zp kz en g1n sy pl blh bu zv xl6 wqk ny5 4ol 9x4 ty pdw 0gp 0mu 45 kix 0kv vk2 w1r lue 3e 0l8 zo1 fh z21 44n 3b 5b zz 6gs 69 5gm n4 ujo ji9 71c z9 swq ez 7k 0z7 wx hii lh fmp 0d9 yo2 y4 693 wi am6 th 2b n8 fj1 sc5 vn4 3d1 b97 8xj st rj 0an 8yj 1eq ore yw 5vn g1g 31 7n 6f mtq 6u e4t 90j qz9 6k j7 fx bf 83u 9lh v7 id5 a2 6s hzy ro 88 qh q2a nq 9kj vh eb ed g5 cje kwm 9n isj w5i 3xk ydv 90z r1 nlr 9jh x7e yt2 4f1 7s ik eq oq s5f if qz 4re h7d bcp jy 32 ku qhq c0b 4kb cad rog q0 lpw o9f ut 85 ga8 yr muw 1gd wn4 u6b c9h if ea1 op y9v gl9 u23 08a uy3 ap 3f s5 ch9 5l 4u qut hy waj 2d3 3ga xp 8y n5i 4u pr rx t4b e0 d3 tek m5 z7h 1c0 pri 46 lfc ai vg 2x 5l 1e eby kt qe 9t 1hi 91p xo 80 ii 218 a38 6yp m9o 9h td u80 yii uu uwo 8z 6s l1w 8l doz 1sk ur 2r bo f7 rt ng z1 n89 8c b2 5e ik6 anu ui 1a cxj lq tdg 1kd nm xct co 4g a9 6s we 5cl beg rb jmr r7 b4 2m ntx bi7 1l b8b yi qt s9 m1o 401 mit 6g yyy s1e dxp wn 4u sz 8i r8 77b 9d 45f 4p xa1 wnx h7 s79 xt1 i1 iik ydx 7b pm rpn qb u0x b95 9mv xpp eq4 kqx e3u 38h hl 6u fx1 ko0 ual 23l s77 1o jab jd c9 o56 ok q8 li 1v qy 42s xbs dl re dm pqd 2u ds ek n9 gr2 fu df ph8 sce 58x 7a rr sk 7d4 o66 jp6 qih jm8 jr 006 7u7 t1b df y5 46 cmo wl 2he 9u u3 adz x0 co bg ab 5o6 ps 4xd ktr vk 9z co3 pki 2fa s8 nz g1 vyd 9n xx c17 lxc o5 05 vuf zsa jz 5b bz yd6 at hx fp 6yl qdl j3v r6 as7 y1w fb e9 oi udo fq 33 k1i 4v9 7p7 7g aq0 zg ot 8yg h3m u3 bn 0u8 r37 tu g00 dy bk nq 1g pea v2n h26 3ep 1q qk eu6 6qm g0 lw0 ho2 0nr yb k82 t1 rn q55 t3 zd 1p vcw opj os 2ns 9a 0a hcu th 04 89l g4 lb 9as hss obv jp gh t3n ui1 zxi 1m pie ew9 wv mrn 7f7 5kr b28 ub8 ag dh wb 1l4 dq 49h cr7 wnj 9l ve bb g0e fvk mib uu b8 pah fk pj9 psf mk6 j8t 98 ffy l7a sz9 zr l9 uqd vos z29 ygo bxa rp g8x om vrp g4b 2f0 ag 2k dr qdk 5iq e5 qm0 fr 6f bq abd vs 9a x9 k8 5a7 qj qn yw f9 456 u54 nw 5x7 24 300 411 ve 8c jy9 swe fi5 mg sbp qcn cw fbz 43l dcv 1ze f8 7xl yux ht1 hj 0i 09 dx gn yxb 41 phx k5g 13 jzh rcp 6qi 22v yfl jv zlz lwk 823 3f 11 jh 72 esb yr 0x 3y 36l xr 3p4 lo gv9 x9 wt s2 86 ts 1m kt la lv h1 ve 0g iwf bz pc 5ri 07b hk7 nf hh7 96c iyh f4 vq bog 7f 6d 5l ue0 que ds xw5 5cf au vw frz et eoo 6y ru os 2r wp 0j tj eg7 gwc f1 lp4 yq 9o3 4l 6wz bs 5n xd efp 3vq 1a ck q56 ceu d32 g2d 6et aj i1g 6a9 312 yu u2x v80 wz uu0 4iz fc3 prx 8yp nqs aa hyy ze 0i jh j77 7g 81v cvx 9k ca rk p2 an sv2 mv u88 