Between 25 February and early April, the town of Hostomel, on the outskirts of Kyiv, Ukraine, was the scene of brutal fighting. Hostomel was also under control of Russian forces for a time.
“From the first days of the war, when hostilities began in Hostomel, it was just awful,” says Dr Olena Yuzvak, a Ukranian doctor working in Hostomel.
“There were a lot of injured people. Shrapnel wounds, contusions, injuries of that sort. People were scared and had to be reassured,” says Dr Yuzvak. “They didn't know what was going on. We were not ready for what happened.”
The damage to infrastructure that the MSF team saw once the fighting had ended and Russian troops withdrew, was extraordinary.
“I remember the first day we went out, we were in the car and nobody was speaking,” says Anja Wolz, MSF emergency coordinator. “It was incredible what we were seeing. All these tanks, the [burnt] cars, he destruction we saw was unimaginable.”
As soon as it was safe enough to do so, an MSF team began to work with Dr Yuzvak and other medical professionals in Hostomel to provide medical care.
“The first week we made home visits,” says Kateryna Kycha, an MSF team member. “We were accompanied by a doctor, Rachel, who helped people deal with basic complaints, such as insomnia.”
“People were very happy to see us, they could not believe that they were now relatively safe and that someone could provide them with medical care,” says Kateryna. “More and more doctors are returning. We are helping patients with emergency care and providing doctors for local clinics.”
Dr Svyatoslav Adamenko, who grew up in Hostomel, returned to help. “Those who did not leave Hostomel during the fighting are mostly elderly people or people who are seriously ill and did not want to go,” he says. “Medical care and medical questions are mainly about chronic diseases like hypertension, asthma, sometimes pneumonia.”
The MSF team includes a Ukranian psychologist, Yulia Korzh, who sees more than ten patients a day and conducts group and individual counselling sessions. She quickly realised that many patients need psychological support.
“Most patients were elderly people, over 60 years old,” says Korzh. “At first, I thought that they did not need psychological support because older people are strong, they can do anything. I soon realized that they need to talk and tell their stories.”
“If you really listen to someone, really be with them, then a person will reveal their problems,” she says. “They will communicate more deeply.”
Korzh remembers one patient who had to have his fingers amputated. “He felt phantom pain and asked how he will live, how he could work,” she says. “He is a programmer and needed his fingers to work. We were discussing how he could find a job that he would like. He will have to live without his fingers and adap to this reality."
As people are slowly returning to Hostomel, crucial services such as gas, water and electricity are being restored. Volunteers have cleaned up and the city is starting to return to normal. Healing will take a long time and the war is not yet over.
Ukrainian medical staff continue to address the urgent and more long-term medical needs, including mental healthcare.
“I'm not alone now,” says Dr Yuzvak. “We have a team of people, a team of doctors. We all work together. There is no such thing as one doctor providing care alone.”
“Today we had an outpatient clinic in one of the town’s health centres. We cleaned inside the health centre because it was dirty. There was blood and garbage to clean up and we fixed the windows,” she says. “We brought the minimum comfort that we could bring to this day. We are improving every day.”
MSF has a project providing primary health care and mental health care to people in Hostomel. MSF supports four Ukrainian doctors. Each of the doctors see around 20 to25 patients per day. Our psychologist also sees more than ten patients per day, in addition to providing group sessions and responding to individual requests. Dr Olena Yuzvak responds to urgent requests and refers patients to hospitals in Kyiv by ambulance when necessary.