ZOLOCHIV, Ukraine — Dr. Ilona Butova almost looks out of place in her neatly pressed lavender gown as she walks through a door frame hanging from a crumbling wall into what used to be an administrative office at her hospital in Zolochiv.
No building at the facility in the northeastern Ukrainian city near the Russian border has escaped being hit by artillery shells.
Since Russia’s invasion on February 24, the space for treating patients at the hospital has steadily shrunk due to damage. His staff has been reduced from 120 to 47. And the number of people seeking treatment in the small town 18 kilometers (11 miles) from the border is often higher now than before the fighting began.
from Ukraine health care The system struggled for years due to corruption, mismanagement, and the COVID-19 pandemic. But the war has only made things worse, with facilities damaged or destroyed, medical staff relocated to safer locations, and many medicines unavailable or in short supply. Doctors who have refused to evacuate or rushed in as volunteers are providing care in the hardest-hit areas, putting themselves at great risk.
“It’s very hard, but people need us. We have to stay and help,” said Butova, a neurologist who is also a hospital administrator in the city near Kharkiv. UkraineThe second largest city in . He added that he has had to do more with fewer resources.
The World Health Organization declared its highest level of emergency in Ukraine the day after the invasion, coordinating a major relief effort there and in neighboring countries whose medical systems are also under strain.
Around 6.4 million people have fled to other European countries and a slightly higher number are internally displaced, according to UN estimates. This presents a great challenge for a Health system of care based on referrals from family doctors and regionally separated administrations.
Across Ukraine, 900 hospitals have been damaged and another 123 have been destroyed, Health Minister Viktor Liashko said, noting: “Those 123 are gone and we have to find new sites to build replacements.”
In addition, dozens of pharmacies and ambulances have been destroyed or severely damaged, and at least 18 civilian medical personnel have been killed and 59 others seriously injured, it said.
“In the occupied areas, the referral system has completely collapsed,” Liashko told The Associated Press. “People’s health and their lives are in danger.”
Kyiv’s economy was crippled by the conflict with Moscow-backed separatists in eastern Ukraine that began in 2014. When he came to power five years later, President Volodymyr Zelenskyy inherited a health care system that was undermined by reforms initiated by his predecessor that had slashed the government. he subsidies and closed many small town hospitals. During the pandemic, people in those communities had to seek care in big cities, sometimes waiting up to eight hours for an ambulance in severe cases of COVID-19.
As Russia has expanded the territory it controls in eastern and southern Ukraine, the supply of drugs in those areas, along with the medical staff to administer them, has dwindled. In the southern frontline town of Mykolaiv, “things have been very difficult,” volunteer Andrii Skorokhod said.
“Pharmacies have not been operating and the shortage has become increasingly acute: hospital staff were among those evacuated, including specialists. We just need more staff,” said Skorokhod, who is leading a Red Cross initiative to provide free medicine to residents.
Volunteers like Skorokhod saved the life of Vanda Banderovska, 79, whose home near Mykolaiv was destroyed by Russian artillery. Her 53-year-old son, Roman, died and she was taken to the hospital severely bruised and barely conscious.
“My son went out to the car to get his mobile phone when the Russians started to bomb. He was hit in the head,” he said in a recovery room, his voice trembling with emotion. “They have destroyed everything and I have nothing left.”
Banderovska said she was deeply grateful to the people who saved her life, but was also overwhelmed with grief and anger.
“The pain I feel is so great. When the doctors took me to the hospital, I had black and blue bruises, but I recovered slowly,” she said.
Derek Gatopoulos reported from Kyiv. Vasilisa Stepanenko and Hanna Arhirova contributed to this report from Kyiv.
Follow AP’s coverage of the war in Ukraine at https://apnews.com/hub/russia-ukraine