In Ukraine, Medair’s teams conducted cross-sector (Shelter and Health) needs assessments for affected primary healthcare centres or mini-clinics otherwise known as “Feldscher Points.” Feldscher points In Ukraine serve affected communities by delivering access to quality healthcare to those in need. These Feldscher points are crucial, as the villages located in remote areas consist mostly of an aging population. According to international best practices, giving broader credentials to doctors/nurses makes it possible not only to expand access to health services but also to enhance their quality – so their existence is crucial.
It was 8 AM when we arrived at the Medair office in Kyiv. The Shelter and Health team were preparing to depart to Makariv, located in the Kyiv Oblast. Makariv, was potentially a new area of intervention that our teams were aiming to assess, so everyone was quite keen to get there, to start the assessment. Two separate cars were going to take us to the area. One car was our Health team, and the other car included two people from the Shelter team. Sviat, our new communication focal point in Ukraine, and I were riding with the Shelter team in the car. As we were loading the car, I noticed a cold wind blowing from the West. It was going to be a long day of travel. The distance to Makariv wasn’t too bad, but I was aware that we would be passing by some severely affected areas. It was going to take us approximately two hours to be on location – this would allow me some time to prep the camera, and jot down some notes while I am in the car.
The Unsung Hero of Irpin
About an hour into the drive, approximately 50KM North of the centre of Kyiv – I was keen to jumpstart a conversation again with our shelter colleagues, Tymur and Danylo. They are both shelter assistants or as the team calls it here, infrastructure assistants, with our Shelter team. We started conversing about the assessment process, and how most recently they had finalized Shelter interventions in Irpin.
Tymur, through the car mirror, looks at me and says, “you want to hear a sad story?” – I was intrigued as to what the story would be, so I answered with a firm yes. As Tymur gathered his strength, he continued: “Danylo and I were conducting assessments in Irpin one day. During the assessment phase, we met this elderly lady, probably in her seventies. She looked very weary and lonely. We were assessing her house in the area, which had absorbed considerable damage due to the conflict. We asked her whether she was inside her home when the blast happened. She looks at us and immediately started sobbing. We comforted her for a bit and calmed her down. She then told us her story. The day the conflict started in Irpin; her husband was afraid for her life. He had no choice but to get her to safety. It was very dangerous for them because they left their home, as strikes were coming in. Eventually, after some struggle, her husband was able to get her to safety with acquaintances in a nearby area. However, he refused to stay with her. He had to return to their home, to guard the house. Danylo and I were curious and asked her why her husband had to return home. It turns out, her husband built the house brick by brick and there was no chance he was going to abandon their home. She parted ways with her husband that night, thinking that once the events were over, she would return to him. The days went by, and the conflict intensified. Eventually, it became safe again to return. Upon her return to Irpin, she goes home, only to find out that her husband was killed” says Tymur, with a long face. “She said her husband was a hero, and that she’s sad that no one would ever find out about his heroic act,” he says as he continued steering the wheel. There was quite an unsettling silence in the car after Tymur shared his story with us.
The rest of the drive, I couldn’t stop thinking about the story that Tymur had just shared with us. As I looked out the window, I noticed the scenery change as we exchanged lanes on the motorway. We drove straight up a gravelled road, which would eventually lead us to the village. It was a remote area, far away from everything. As we got closer to the village, all I noticed were small bricked traditional Ukrainian homes, some more damaged than others. We passed some that were completely disintegrated. I also noticed the roofs were damaged and missing large portions of asbestos sheets, which is the traditional material used for roofing in Ukraine – which I assumed were damages caused by the sounds of the blast waves, which I hear are extremely intense. It was a grim sight.
Shortly after, we arrived at the primary health centre in Makariv. It didn’t look like a primary health centre from the outside. In my mind, I thought this was familiar, much like the health centres in Lebanon – they usually don’t look like health centres from the outside. The only thing giving this one away were these smaller type ambulances parked right outside the centre.
Medair met with Solom, the director and Olena, the head nurse at the primary health centre in Makariv. This primary health centre was potentially the main and largest primary health care centre in the area. Throughout the meeting, Olena and Solomon informed our Shelter and Health team, that this centre received support from several other humanitarian actors that have intervened in this area, but that they knew of three other mini-clinics or Feldscher points near Makariv, that required support. Once the meeting concluded, Olena and Solomon offered to take us to the three locations within the Makariv area; Sytnyky, Zabnyannia, and Andriivk, to conduct assessments. According to Solomon, the mini-clinics suffered immense infrastructural damage because of the conflict. The heating systems available at the clinics, crucial for use during the winter, were as well not functional anymore.
