How do Ukrainians get medical care in the occupied territories? How are operations performed there? Are there enough specialized doctors? Medicines? Equipment? How does the medical infrastructure work in small towns? What about big cities where the invaders use medical facilities to treat wounded Russian soldiers? In this article, we are trying to answer these questions.
The National Health Service of Ukraine continues to support part of the medical facilities in the occupied territories, and the government continues to pay salaries for Ukrainian doctors. Most of those whom we contacted refused to talk to us even on the condition of anonymity because they fear the occupation authorities.
However, their patients did not refuse. Urgent eye surgery, which can be performed only 200 kilometers from the hometown. Children with severe illnesses who are taken to Russia for treatment. "Free" medical treatment that costs tens of thousands hryvnias. Refusal to stop bleeding because there are "no materials and equipment" in the hospital. "Suspilne" publishes the stories of Ukrainians who tried to get medical help in the occupied territories and tells how it ended for them.
"Nobody will help you in our town: there is not a single doctor here"
"We had a maternity ward, a surgery, and ambulances. We had our own morgue. However, everything is closed now," says 73-year-old Hanna who lives in an occupied town in Zaporizhzhia region. The woman has a disability. She is diagnosed with a manic disorder, generalized anxiety disorder, schizoid disorder, and depression. Hanna says that earlier, when an exacerbation was approaching, she phoned the local hospital and asked for help. It was like that until 2022. "But now the doctors have left, and there is no equipment," says the woman.
"There are not enough doctors even in big cities," says Olha (the name has been changed at her request), Hanna’s daughter, who left the occupied territory. "A new psychiatrist was appointed to my mother. He is almost 90 years old, so how can he provide quality medical care?"
The nearest medical facilities where Hanna can get assistance are in occupied Melitopol and Berdyansk. Melitopol is about 40 and Berdyansk is 200 kilometers away. However, even there, when the woman needed to be hospitalized, they initially refused to admit her.
"They said she needed to go to Simferopol because in Berdyansk and Melitopol only Russian soldiers are taken to hospitals," says Hanna. In the end, she persuaded the hospital in Berdyansk to accept her. She says that for a month and a half she was the only civilian patient. She tells about the medical treatment as follows: the phone was taken away; she was injected with drugs the names of which were not mentioned and not indicated in the statement. However, in general she felt better after the treatment.
"My mother has a serious psychiatric diagnosis, panic attacks, tachycardia, she moves with the help of sticks. The war and occupation only exacerbated all this," says Olha. "In addition, my mother speaks Ukrainian, which also creates problems. She has not registered her disability according to the Russian rules because for some time she did not want to take a Russian passport." In the end, Hanna had to take a Russian passport when she started having problems with her eyes and needed immediate surgery.
The surgery was performed in Berdyansk, the woman did not pay for the operation itself, but she had to buy medicines and medical materials with her own money. Olha says that even with the money it is impossible to buy the necessary medicines in Hanna’s town, "Mom has to go to Berdyansk or Melitopol, order them there, and then ask someone to bring them. Earlier, it was possible to transfer some medicines to the occupied territories, but now it is impossible. Medicines are given free to those with chronic diseases, diabetes, for example, but there are queues for them."
One trip from the town where Hanna lives to Berdyansk and back costs 10,000 rubles (approximately 4,700 hryvnias). This is exactly the sum of the pension the occupation authorities pay to the woman. She makes several such trips a month. Olha pays for them, "There is no other way out because there are no ambulances or doctors left in the town, if things get bad, no one will help you."
Olha herself has several children. One of them has a congenital brain defect, severe epileptic encephalopathy, West syndrome, and tetraparesis. The woman says that children with such severe diagnoses are taken from their town to Russia for treatment, so she is glad that she left the occupied territories, "The Russians messed everything up. Their propaganda promised a high level of medicine, but there is nothing. They cannot even provide medical assistance at the level we had. People see this. They see that Russia brings only grief."
"There is a large-scale showy development of the hospital"
Those occupied towns where the Russian troops are stationed are more "lucky" with health care. Medical facilities work there, and there are specialists who are often brought from Russia. However, the priority is the treatment and rehabilitation of the military.
In addition, Russia launched a "program of patronage" of its regions over the captured Ukrainian towns. For example, the “patron region” of Skadovsk is Kabardino-Balkaria. Russian regions send their doctors to the occupied towns and must allocate a certain amount of money for the development and maintenance of the medical infrastructure. Russian doctors who are willing to stay and work in small towns in the occupied territories are offered a payment of 2 million rubles (about 950 thousand hryvnias).
Svitlana (the name has been changed for security reasons) lives in one of the towns in the occupied part of Luhansk region. She works at the hospital and says that it is "flourishing" due to the support of the "patron city" of Tyumen. However, she calls this development showy, "Modern equipment has been brought. They are rebuilding the maternity ward and children’s clinic. It is a show, but I do not remember such construction here before."
