Voices from Ukraine: "Something that shines amid all the darkness"

How Ukrainian MSF staff and local residents manage to find hope amid crises.

Two patients of a mobile clinic in Pervomaiske village, Mykolaiv Oblast, Ukraine.

Ukraine 2023 © Laurel Chor/MSF

The war in Ukraine is driving enormous medical needs and disrupting people’s access to urgently needed health care. Teams from Doctors Without Borders/Médecins Sans Frontières (MSF) provide medical and humanitarian aid in various parts of the country, including war-torn areas in southern and eastern Ukraine. We recently received this dispatch from Ivan M. García, head of media at MSF Spain, who visited a small enclave in the Mykolaiv region where our mobile clinics offer primary health care and psychological support.

Ivan made this visit before the latest surge in fighting and last week’s destruction of the Kakhovka dam, which caused flooding across the Kherson and Mykolaiv regions. In response, MSF teams in affected areas are now also distributing drinking water, water containers, water tanks, and hygiene kits, as well as raising awareness about possible health risks.
By Ivan M. García, head of media at MSF Spain

"Hey, try to bring back some positive stories, too!” is a mantra we hear from colleagues every time one of us on the MSF communications team visits a [medical] project.

Positive stories, stories of overcoming, happy endings. …Those are the words I repeated to myself at the end of February, when I entered Ukraine from Slovakia, a year after the escalation of the war.

After several days of travel by road, an MSF medical team and I arrived in the southeast of the country. From there, we visited Liubomyrivka—a small enclave in the Mykolaiv region near the city of Kherson—to assess the medical and humanitarian needs of the few people who remained. We were greeted by the mayor, Nadiya Heorhivna. "Come, then you will understand the extent of my sadness,” she said as she led us to Liubomyrivka’s school—or what was left of it. The school had been hit during the fighting a few months ago and only part of the building was still standing. Fortunately, this occurred in the early hours of the morning, when there were no children or anyone inside. But now, the little ones have nowhere to gather or play. The bunker on the school grounds—the only one in the village—was also destroyed. 

Liubomyrivka is one of Ukraine’s many villages and towns cut in two by the frontline. Those who could flee, did, especially young people. Others, especially the older ones, stayed, either because they had no way to leave, no place to run to, or because they refused to leave the home where they had lived all their lives, in a show of resistance.

[As the war continues], neighbors and relatives have disappeared, [as have] those who worked in the fields or tended the counters in the shops. The medical workers were also gone. Pharmacies and medical centers closed, and some of them had even been attacked, damaged, and destroyed. As MSF recently reported, 89 medical structures in the Kherson region retaken by Ukrainian forces were damaged and unable to function, leaving more than 163,000 people without medical care. 

Eventually, almost no one was left in Liubomyrivka. Only about 50 of 600 original residents remained. 

Now, with the frontlines shifting [from Russian to Ukrainian control], those who fled Liubomyrivka are beginning to return. This is good news, but Mayor Heorhivna is aware that the needs are great. Houses need to be rebuilt and materials are in short supply. Worst of all, there is no one to cultivate the fields—not because there are no available hands—around 200 villagers have already returned—but because it is not safe. The fields are contaminated by landmines. 

Finally, I asked the mayor if, in this difficult past year, there has been anything small that brought a smile to her face. Perhaps a hint of joy, in the middle of so much misery?

"The way things are..." she began, before twisting her face into a grimace. There was silence, and then she offered me more biscuits and chocolates from a tin and gazed out the window of her office. 

“A joy?” Joy is seeing people come back. There was a time I was afraid that no one would return, and that the village would eventually disappear. I've lived here all my life, you know, and I want this place to prosper. Now, with neighbors returning, I’m seeing how we help each other. It's that kind of thing that has always made me happy.”

Mobile clinic in Kherson region
Ukraine 2023 © Laurel Chor/MSF

Shrapnel in the hospital

Dr. Viktoria Baranyuk holds a shrapnel fragment in the palm of her hand: [almost an inch] of twisted metal forming razor-sharp ridges. Dr. Baranyuk said she picked it up from the floor of her office in a hospital in Novyi Buh (Mykolaiv) one morning last May. Fighting raged nearby, and shrapnel was raining down. There was shelling from hundreds of kilometers away, in Kyiv, Irpin, and Bucha, and scores of injured people. Roads were cut off, homes turned to rubble, and entire families were hemmed in by artillery fire. 

The most serious consequences of those days, said Dr. Baranyuk, were not the physical damage or wounds, but the invisible impact on people’s mental health. This is corroborated by our teams when they visit places like Novyi Buh, where people are grappling with mental health issues like anxiety, depression, grief, insomnia, and post-traumatic stress disorder. Many of our patients admit that they did not believe this war would last so long. Others assume they won’t be able to return to their homes, and if they do, they don't know what they will find. They wonder, will my house still be standing? Will my father still be alive? My mother, my brother? 

But Dr. Baranyuk was optimistic. She smiled through much of the conversation, even as she recounted the hardest days in the hospital. She said they never stopped working, not for a moment, caring for injured people as well as pregnant women. She conceded that some staff left the area quickly, but most came back soon after to lend a hand like everyone else. "This has brought us together. We have worked together and helped each other like never before. When the war is over, because it will be over, we will be better than before. We will have grown.” 

Mobile clinic in Kherson region
“I have high blood pressure and my knees hurt,” said Tamara, 90, who came for a consultation with MSF doctors.
Ukraine 2023 © Laurel Chor/MSF

Affected colleagues 

Dima is a big man with a bushy beard and a clean look. His handshakes threaten to crush your hand, and his spontaneous hugs are comforting. He's a nice guy, and no one would guess that behind his smile is the memory of the terrible attacks on Kramatorsk. It has been a few months since he and his wife left Kramatorsk, almost as long as he has been working with MSF as a radio operator.

But his elderly parents remained. Dima says they talk often: his parents from their bunker and he from the MSF base in Kropyvnytskyi, in the center of the country. "They don't want to leave,” he explained. “They say it's their land. They know they can die, of course, but it's their home and they won't leave.” Dima said that yes, of course he understands them, but no, it's not easy. 

Dima is also a grateful man. "This job is fantastic," he said. He said that day-to-day life in cities and towns like Kropyvnytskyi can disconnect you from reality, but as soon as you go out with MSF teams to a settlement for displaced people or a hospital, you quickly understand the situation in Ukraine.

"People need to talk, they need psychological help. They have seen family members die, and they themselves have spent months not living, only trying not to die,” said Dima. “In this sense, what we can offer them—beyond medical help—is hope. I look at the white of our MSF vests, and I think of that, something that shines amid so much darkness.” 

And hope is something that Dima has plenty of. He often thinks about the day this will all be over, the day he can go back to his home and put into practice what he has learned over the past year. He also thinks about finding a house and, above all, starting a big family. He dreams of having a baby: "I was a little bit of a dork, so, yes, a girl would be better." 

Of course, there are positive stories. There always are.