Ukrainian medics carrying out surgery in 'medieval' conditions at Mariupol's Azovstal steel plant

Injured Ukrainians attempt to recover in cramped conditions in Azovstal's basement. Credit: Mykhailo Vershynin

Medics at a makeshift hospital in the basement of a Ukrainian steel plant are performing surgery in "medieval" conditions, a Ukrainian military spokesperson has said.

The sprawling Azovstal steelworks, in the shattered city of Mariupol, has been almost completely destroyed by Russian attacks. However, it is the last pocket of organised Ukrainian resistance in the city.

An estimated 2,000 soldiers and 1,000 civilians are said to be holed up in the plant, while the head of Mariupol's police patrol told ITV News around one in six people there are injured.

An aerial view of Azovstal steelworks in Mariupol Credit: AP

From inside the plant, a spokesperson for Ukraine's Azov regiment said those requiring surgeries have been operated on by sleep-deprived, over-worked medics.

"The working conditions for doctors are horrible, as attacks of Russian aviation and artillery are constant," Valeria Karpylenko said.

"They are in medieval circumstances for the surgeries, they have only basic light during operations."

Soldiers with lost limbs are among the injured, Ms Karpylenko said.

Some of the images of the injured in the plant are too graphic to show.

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"There's a shortage of medicines. There's not enough painkillers, anaesthetics, and antibiotics," she said.

"That's why the injured, even after successful operations, have high risks of dying, due to sepsis or gangrene."

Ms Karpylenko also alleged that when Russian forces initially surrounded the plant, they deliberately shelled ambulances, which further hampered the work of Azovstal's medics.

UN secretary-general Antonio Guterres and Russian president Vladimir Putin met one-on-one on Tuesday, and the United Nations said they agreed on arranging evacuations from Azovstal.

Discussions will be held with the UN humanitarian office and the Russian Defence Ministry on the evacuation, a UN's spokesperson said.