According to Svitlana, some Russian medical and social programs have been implemented in the town, "Patients with diabetes, hypertension, children under three, and people with disabilities are given free medicines. About 8,000 rubles (about 3,800 hryvnias) are paid to pregnant women monthly upon registration. There is an annual examination with free tests, cardiograms, and examination by a gynecologist. According to the decision of the therapist, there may be a free ultrasound. We have our own mammography, as well as laparoscopy. Coronary bypass surgery is performed in Luhansk, and the equipment has also been brought there."
However, not so long ago, Svitlana’s husband had joint surgery not in their city, but in Luhansk, and it cost 90,000 rubles (about 43 thousand hryvnias). The woman says that he was operated in Luhansk because of the lack of specialists in her hometown.
The doctor turned away and said, "I cannot help you, I have nothing"
After the occupation, Tetiana (the name has been changed at her request) remained in Oleshky, Kherson region, to take care of her parents. Her father had progressive Parkinson’s disease and dementia, and her mother also had health problems. "One day, my dad’s bedsores started bleeding profusely. I went to our Oleshky hospital, ran to the doctor and asked him to come with me. He turned away and said, "I cannot help you, I have nothing." I went to the nurses, to the intensive care unit, but they said there were no hemostatic agents in the hospital. So I went home, turned on the electricity generator and was giving dad cold from the freezer all night."
The next day, Tetiana found a surgeon. He sent an ambulance for her dad and performed an operation. The man was taken home in an ordinary car because the ambulance could make only one trip a day, the woman says.
Tetiana says that there are almost no specialized doctors left in the Oleshky hospital. This is not only because the doctors are leaving. Last year in August, a Russian shell, which was aiming Kherson, missed the target and hit the home of orthopedic traumatologist Ihor Vasyliev. His legs were torn off. No one could help in the hospital where he worked, so the man was taken to Simferopol, but he died. His relatives later said that he did not leave the occupied territories because he could not abandon local patients.
In Oleshky, operations are almost never performed and patients with severe illnesses are not hospitalized. The closest place for hospitalization is in Skadovsk, but not all civilians are accepted there because the priority is the Russian military. There are only Russian medicines in Oleshky. Sometimes volunteers manage to bring Ukrainian medicines, but it is a long, difficult and risky way, says Tetiana.
The woman recalls that her mother’s leg turned blue and swollen in one day. The doctor said on the phone it was vein blockage that could lead to gangrene and amputation. He added that such an elderly person would not be operated. "That is what he said," Tetiana cries. "I injected my mother with painkillers all night, wiped her with a cold towel. She died in the morning. It was June 5, 2023."
"We ourselves dug the grave for my father"
When asked about burials, Svitlana, an employee of a hospital in the occupied town in Luhansk region, explained that everything depends on who is being buried. "If it is a civilian, it will cost starting from 6,000 rubles (about 3,000 hryvnias). If it is a participant of the "Special Military Operation", the funeral costs nothing for the family." The woman said that in occupied Luhansk region, such funerals are not paid from the local budgets, but she did not want to say from where exactly the money come.
Tetiana’s mother was buried in Oleshky without any help of the local authorities and in extreme conditions. On June 6, 2023, the day after her death, the Russians blew up the Kakhovka hydro power plant. The flood was rushing to Oleshky, so it was necessary to bury the deceased as soon as possible. Tetiana recalls that she and her neighbors put the coffin on the car trailer and drove it to the cemetery, "We did not even have a church service because the water was already coming, the forests around Oleshky were on fire, terrible things were happening."
After that, the woman returned home to take her father out. She says that at checkpoints, Russians looked into the car, saw a pale, sick man and let the car pass. They stayed in one of the villages with their friends, "There, my father could not sleep at night, mumbled something, suffered from bedsores. On the ninth day after my mother’s death, my father died. I decided to return to Oleshky to bury him at home."
The woman recalls that they arrived at the cemetery, and there were nine burials there during the day. The Russians buried those who drowned in the flood. The cemetery workers refused to bury Tetiana’s father because the Russians said that they would shoot them if there were one more burial. In the end, they agreed to let Tetiana in, but refused to dig the grave. "We dug the grave with the help of our neighbors," says the woman. "You know, it was so scary. My mom had died, my dad was lying unable to move and communicate, the forests were burning, the water was coming. I went out into the yard and just screamed wildly! The Russians turned our life into hell, and not only life, they do not let us die normally either."
After the funeral, Tetiana received certificates from the occupation authorities about the death of her parents and left for the Ukraine-controlled territory. In Odesa region, she received Ukrainian death certificates only in two months via the court verdict. She recalls how difficult it was to leave the occupied territories, and then how painful it was when she called the hotline to find out how to get documents, and they answered, "Only via the court verdict because nobody knows where you were all the time and what you were doing in the occupied territories."
"Those who did not experience the occupation will never understand us. Just believe me — it is hell there," Tetiana says.