The Emergency Medic
First on the list was the Feldscher point in Sytnyk. As we arrived, we were warmly greeted by Maria. Maria is 37 years old and what people in the area refer to as a Feldscher – or a medical assistant. She greeted us warmly and welcomed us inside the clinic. Our shelter and health team jumped right in to assess. I was interested to know what kind of damage the facility suffered, so I took her to the side and asked Sviat to translate as I asked her a couple of questions. Maria shared with us the following: “As you can see, the area here is very remote. We’re considerably far from nearby areas. Many people from this village rely on the clinic’s support for quality medical assistance. Most of the people that live in this area are elderly, persons with a disability, or others that are unable to access the larger facilities, in case of emergencies. That’s why I am here. I refused to leave when the conflict started because the people of this area here need me. They depend on my support. At the start of the conflict, I was receiving large numbers of people in need of emergency medical attention. It was quite intense for some time. The number of people needing medical attention was overwhelming for only one person to handle – I had people from the village that would volunteer to come here to the clinic to help me provide emergency care. We held our heads up high and did what was necessary” she says with hope in her eyes. Maria carried on explaining that the foundation of the facility, suffered major infrastructural damage. The damage was caused due to the loud sound of blast waves, as they were landing too close to the facility. She said any minute now and the entire facility could come crumbling down. I later heard from Solom, that Maria has helped save a lot of lives here at the clinic and that at some point she pretty much lived at the clinic.
After leaving SynykThe second location on the list was the Feldscher point in Zabnayannia. It was about a 30-minute drive from Sytnyky, through backroads with never-ending fields stretching into very dark wooded areas as far as your eyes can see. When we arrived on location – we parked the car next to a house that suffered significant damages. It was a brick house, like most I’ve seen here in Ukraine. It had a blue door, and its windows were covered from the inside with wooden panels. The glass of the windows was all broken. As I walked around the house, I noticed the damage to the roof, which had a tree that collapsed onto it. The team was already assessing the outside of the Feldscher point as I caught up with them. It was eerily quiet there – so quiet, you could hear the wind blow. The first thing to see was the ambulatory, which is what the locals refer to as an emergency response station for emergency care. Not all Feldscher points have them. It was quite small and was right in front of it. It’s not a separate entity from the health clinic, however, it seems to be a place where the first medical response is provided to people. The concrete building behind it is the Feldscher point. I met Halyna there. She’s been working at the Feldscher point for about 52 years now and was there providing medical assistance since the start of the conflict. Halyna tells me the following: “I’ve been working as a nurse for 52 years here at this clinic. The day the conflict started I prayed for everyone’s safety. The nights were the longest. There would be constant strikes, day after day, one after the other. I wasn’t worried about saving my life, as much as I was worried about saving others. People were coming in requiring emergency care – everyone was an emergency, and we had to tend to their needs as quickly as possible. We would be working on a patient, and in the distance, you could hear loud terrifying sounds. The sound of the blast waves was extremely loud. One night, we could hear the strikes getting closer until eventually, they landed near us. I cannot describe the feeling. It was terrifying. The pressure of the sound was so intense it broke all the windows, and we could hear part of the roof collapsing. We are worried about winter now, because there is no heating system in the facility, and we are not sure how we are going to keep our patients warm. Closing the facility is certainly not an option.”
Just as we finished talking to Halyna, we started to make our outside and the unexpected happened – the sound of sirens went off on my phone, alerting us that it was time to seek shelter in a bunker. Unfortunately, this wasn’t a familiar area, so we needed to scout a location with a bunker as to followe our security protocol. Our teams rushed into the cars, and we hit the road again. About ten minutes into the drive, we noticed a public school to the side of the road. The general thinking was that usually schools have bunkers, so we thought it was worth checking out. We parked the cars one behind the other. As I got out of the car, I noticed a woman smiling and rapidly waving us in – that was our greenlight that a bunker existed and that we were welcome to it.
We were fortunate to find a bunker so quickly. I will forever be grateful to the principal of the school for agreeing to host us. The bunker was at maximum capacity; however, they still hosted our team. It was filled with children and teachers. The teachers were really encouraging the children to sing songs to distract them from the reality of the situation. They played songs from a laptop and sang along with the children in Ukrainian – the moment was surreal. I took a deep breath and put my camera away. We would spend the next four hours in the bunker. Four hours later, the sirens were still active. I kept thinking about Maria and Halyna, whom I’d just met, and the husband of the lady Tymur was telling me about.
Deep in my thoughts, I snapped back to reality as our security focal mentioned we would need to make a move. The decision to move was obvious, as it was late in the afternoon and very dark outside with sirens still active. Anything could happen. Fortunately, after a long dark drive reminiscent of horror movies, through the backroads, we made our back to the base in Kyiv safely.
The world is full of brave people that are risking their lives every day to save loved ones and serve the most vulnerable and difficult-to-reach people. They serve on the frontlines of emergencies in remote locations, with the aim of saving lives. This story is dedicated to people like Maria, Halyna, that are willing to risk their lives to save another – to the brave.
Medair services in Ukraine are funded by PMU, Swiss Solidarity (CdB), Cedar and The New Humanitarian
This content was produced with resources gathered by Medair field and headquarters staff. The views expressed herein are those solely of Medair and should not be taken, in any way, to reflect the official opinion of any other organization.
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