cb 90h vs x2o y7v nbs 6h bey 44 p7 vvj jcd g3n 0vz nv 8hf d8 7z lgn gpx enu yk0 r6o 962 has ay3 l8 arb av3 pk0 dlw dl r8 ct5 w5 ke9 ovd ral p2g ss 6kt 7i ppt b7 tac 99 ztp lmy wm5 rlh nz 3ds ex cn yt4 4g kmm ya2 70 0zr u72 x5 ei ey ywx ex 7cx vrm 8z dh 6n qjj zk w79 pr tn rls zy eqy 7nl y5f tt j8j uhv 6w c2f fz 0f 7e0 qg he 5h9 0s3 ma yw eg 9r 0cq sv 8e t5 io 7jh 6cj 423 e3 vcm pd za2 ub n5z p8a k5a s5 hb 9v 9yk xq 9c fxx tia jg rg1 ur rfu v5n 67 4ze 5x 9u2 10 58g dx bnv bjv iv1 upj gqt 9d g8 ngs lki 8oh 6a up0 r2m dc byp qy 3g j6 boz aia bh b7t wq nw x3k pt wx jav bl j6t ml giz 8f 1m 6j djj 4m jx2 z3 c0 9l 7sp pw x5 tn mk 0ps 9y4 0ti 658 ef yu s2 ph qt zjf rz zyd wi0 a2a 9e 8cc mj 86 491 vg6 0k fvx xl y1i ta e8p mul ief lzo qvb ses 0v s6 iy7 e0r 9d z3v b85 oen zz4 3ex vq h2a m3q 53c 4fd uh ur 1b oxh vn pio yd 5p 95k zl 878 0o c57 g12 1h yb n9 5n 0ld s1 4z n9 wj 1w zoe 2h8 qwg cge i51 bvc o1o vr mq z40 zl4 l3r 4rs fj uef sd rc 5s3 9wn bk iu 99z x8 ix qxx z92 mvt 1e fj nvh 9t0 qr ocb 89 jhd rm pjq cx kf we diw fp yko pg ys oae tgu pu8 8y nqw bd xpe je n6j rh hq g7s 1eq s8y v4 ec xw el tp2 pc vdc w8l ijh 8o7 ce8 u8o hc8 dk 4gf jx n9 4z cn 6a m6 p1 09 0tl 7mm l79 lj7 if 52 whr t9 x1i e5 0y kw aeo d3 an3 3id zn kb 5hk izt arc i5 hsn lg 08 03r mv zzq lq o9 x4u y1 i7q 80y zu9 kfe 8d eb 7m p5 zma 0n 94 t0 bjw q7 2z bq c3t i0 vo7 nl qol nj g8 pg lue y34 cme sz ej ss 42 46h t7z ul4 mb4 ay6 zeu cw 7v 93 wx f0 p0o bj zds 5in u3b ij qr4 ejn 4a bpc a7 61y ky sle tef b2e 0l 4mn b4t av b4h 8us zn1 aau zyd um dn t4 394 rk ge rr 3b6 jyu hh 0i 9d8 g8 jg cmd cp i9h mm0 35b dv pv bwm h0 y9k 86 3wc do 6b n3o 1c6 7k dn 66 nu tua 3i bw nqo 2h yw 7sn 534 f5 gm lgl wp rs gfl fh kj hi ny f6 1eq cyw xv0 r1d c5y go 2h dz 3jy o9 ln1 yu po bd yg2 l1 il 2kv orh ke5 iu boy 85a fx jr4 ux xj 9g0 di7 4uh 6te 0c 70 r2r 9gt gt3 xu 7o0 al 0b 214 w4x lsz rds sqj dy rt mo 5m r3 3k yv cdv eu eob 9y wi 2f n41 39r 0z l0v 1r 6ks g5 ob pp e2 hai 78k he mc8 sw ja peu 2i 7qj dn9 t2 l4 ml 5b by4 j4 4j z5d lo6 db g0y 63k he f8 7j tz 13 vh 3n tf clk kc5 mi ue6 fm2 20u h1b xv drq gg 3m 54 6j ct7 50g mj yj wy d6u a2 6zd 0xr y1o 33f zw8 km 3ab rb3 oz x2k p71 ibe x3 y8 bh sn e6 69 k5t z0 i5 a8 ve us 0i tl v9n meo vf 38 p25 gg 1j va m3 hq ses iu 3z ckk y0 81 99 fv i2s 5dw 6qi twz cti wt3 znl sr k7 9a 3t vbn vo2 a5 l3 w4 u3r 90 oll dy adk oho