“My town is on fire”: Ukrainians flee front lines in Donetsk

“My brother is under the rubble,” repeats an elderly woman sitting in a wheelchair next to her husband. Her face is covered with small scratches and she is crying. Her husband leans over and whispers something in her ear, trying to comfort her as Dr. Hontariev treats a wound on her arm with initial trauma and moves on to others, such as a father and son waiting inside a vehicle.

“The older man has burns and shrapnel wounds to his back and shin,” says Dr. Hontariev. “He was injured four days ago, and only now he was able to get help. Burns like this can only happen when hot metal comes into contact with the body. The debris burned through his clothes and injured his back.”
 

Evacuation delays mean injuries stay untreated for days

MSF teams frequently encounter patients with similar mine and blast injuries that are four or five days old.

Dr. Hontariev recalls one patient who was on the street when an attack started. “He ran into the basement of someone else's house and had to spend two weeks there before he could evacuate. All this time he ate only canned vegetables that were in the basement. He came to us with bilateral pneumonia.” 

Delays in evacuation caused by constant bombardment mean that people are unable to access lifesaving care right after they are injured. In the past two weeks, 25 percent of patients treated by MSF teams at the at the Pavlohrad center had injuries from blasts that struck their homes.

As the front line moves with the continuing offensive of Russian troops, and living conditions deteriorate, people have no choice but to leave their homes. In these areas, the shops, pharmacies, and hospitals are closed, and the constant bombardment makes evacuation incredibly difficult. Many people from Kurakhove and its nearby towns and villages in the Donetsk region stay in the transit center in Pavlohrad for a few days before moving westward in Ukraine or abroad. 

Needs grow among elderly and chronic patients

Ms. Yelyzaveta, 83, rests on her bed at the transit center. She came from the village of Dachne, near Kurakhove. All her documents and money were burned along with her house.

She recalls that during the constant shelling she was looking for something to distract herself.

“I was sitting with my neighbor under an apple tree,” says Ms. Yelyzaveta. “Shells were flying over us. And I said, 'Why are we sitting there like we're waiting to die?' We have to do something, so I went to sweep the leaves from the yard.” 

Soon after, an explosion occured near her house, starting a fire. She and her son managed to escape.

“The house was on fire, so we couldn't go back in,” says Ms. Yelyzaveta. “The neighbors’ houses were cut in half by the bombing, but ours caught fire.” 

Ms. Yelyzaveta’s son refused to evacuate, so she came to the transit center alone. She hopes to move on soon and reach her relatives in Poltava, central Ukraine.

“These are elderly people and people with disabilities, so they often have underlying conditions or complications,” says Dr. Hontariev. “They have hypertension, heart disease, diabetes. Many of them come to us with respiratory diseases, because they were in basements for a long time during the shelling. People with minor injuries are also often brought here.”

Addressing acute stress among survivors

One patient tells the doctor that his son is missing. After his medical examination, Dr. Violieta Kozhukhovska, a psychologist working with MSF’s mobile clinic team, comes to talk with him.

“This man has a sister, but he can't contact her,” says Dr. Kozhukhovska. “His phone burned in the explosion in his house, and he doesn't remember her number. I advised him to try to find her through social media.”

Most of the evacuated patients, she says, are now in a state of acute stress. “The task of a psychologist at this stage is to carry out a crisis intervention, that is, to listen without asking unnecessary questions so as not to traumatize them again,” says Dr. Kozhukhovska. “It is important for people to speak out.”

The people arriving at the transit center have suffered the loss of loved ones and miss their homes, but they can find solace in the center. Back in their besieged towns and villages, many were sheltering in cold basements with limited food supplies.  

“They are now enjoying warmth and hot lunches, enjoying the electricity,” says Dr. Kozhukhovska. “It's a blessing for them right now.”

Our work in Pavlohrad

The transit center in Pavlohrad has been operating since August 2024, when the front line approached Pokrovsk. Various humanitarian organizations host people fleeing from the Donetsk region in the center and provide them with legal, medical, and social services. The MSF mobile clinic comes to the transit center every week, with doctors and psychologists seeing up to 50 patients a day and providing examinations and needed medications.