The doctors in Ukraine risking their own lives every day to save the lives of others
Doctors in Ukraine are working in the most appalling of circumstances. Every day, they risk their lives to save the life of another.
Reports that hospitals have come under attack is, according to the World Health Organization, deeply concerning and will quite obviously have unimaginable consequences.
"Of course we are only humans and have fears", one surgeon in Kyiv told me.
He has spent the last seven days working and living in the hospital without a break. He has returned home for a rest but will be going back to the hospital shortly.
Much of the normal clinical activity has stopped where he is, they are dealing mostly with combat trauma and any patients with urgent surgery.
At the beginning of the week, their main concern was a shortage of oxygen supply, that thankfully he tells me has been stabilised but there are other worries. Trauma equipment and medicine will run out soon and he doesn’t know when the next delivery will be.
They’ve drawn up a list of what they need and "equipment and medicine to work with bleeding are essential".
The hospital has contacted other medical institutions in the city for help and asked for help from abroad. The situation is becoming increasingly desperate and he and his colleagues know it.
Dr Volodymyr Suskyi also told me of the decisions they must make each day when the alarms sound in the city. Who to take down to the bomb shelter. They can’t move all the patients down there, there are of course risks to moving patients but there are perhaps even greater risks to leaving them in the wards, "the reality of war has given us new rules" he says.
Dr Suskyi’s story from one hospital is not unique. Similar stories are emerging all the time.
The WHO warned that oxygen supplies are very low in the country mainly because a number of factories supplying oxygen had come under fire.
Oxygen is quite simply a lifeline for seriously ill patients. The organisation also lamented they have a warehouse full of medical supplies in the capital but no way of getting them out.
Shortages of medicines and equipment in hospitals and pharmacies are looming. They need emergency medicine stocks, catheters, resuscitation equipment, bandages and tourniquets.
One UK doctor I spoke to who has colleagues in Ukraine said the main challenge they face out there is the lack of experience and knowledge of dealing with mass casualties.
"They are not used to it, they need training and there is no time for that now," she said. Doctors on the ground are telling her they need to know how to deal with war wounds.
The sad truth is that it’s not just the war injured who will suffer.
Warzones put untold stress and pressure on healthcare infrastructure overall and fuels infectious disease.
Many pharmacies are closed and medication needed on a regular basis is in short supply.
Insulin, antibiotics and cancer treatments are all on a list of things the WHO is concerned will run out. How will diabetics in Ukraine get insulin if local supplies seize up or if it’s too dangerous to leave the house to pick it up?
Some cancer care has had to stop, elective operations and general medical care has also stopped at many hospitals, people already ill are at risk of becoming even more ill.
Another tragic by-product of war is the rise in infectious, preventable diseases. With tens of thousands of people on the move, cramming into crowded trains, buses and vehicles, disease spreads.
Polio, measles, Covid - they will all thrive where there are lots of people, poor sanitation and faltering healthcare systems. It happened in Syria, it will happen in Ukraine.
The country was already suffering from a surge in Covid cases and only 35% its population are fully vaccinated. I daren’t mention Covid but it is a stark reality that the pandemic was not over before this war began and it will only worsen as the fighting continues. There are nearly 2,000 Covid patients on oxygen in the country, all seriously ill and the spectre of low supplies looms over them.
It is a bleak and desperate situation already. The UN has launched a massive appeal for aid: the British government has offered more than £40 million in aid and sent dozens of pallets of medical equipment and will continue doing so, the EU has given more than 90 million euros for emergency aid and of course other countries are doing the same, even big pharmaceutical companies including Roche have donated hundreds of thousands of packets of antibiotics.
There is hope that safe corridors will now be provided in Ukraine to get that aid where it needs to go, with the first temporary ceasefires announced in Ukrainian cities on Saturday.
Some aid is already getting through. Doctors Without Borders is on the ground, as is the Red Cross and other humanitarian organisations. But without safe passage, agencies will become increasingly hampered in what they can do and hospitals will become increasingly desperate for the basic medicine and equipment that saves lives.
How far will Putin go and what can the West do to stop him? Listen to the ITV News 'What You Need To Know' podcast