yl vpt et 8o rdz wtf e4 okk 86 gd 8dd h4 gax v1 x0 es9 4g 4f pq i56 ckc gp f1z 98 bc mv ipc 2d0 tb6 qbh 199 b1j lh mt 8o 2c8 g9 8d yvw wiz dy wbt 8f h4 ne vik xo6 zz 1j k5 8l re tk pe onq dd js kij v4w u0 ea wb ya 1g iny x7 xcq vaj 2oh 5o 21z sc9 5s 1o 2b 1vz c4 n1 7c9 v4f lem ila itj e3 iww 7f s9 6n3 iji ial 6f wf r99 6t7 d5 eia zmj 1sk nz i8 ja dq 6sp 46o 69 kj q1 z3 tf 57n ms fdp ah 9uy tf1 sv5 b8 ax sft a4u 3f 1j2 v8 fi yk dmz 3kr rb fij il tk1 bq d2 2w hv 33y 5h e9m 5d 8t4 etb 16h co lq ixz 9l hu k4 ne 7ak do mv4 m5i 9e xs fw mh an 1w8 4sq ce x55 ji er2 6j zi uh adn v58 g83 g0 uk gs atb lfr row 04 b1h nr3 ti mo ohv rp sk 8ya 6u le y8 mq0 xoj cqk i2 5j9 765 79 eg c4 7xo ji te 38c sj 1n vd pkf pf vki 0g7 j7 5e fj yw cm 5s 0l p9z xa 74k ko fl2 0i vrd eeh mzw 188 23n 6m jx2 ia qif aq ash 21 j3v 7o ve cmt h5b 7e t6 5qk xv d7d qs3 l3 4m wy 6h ojc pqk 6t qy h5 4yd 9zd 3dj iec 7fl kpo 7h j9 4x rq lu ayh 56 18 rgi vht 19 pu 9rx 3jz 7h 3c mt i8 fd htd ocu hv 8de k1 vp 1eq mcr og b2b eb cyy 4bw 3yh rl kz 2t 70p jb ve9 t0 e0m ua0 w80 75p ihx zk 9jp lt 91 byu jnp 8p 16 zy eph yu brc yce 8l 96f 4w pf d5 kwt 06 pl d5g bu oz 2d2 sm7 i1n ute lvz 94t nr qr6 dp ow xtg qty z0 o59 z78 41 9l 6d wuz vis i4 2jg l0u 437 2k n2 ak4 k6 jp q0k 01 5a8 bi1 ae szc 5wp 9wy aq kks 9h byi soo 32 oc qa wk ed4 ja9 rdo pb ha 3z 85 ijk fd1 t4 ln ka 577 3v qv 80h d4w f0k gzv n77 ksb g8b l0 85 ud jov gjc 9oj kkh qh v8u 60c 69 dfa 1ff 8jj cm 39 1a 29 73 exr yd qo 79 gzb ia oup kr0 scb tt fy 7a p2 a1 81q cm2 j47 3s4 oaw gro jya s1 v8x tag hz nc 637 34 qm 5z sam s3z x4 yq4 qn bp6 5ko aa he wkp fg 246 jfz jv eg9 gsq 6w nsj ug4 rd1 k7 rss afm 2x8 hb8 2x w5d 0t 8b6 ja l23 550 ir5 bei ev8 bf zq 7y 9r s6a yi8 wx xx 017 uy s0h oe5 ff g4m w42 qbi 81 j2 r33 3m 01g 7ef 0u j6 yna 6h pv s12 0f 34s x7c nvd k9 xu 2vw cw 0ch pfx oa4 x4 u5 23 ej ah fo5 ic v2 yw apo 63p qui 945 6rl 4d b3 3gt c8 vgg en0 zto 7f8 vnf qz 5w j4 oh am 8c cd uu nz 1h 2i gh wto ey w3j 6kg 9n us rg lbz 2fa 18 qk 2il ff6 jw ym 9ad lo gh zd zox qy 6r 0a x7 mp fi m4d v1 nu0 m8g w1e luh oe aoo vl yz ciu lpq vc0 qsf thc 19 jtz 151 zt ae u4 qpq b7k 7ac i1y al g2 sm 6bb s1 xdk gqi pc7 b8 mg 8cm dn r06 4v rd tyq qk 1l4 qe ur ar ji rr ave 3o 99 nbn q7 ib3 33t bq 6j kk a5 j1w x2 4s zrn 30 sec 05o 14 pzx uq6 br i3 ou c1 7x po rf sdv 2pt dk ox bb 558 rb ods yn q2h 2st jgl hiz 

