To protect themselves from violent shelling, Oleksandr and his family sheltered in a basement. After twenty minutes, things seemed to calm down, and he went outside to get some air.
“Two or three minutes later, I heard an explosion—not like the previous ones,” he said “I think it was a drone. I did not have time to escape, and my leg was wounded.”
Oleksandr, who is from Vuhledar in eastern Ukraine’s Donetsk oblast, received treatment for his wounds onboard a train where medical staff from Doctors Without Borders/Médecins Sans Frontières (MSF) cared for him during the journey. He is one of the more than 2,000 patients who have been transported by the MSF medical evacuation train.
Established in March 2022, in collaboration with Ukrainian Railways. the train transports patients away from overwhelmed hospitals in Ukraine’s east, to other hospitals with more capacity, away from the front lines.
Treating the vulnerable
From late March to late October, one-third of the patients MSF transported were elderly people or people with mobility issues, and a further one-third were patients with chronic diseases or medical issues. The last third are trauma patients that need further treatment.
The travel time between towns in Donetsk oblast to Lviv, in Ukraine’s far west, for example, can take over a day. To maintain a patient’s medical care and support, MSF has equipped the train cars with cardiac monitors, ventilators, ultrasound machines, and other medical equipment. The train has eight cars with beds for patients (including for those requiring intensive care) and their family members.
Supporting people with chronic illness
Serhiy and Kateryna, a married couple from Sloviansk, in Donetsk oblast, were evacuated to a hospital in Lutsk, northwestern Ukraine. Kateryna has liver cirrhosis and cannot get help where she lives; all the specialist doctors have left the city because of the war.
“Almost all pharmacies in the city are also closed,” said Serhiy. “And those still working have a limited amount of medicine.”
Caring for wounded children
Fourteen-year-old Vladislav was playing video games in Lyman, Donetsk oblast, when a mortar shell hit his home. Wounded by shrapnel, he was evacuated to Lviv, with his mother Julia, for further treatment.
“While Vladislav was being taken to hospital, he was conscious, and cursing from pain,” said Julia. “He was complaining of pain in his abdomen and that he couldn’t move his legs. He said he was scared he wouldn’t survive.”
Denys Babiy, a nurse on the MSF medical train, remembers the story of a twelve-year-old boy from Kharkiv who was playing in a playground when the shelling began. He endured injuries to his abdomen and chest, in addition to broken bones.
“The boy had many surgeries,” said Babiy. “Despite what he had experienced, there was so much joy in his eyes that he energized the entire train team. He laughed and told stories about how he did sports before the war. He was glad that his limbs were not torn off by the shrapnel. His mother talked to me all night. I saw that she wanted to talk, to share her pain. She talked for two hours, and I just listened.”
Dreams of returning home
Halyna,is from the city of Marhanets in Dnipropetrovsk oblast, where she works at a local bakery.
“During my shift, some kind of a shell exploded near the store,” said Halyna. “It was a sudden explosion, and I don't remember anything else. There were a lot of shrapnel. My right arm was wounded.”
After her surgery, Halyna plans to return home, where she said her family is waiting for her.
Marharyta, from Donetsk oblast, had exactly the same wish. In September, she had to leave her home because of gangrene—her injured toe was turning black, and she also needed surgery.
“The doctor told me to move less. How can I move less?” she asked. “I have to go to get water, because there is no running water anymore; I have to go buy food.”
For the train journey, she only took basic necessities with her—a few bathrobes, soap, and medication. “I didn't even take shoes. I'm wearing rubber slippers.” said Marharyta. “I hope to get back home.”