Ukraine’s First Responders at War

Emergency first responders provide a service as essential to Ukraine’s victory as the country’s armed forces. They have become wartime medics, as they navigate types of medical aid they had never performed before February 24, 2022, when Russian forces attacked their country. Equipped with aging vans and little protective gear, they have become a target of Russian assaults.

Russia’s war on the healthcare system began in the first months of the conflict, as attacks increasingly targeted civilian infrastructure. During the first year of the war, nearly 1 in 10 hospitals in Ukraine were damaged, and there were a total of 707 attacks on Ukraine’s healthcare systems, according to ReliefWeb, part of the UN Office for the Coordination of Humanitarian Affairs, which has stated, “Nearly 200 medical workers, who are protected under international human rights laws, were either killed, injured, kidnapped, or arrested during the war”; this includes the “torture of individual health workers.”

Oleksander Hlazyrin had never considered that he might die on the job, but in the early days of the war, he says, “I was afraid, everyone was. It’s not that our work will kill us. The Russians are trying to do it.” A cardiologist with Kyiv’s Emergency Brigade, a group of medical first responders, Hlazyrin usually treated heart-related conditions. But since Russia’s ongoing assault on Ukraine began, Hlazyrin has been forced to work on a broader scale and aid multiple people at a time. “The problem is not in its types but in the numbers of patients and the numbers of victims,” he explains. “If previously there were few gunshot wounds in our region, in the early days of the invasion it was a much bigger problem. For example, elementary operations, such as applying a tourniquet, tapping a wound, and controlling bleeding, we encountered it in large numbers.” 

“Try to imagine that hordes of Russians broke into your house, killed everyone who resisted, robbed, raped, having previously burned everything with artillery. Even when you are in safe places, you feel the taste of terror, human grief, horror.”

Like all of the frontline workers, Hlazyrin raced around Kyiv in a frenzy, pushing himself to the brink of exhaustion to answer the desperate calls that poured into the emergency service hotlines. Although the ambulance did not have all the necessary equipment to treat war injuries, Hlazyrin’s unit drove through air-raid alarms and falling bombs to evacuate civilians out of such embattled suburbs as Bucha, Irpin, and Hostomel. “We just do what we have to do. In the beginning, there were patients with combined polytrauma [multiple injuries], mine-explosion injuries, bullet wounds, and mass cases. Now there are more evacuations and interregional, interhospital transfers for injured patients. We didn’t do that until the war started and Russians came at us.”

What stands out most to Hlazyrin about the weeks following February 24 are his efforts to evacuate those trying to escape from Bucha. A 40-minute drive from Kyiv, Bucha was once a place where people could live peacefully outside the hustle and bustle of Ukraine’s largest city. But in an instant, that was taken away. The U.N. has verified that there have been 8,231 civilian deaths and 13,734 injuries since the invasion began, though the actual number is likely higher. The highest recorded death toll came in March 2022, with over 3,900 Ukrainian lives lost. More than 400 of those killed were in Bucha.

“Bucha and the nearest occupied towns were closed until our armed forces threw the Russians out of there. The main aims of our service were to take the injured out of the evacuation point, children, women, elderly,” recalls Hlazyrin. “Only after the liberation we were able to get there and see the extent of this horror — the graves in the courtyards of the houses speak a lot. Bucha became the first publicized tragic place. How many such Buchas in Ukraine? In the currently occupied cities and villages, it is scary to imagine these atrocities. Try to imagine that hordes of Russians broke into your house, killed everyone who resisted, robbed, raped, having previously burned everything with artillery. Even when you are in safe places, you feel the taste of terror, human grief, horror.”

It is nearing midnight when Hlazyrin speaks with the Voice at the dispatch center where he works. He is 15 hours into a 24-hour shift that starts at 8 a.m. Though he’d had this schedule before the war, Hlazyrin now works in the eeriness of the post-invasion night, under Kyiv’s curfew, when only those the military has approved can remain out. The streets of the capital city are silent, and in the distance the sky is lit up with an orange hue. It is impossible to tell if this is the war, or perhaps a fire in the distance. Although Kyiv is calm, the frontlines are just a few hundred miles away.

Hlazyrin has continued working throughout the war, but other medics have left, causing a staff shortage in the Emergency Brigade. Some fled with their families during the height of the war, relocating to the west of Ukraine or elsewhere in Europe, but others were trapped in the crossfire of fighting on the outskirts of Kyiv, with no way to go to work for months. 

Victoria Nagornaya is one of five doctors working a 24-hour shift as a medical consultant at the Kyiv Emergency Brigade headquarters. “On February 24, I was supposed to go to work at 8 p.m., but I could not get to work for three months. I live on the other side of the Dnipro [River],” she says, referencing the fighting and traffic jams that made it nearly impossible to get through Kyiv intact. “I have four children. We were depressed. We were upset.”