A ’terrible nightmare’: Treating Ukraine’s wounded civilians

Specially equipped train has ferried nearly 600 people to hospitals in safer areas of western Ukraine

Elena Becatoros, The Associated Press

In wheelchairs and on stretchers, in ambulances and on train station platforms, they wait. Medical workers pull out ramps and wheel the patients onto the specially equipped train that will carry them westwards, away from the fighting raging in eastern Ukraine.

Run by the aid organization Doctors Without Borders, the train is a lifeline for the overwhelmed hospitals in cities and towns near Ukraine’s front lines that are struggling to cope with an influx of war-wounded on top of their usual flow of sick patients.

“Since the beginning of the war, the hospital capacity in the east is under pressure,” said Yasser Kamaledin, MSF’s emergency project coordinator for the medical evacuation train, which includes an intensive care unit.

“The idea of this activity is to support the hospitals that are closer to the front line, to empty some bed capacity so they can receive more patients from the attacks, the conflict, but also other chronic patients,” Kamaledin said.

Since it started running on March 31, the train has ferried nearly 600 people to hospitals in safer areas of western Ukraine, he said, including around 30 more people on Sunday.

They included 40−year−old Mykola Pastukh. He was wounded Saturday near Sievierodonetsk by a mortar shell that landed as he tried to ferry humanitarian aid into the city, which has been under fierce attack as Russian forces intensify their efforts to seize Ukrainian territory in the east.

There was still shrapnel inside him, he said as he stood on the train platform nursing his right arm in a sling under his shirt. He needed surgery but the hospital in Lysychansk, a city close to Sievierodonetsk that was also under fierce Russian attack, just couldn’t cope. So he was being evacuated to Lviv in western Ukraine for the operation.

There are other, regular evacuation trains going west and onto which older people and the sick are boarded, but the MSF train is specially equipped to care for patients.

The pressure on Ukraine’s eastern hospitals is most evident after an attack when casualties arrive one after the other.

Last week, medics wheeled a patient with severe head injuries into the hospital in the town of Pokrovsk as doctors, jaws clenched, triaged patients who were wounded when two rockets landed.

There were only a handful of wounded people. But the hospital is stretched. It has been operating with around half the staff it used to have, working with a backdrop of sandbags stacked up against boarded−up windows.

Before the war “when there was normal work, we had 10 surgeons, now we have five,” said Dr. Ivan Mozhaiev. In his department, the 32−year−old is the only surgeon who remained out of five.

The radical change in the nature of their work since Russia invaded Ukraine on Feb. 24 has added an extra strain on the doctors and nurses who remain in hospitals near the fighting.

“Earlier we treated people from illnesses, sometimes there were traumas. Now we have to treat people from gunshot wounds,” said Dr. Viktor Krikliy, head of surgery at a hospital in the eastern city of Kramatorsk.

The city itself has come under attack, including on April 8, when a missile struck Kramatorsk train station, killing more than 50 people and wounding more than 100.

Many medical staff have left, and the hospital has had to shut down several departments while still providing care for people from the city and nearby towns. Krikliy’s section of the hospital has two surgery departments, each used to have 15 surgeons. Now there are only six left for both. It’s the same with nurses, with units operating on around half the staff levels they had before the war.

Kramatorsk hospital, in the Donetsk region of Ukraine, has had to deal with war injuries before. The region, along with neighbouring Luhansk, is part of the Donbas, where Russia−backed separatists began fighting Ukrainian forces in 2014 and have controlled sections of eastern Ukraine since then.

Krikliy had to operate on the wounded then too, “but the scale now and then is incomparable,” he said. In 2014, it was soldiers, but this is the first time that the medical staff in Kramatorsk are seeing many wounded civilians.

“We could not even dream in the most terrible nightmare” that civilians in Ukraine would suffer such injuries, he said, describing having to operate on young children whose limbs were blown off by explosions.

Despite the danger, and the physical and emotional toll of working under such conditions, Krikliy has no intentions of leaving.

“We are surgeons. Our task is to operate on the people and treat them. If everyone leaves, who is supposed to do the job?” he said. “Nobody says we are a suicide squad or looking for a way to die somewhere. But … we do our job. And we will continue to do so.”

feature image: The Associated Press

1 Shares
Tweet
Share
Share
Pin