Press play to listen to this article
Voiced by artificial intelligence.
Kris Parker is a freelance journalist currently covering Ukraine. Her work has been published in media outlets such as Nation, OpenDemocracy and Euromaidan Press.
ZAPORIZZHIA—Every day brings new challenges for Mykhailo Danilyuk. The 34-year-old surgeon has been operating on injured patients since the start of Russia’s invasion of Ukraine, dividing his time between three hospitals.
“Today we only had 10 soldiers and 20 civilians. Yesterday, we had 48 soldiers and 40 civilians. And I don’t know what tomorrow brings,” he said during a cigarette break in front of hospital number five in Zaporizhzhia.
“The only reason we’re still alive is because the volunteers are helping us with materials.”
The Russian invasion sparked a widespread outpouring of international support for Ukraine, with governments, nonprofits and volunteers rushing to help the struggling nation as Ukrainian society quickly mobilized to defend itself .
Of course, as hospitals responded, one of the biggest challenges was ensuring they had the necessary supplies. But today, after more than 18 months of war – during which one in ten hospitals has been attacked – some volunteers and health workers are increasingly concerned that donor fatigue, combined with complications from supply, threatens the ability to procure essential supplies in some countries. frontline hospitals.
And in war-ravaged Zaporizhzhia, just 25 kilometers from the front line, exhausted doctors and volunteers are sounding the alarm.
With a population of 750,000 as of February 24, 2022, the city is currently home to approximately 500,000 people, including thousands displaced by war. On more intense days, the sound of explosions can be heard from the front. On the worst days, explosions take place in the city. And as Ukraine’s summer counteroffensive advances along the Zaporizhzhia front, local hospitals are trying to handle the influx of civilians and wounded soldiers.
“We have a lot of injuries right now, and they just keep coming,” Danilyuk said. “This is why we need more permanent support, but our government is working very slowly. »
When the injured arrive, they may find themselves in physical conditions that are difficult to imagine. “This is an example of what I consider difficult surgery,” Danilyuk explained before showing me a photo in which a soldier looks more like a bloody jellyfish below the waist.
“In a 24-hour work day, I usually do at least five surgeries, but my record is 12, not including minor soft tissue injuries,” he said. “But we usually have about five that are this complicated every day.”
The intensity of the fighting resulted in a torrent of horribly injured soldiers and civilians and, consequently, a relatively high consumption of medicines and medical supplies. Ukraine does not publish casualty data, although a recent estimate puts the combined toll at nearly 500,000 people.
Currently, public hospitals overseen by Ukraine’s Ministry of Health are legally required to procure supplies through ProZorro, a digital platform designed to encourage competition among medical providers and transparency for the public. To order supplies, doctors tell their hospital’s medical director what they need, the directors then submit a proposal to the city government, which then puts out a request for proposals. Even when everything goes well, it can take two weeks for orders to be delivered. Sometimes it takes longer.
“An order took six months to arrive,” Danilyuk said. “When the wounded come in, as they are today, as they did yesterday and as they will tomorrow, we constantly need to resupply. And if we’re short on a specific item, it’s much quicker to call a volunteer and tell them what we’re missing. I would say 90 percent of what I use comes from volunteers.
Under normal circumstances, hospitals attempt to order equipment in large quantities, but the intensity of the fighting and the large number of casualties can make it difficult to estimate future needs.
“There have also been situations when the national drug catalog does not include the necessary drugs,” said Yatsun Evgen, chief traumatologist and head of the department of Hospital Five.
“Formally, with the help the government gives us, we can take a limited number of patients, carry out simple procedures and that’s it. Anything that requires complex assistance, such as serious surgical interventions, specialized treatment, rehabilitation, that’s where volunteers come in,” explained Evgen. “The government gives us the essentials, everything else comes from volunteers.”
Serhiy Malyshev, a 45-year-old ophthalmologist, is a leading figure in the Zaporizhzhia volunteer network, which helps procure medical supplies. He and a team of 35 work from his eye clinic and a warehouse to support area clinics and hospitals, regularly delivering products to 22 of them. “In the beginning we had more help, more deliveries and more donors for supplies. But now only one or two actually continue this work,” Malyshev explained. “People are tired, or they are living with higher fuel or gas prices and think that maybe now is not the time to help Ukrainians. But something has to change,” he said.
Malyshev and his team helped deliver medical supplies worth over €150,000 from abroad. A truckload of Dutch supporters worth €26,000 arrived in July. At the time of writing, no other major donations had been pledged since April.
In addition to seeking donations, Malyshev and his colleagues also independently produced tourniquets, insect repellents and more than 14,000 hemostatic bandages for hospitals and the military. The hemostatic bandages are made using a patent donated by Andriy Kravchenko, a respected scientist who died in combat in April 2022.
“We have been communicating with Serhiy and his team since the beginning of the war,” said Ihor Belkin, 39, head of the surgical department at the Orikhiv regional hospital, close to the current main axis of the counter-offensive. The hospital was hit by artillery fire and the town is under constant attack.
“The first problem is that the government is not providing what we need quickly enough. The second problem is that medicines and equipment pass through Lviv, kyiv and Dnipro. By the time they reach us, maybe 1 percent of these goods are left,” Danilyuk explained. “We are a front-line hospital; I don’t have time to track these deliveries, but the volunteers can.
Despite the critical need for medical supplies at the front, another sad reality of war is that equipment goes missing. “I have heard many stories of the theft of humanitarian aid,” said Dr. Andriy Nykonenko, a colleague of Malyshev based in western Ukraine. “For me it is incomprehensible and shameful that people can do such things when there is a war and people are dying. But I have heard many, many stories.
To ensure transparency, Malyshev and Nykonenko document all supplies and deliveries. “It is very important to maintain the trust of donors abroad,” Malyshev explained. “Without them, we would be in a much worse situation. »
And with the counter-offensive underway, the pace of fighting shows no signs of slowing down anytime soon. “The most important thing to emphasize is that the injured do not stop and, although we know that volunteers will help them, they are short of money and do not have unlimited resources,” Danilyuk said.
“Here we are dealing with new trauma, and without the necessary equipment, God forbid, someone can die.”