Tanya.

Ordinary ambulances don’t usually get here because of the risk of shelling and the bad roads, which even ASAP military transport finds difficult to drive on. For medical care, people have go to Toretsk or Bakhmut, which quite far away. In addition, there are no pharmacies in the village; the last one was closed in Soviet times. ‘It would be quite difficult for us here without the help of paramedics’, people say.
Meanwhile, the health care reform, which intends to make medical care effective and affordable, is being widely discussed in Kyiv. People on the frontline continue living from day-to-day in the hope that ambulances will be able to get to them and that they receive the medicine they need.
/Anastasia Kanareva, Bogdan Kinashchuk
/Translated by Olga Kuchmagra