As War Rages, Ukraine EMS Performs Heroically

Two weeks into the war in Ukraine, the country’s EMS sector continues its heroic work amid the ongoing movement of Russian troops into Ukrainian territory.

As the healthcare and EMS sectors of Ukraine have significantly suffered since beginning of the war, large volumes of support have been delivered to the country, providing needed help to local troops and civilians. An example of this is new ambulances as well as emergency medical equipment delivered from the United States and many countries of the European Union. Finland, for example, is providing 15 new ambulances that will be delivered shortly.

A significant part of the Ukrainian ambulance fleet was destroyed during the first days of war, making the supply of new ambulances very timely. More than two weeks after the beginning of the Russian invasion, the humanitarian situation in Ukraine continues to deteriorate, with millions of civilians under attack. Many areas lack power and heat, and food and medicine are running out. Currently the most complex situation is in the cities of southeastern Ukraine, among which are Mariupol, Kharkiv (Ukraine’s largest Russian-speaking city), and some others.

In Kharkiv at least three medical facilities have been damaged by the Russian artillery: the Kharkiv City Hospital, the Regional Children’s Hospital, and a blood bank. In the capital of Kyiv, the situation is slightly better, which allows local paramedics to work in full force. In contrast, the situation surrounding the city remains complex—due to military actions ongoing in various suburbs, ambulances cannot reach patients. Fighting has also damaged infrastructure and roads.

Underground EDs

As a rule, many doctors and nurses in the largest cities of the country are working in hospital basements. They have created backup emergency rooms and placed cots there so they can move patients underground if needed.

All health care professionals in affected areas are working in difficult conditions, under air raids, risking their own lives. In addition to the lack of ambulances, the country is experiencing shortages of oxygen and insulin, personal protective equipment, surgical supplies and painkillers, as well as systems for blood transfusion. There is a great need for humanitarian help, with deliveries ongoing. In recent days several shipments with a total weight of more than 200 tons have been sent to Ukrainian EMS, including materials for trauma care, freezers, refrigerators, ice packs and thermal containers, as well as 500 oxygen concentrators. Another 400 tons of aid will be sent in coming days from the World Health Organization hub in Dubai.

Attacks on Medical Facilities

Despite fierce military actions and a massive exodus of medical personnel from country in recent years, its providers continue to do their best amid conditions that have included direct attacks on medical facilities. The WHO has confirmed more than 63 attacks on medical facilities thus far, in which more than 30 people died and at least 46 were injured, including medical workers.

According to Viktor Lyashko of the Ukrainian Ministry of Health, the Ukrainian health care and EMS system remain stable, although “facilities were reprofiled,” as those who could be treated as outpatients left to clear room for wounded troops and civilians.

“We did this throughout the entire territory of the country,” Lyashko said.

According to Lyashko, since the beginning of war, up to 45 hospitals in the country have been partially or completely destroyed, figures that will likely grow in coming days. Moreover, at least 13 doctors have been killed.

According to the ministry, ambulance workers have also been killed. An official spokesperson of the ministry said 7 ambulances had been fired on, killing 4 emergency medical technicians in separate incidents, and that another 2 EMTs were killed while traveling in civilian cars to treat the wounded.

Lyashko said most of severely wounded are currently evacuated to hospitals and emergency departments in some western cities of the country, where the situation remains more stable. Still, pressure on the hospitals of Lviv and other western regions is steadily growing, and there is a high possibility the number of wounded may significantly exceed their capacity soon.

At the same time, representatives of military hospitals in Kharkiv and Mariupol said they are receiving 60–80 wounded people per day.

Volunteer Reinforcements

During the first days of war, many doctors left Kyiv and other large cities in East (including some who evacuated to Ukraine’s western regions or left the country), posing a threat of workforce shortages, but in recent days the situation has stabilized.

That has been mainly due to a significant increase in volunteers—people with medical degrees—the total number of which has already exceeded several hundred. These volunteers come from various countries, including those of the post-Soviet space and West. As rule, the governments of these countries have already agreed upon salaries, bonuses, and the provision of other support for these people.

For example, according to recent statements from the Lithuanian Minister of Health, Arunas Dulkis, at least 24 doctors will soon be sent by that country to some hospitals and emergency departments in western Ukraine. He added that hundreds of doctors had declared their readiness to go.

Eugene Gerden is an international freelance writer who specializes in coverage of the global firefighting, EMS, and rescue industries. He has worked for several industry titles and can be reached at gerden.eug@gmail.com.