DNIPRO – Most soldiers are unconscious by the time they arrive at Mechnikov Hospital, the main gateway for the wounded fighting in Donbas.
Located in Dnipro, a city of 1 million people 185 kilometers west of the front line, the massive Soviet-era medical facility works around the clock to save as many lives as possible.
The hospital – known for treating the most complicated injuries – is home to some of the country’s most experienced doctors and nurses. Many have worked since the start of the war in 2014.
For the first eight years of war, from 2014 to 2022, the Mechnikov Hospital took in over 3,000 wounded, with just one to five soldiers arriving each day, Sergii Ryzhenko, the hospital’s director, said. Following the start of the full-scale invasion, demand is pushing Mechnikov’s doctors to their limits.
About 29,000 wounded soldiers have been brought to the hospital since the beginning of the full-scale war, said Dr. Ryzhenko, who still performs some surgeries himself. Around 50 wounded soldiers are brought to the hospital every day, according to doctors.
Many arrive in ventilation masks, unable to breathe on their own. Some 82% of soldiers are unconscious when they arrive.
Only those lucky enough to be pulled out of the fierce fighting on time get to the hospital alive. It takes hours, sometimes days, for the wounded to be transported from the battlefield.
There is a growing fear that the hospital could run out of surgeons – especially neurosurgeons – needed to keep up with the intense pace.
“Every day, when we form work teams, we are already afraid that we will not have enough people to save the wounded,” said the 60-year-old veteran doctor.
The days are long. Doctors work 15 to 18 hours a day, and getting about five hours of sleep is a luxury, Ryzhenko said.
Not everyone can cope with the physical and psychological demands of the job, he added. Staffing the hospital is a challenge.
More than two years into the full-scale war, Ukraine’s doctors saving the wounded are fighting exhaustion and burnout – just like soldiers – ahead of what is expected to be a difficult summer.
As the battlefield situation worsens amid a prolonged lack of crucial resources – from manpower to ammunition and equipment – Mechnikov Hospital needs more surgeons. There are over 200 surgeons and anesthesiologists working at the hospital, but it ideally needs about 40 more, according to Ryzhenko.
Some injuries are fatal, and there is nothing the doctors can do. The most difficult and lethal are brain and skull injuries, Ryzhenko said.
The 200-year-old regional hospital has thus far kept about 95 percent of the wounded brought in alive, according to its own figures.
“For a war, it’s a very large number,” said Ryzhenko, who has been the hospital’s chief for over a decade.
Read also: Intense fighting, lack of resources leave wounded soldiers on their own
Doctors needed
From soldiers missing limbs to brain damage caused by shrapnel, the doctors at Mechnikov Hospital have seen it all.
“When you look at it for 10 years, you understand that it’s just your work,” Ryzhenko said, explaining how it was much more difficult to adjust in 2014 when Russia invaded Donbas for the first time.
The doctor stressed that not getting enough fresh air is harder. On the busiest days, doctors don't go outside for days. Ryzhenko said he tries to go outside for a moment to breathe when his exhaustion overflows.
“We are already used to this difficult work,” he explained.
The extreme work schedule is a must to save as many wounded as possible, the doctors say.
Dr. David Staryk, a 28-year-old neurosurgeon, says doctors in his field of expertise are the most difficult to find because there aren’t many across the country. He said there are about 10-15 jobs at Mechnikov Hospital, but at least four more are needed.
“We are trying, and for now we are okay,” Staryk said. “But sometimes it’s hard when you do two or three operations (in a row).”
One neurosurgery operation can take from three to seven hours and requires significant attention, he explained.
Staryk believes that overworked surgeons can be as emotionally detached as the soldiers on the front line, who often adopt a defense mechanism that helps them stop reacting to traumatic moments.
“We are already burned out (from emotions), and we don’t have empathy,” Staryk said. “Maybe it’s just professionalism, you just take (the patient) and do your job.”
Long road to treatment
The better the wounded are taken care of at makeshift hospitals near the front line, the quicker Mechnikov’s doctors can work.
The wounded are first transferred to the so-called stabilization points, where they receive the initial medical care – most importantly to stop the bleeding – before the long journey to a proper hospital. Ryzhenko said such facilities lack good lighting and certain equipment, which are needed to determine injuries.
“They can’t see everything,” he said, explaining that the rest is taken care of at hospitals to ensure all injuries are spotted.
Detecting all injuries is not easy if the patient is unconscious or not feeling the pain due to adrenaline.
Military medics working at stabilization points also told the Kyiv Independent that there is a lack of experienced surgeons or general doctors in the front-line areas.
Without acknowledging the shortage of surgeons, the Ukrainian army’s Medical Forces said in a commentary that Ukraine is conducting training and “developing a regulatory framework” to fill the stages of medical evacuation in accordance with the needs and skills of the doctors at the military’s disposal.
But if the soldier makes it to a stabilization point and the injuries are identified correctly, the chances of survival are high. The majority of fatal cases are recorded before the injured reach the stabilization point.
The hospital’s Deputy Head, Oleksandr Tolubaiev, said that “internal strength” is also important, with many patients defying the odds and surviving in situations that are fatal on paper.
Endless nights
Nights are peak hours at Mechnikov Hospital. Wounded soldiers arrive one after another and are immediately taken care of by doctors and nurses on standby.
The city is pitch dark. The hallways inside the hospital give away a similar feeling, with the grim silence occasionally broken by the squeaky sound of stretchers rushing patients to operating rooms.
Among the wounded soldiers waiting to be carried to a bed after treatment is Mykola Lehach, who had just been evacuated from the east.
Lehach recounted what happened: Russian troops first zeroed in on his position with artillery and tank fire and captured it by the next morning. Of the eight men at the position, six were killed in action, and two – including Lehach – were briefly held as prisoners-of-war (POW) until a Ukrainian mortar strike freed them.
“We were injured, but we managed to run away,” said the 48-year-old infantryman from Kyiv Oblast, deployed with the 66th Separate Mechanized Brigade in the Lyman area.
Lehach appears calm despite the horrific event he went through. Lying on a stretcher, he said he expected the worst.
Wounded soldiers like Lehach – who had just lost comrades – are brought daily to Mechnikov Hospital, and the doctors need to make them feel safe.
“We defend our front line in this emergency department,” Tolubaiev, the hospital’s deputy director, said.
Editor’s Note: The hospital allowed the Kyiv Independent to reveal the information about the hospital provided in the story, and assured that it won’t endanger the hospital’s patients and staff.
Read also: Ukrainian soldiers recall retreat from Avdiivka – on foot, leaving their wounded behind
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Note from the author:
Hi, this is Asami Terajima, the author of this article.
Thank you for reading our story. Throughout my reporting across Donbas, I heard a lot about Mechnikov Hospital, but it was when I talked to the doctors that I truly understood why soldiers call them heroes. They are exhausted and working with no end in sight, but too humble to admit their extraordinary work in their country's darkest hour.
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