Nagornaya’s entire working day consists of speaking on the phone with civilians, who she connects with through operators, and with responders on the scene, walking medics through what steps they should take and monitoring the vitals of casualties as the units collect them, a draining job that has gotten even harder over time. When she returned to work, in May, she found that her job had changed drastically. “There were a lot of panic attacks. Some people left, mostly elderly people remained. There were more heart attacks. With panic attacks, if the condition is very bad, then while I am talking, I call an ambulance and talk until it arrives. People say the panic attacks are from explosions, fear of war, sirens. There were a lot of cases when a person was on the verge of suicide.”

On average, each of the five doctors takes 250 calls per shift, but there can be as many as 300, according to Nataliia Stakhova, director of the Kyiv Emergency Medical Aid and Disaster Medicine Center. The Emergency Brigade typically receives 4,500 or more calls daily; 1,400 to 1,600 of those calls result in first responders arriving on the scene. The influx is a mixture of those who have fled occupied areas, such as Mariupol and Zaporizhzhia and hot zones like Kherson, as well as people who have returned to Kyiv in recent months. 

Nagornaya is overwhelmed by the number of calls she answers daily. “The hardest thing is the amount of consultation. It happens that relatives of the dead call,” she says. When people list their loved one’s injuries and condition over the phone, Nagornaya says that she sometimes believes the victims are already dead. “In such cases, we call an ambulance, give recommendations on how to give heart massages, provide some kind of help before the ambulance arrives, so that the person understands that he has done everything possible.”

The Emergency Brigade headquarters is bustling as Nagornaya speaks. Outside, it is snowing, and air raid sirens have just begun again. The warning sounds are echoed on a large screen displaying incoming calls mounted on the office’s front wall, where phone operators answer requests for aid. Although the threat is present, staff do not move away from the large windows surrounding the rows of desks or show any signs of distress. But the scars of the war are everywhere, and sandbags still line the exterior walls, an ongoing attempt to protect the building’s infrastructure, though there has been a recent decline in attacks on Kyiv.

“When you are lying in the trench and you are waiting for explosions, will you die or will you live in the zero position?”

Nagornaya typically answers civilian calls, but the phone operators who work a few rows ahead of her speak constantly with the military. These requests result in doctors embarking on hours-long trips to the frontlines to collect wounded soldiers and to evacuate civilians. Another duty is meeting evacuation trains that bring injured soldiers to Kyiv two to three times a week. 

Regarding these missions, Stakhova says, “877 times, this is how many times we went when there were attacks, and this is the statistics for 2022 — 2023 is not included. We saved 740 people with rescue missions, 13 kids, 209 severely wounded soldiers we transferred with trauma, mine explosions. We are going on rescue missions to Zaporizhzhia, six hours away, but we need to get through to where we are going, the whole of Ukraine, to de-occupied territories, providing medical help because there is just no one.” Once rescued, the soldiers are taken to nearby hospitals in safe regions or to Kyiv for treatment. Stakhova continues, “Emotionally, it is very hard, and there is tension because you understand you need to help the person as soon as possible. Because when an attack happens, injuries take also emotionally — very hard to hear all of this.” 

By a stroke of luck, Kyiv’s Emergency Brigade has not lost any team members in rescue missions, a rare occurrence — many emergency medics in other groups have lost their lives. Ukraine’s Ministry of Health reported that during the first year of the war, 106 of the country’s medics were killed. Over the weekend of January 13, 2023, medic Grygorii (Greg) Tsekhmistrenko, a Canadian citizen, was killed while working in Bakhmut. On February 2, U.S. medic Pete Reed was killed in the same city, when an anti-tank missile landed on his volunteer vehicle as he tried to evacuate civilians. On March 7, medic Yana Rikhlitska was killed by shelling while driving between the frontlines near Bakhmut and a field hospital. 

With each passing day, the future of Bakhmut looks bleaker, a brutal struggle referred to as a “meat grinder” by journalists, one for which Ukrainian soldiers are underprepared and under-equipped. In Donbas, a soldier named Damien tells the Voice about his time in Bakhmut: “When you are lying in the trench and you are waiting for explosions, will you die or will you live in the zero position? You can see the statistics on the Internet about dead men. Soldiers are exhausted, but they try to keep their mental health.”

No aid personnel are permitted to enter Bakhmut, an order from Ukraine’s Armed Forces. Instead, they wait on the town’s outskirts to pick up the wounded, much as they did at the beginning of the war. Last month, Hlazyrin collected a soldier from a pick-up point in Dnipro, in the east, where “the case was a 27-year-old boy wounded in the direction of Bakhmut. The patient was in serious condition, with a shrapnel wound. A fragment entered the skull. Patient was on artificial ventilation, sedation, and infusion therapy. We transported Dnipro to Kyiv for the next stage of treatment.” Hlazyrin had no information on the recovery of the soldier. 

“We are talking about human lives and destinies, and it doesn’t matter where exactly this genocide is taking place,” Hlazyrin says. “The war has changed all of us. And the best sons and daughters die for Ukraine, you see, and here it is very difficult to choose some words that can describe everything.”  ❖

Anna Conkling is a freelance journalist based in New York City whose writing focuses on human interest stories and environmental issues. Since the beginning of the Russian invasion, she has been corresponding with Ukrainian students, soldiers, and civilians and writing about them for the Voice.

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