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KRAMATORSK, Donetsk Oblast – As war bleeds Donetsk Oblast, the surgery center in Kramatorsk’s first city hospital has to shoulder the burden of caring for civilians from a large area.
Its handful of remaining doctors and nurses operate on the ill and the wounded before they can be transported west to other hospitals, the closest of which is in the city of Dnipro, 250 kilometers away.
“We are brought patients who need our help not just from Kramatorsk but all the nearby cities,” said Viktor Krikliy, the head of surgery. “Many cities have been left without surgical aid. All the employees left and the people have nowhere left to receive this aid, so they come to us.”
This includes people like Oleksandr, who was standing in the hospital hallway, waiting on his wife’s recovery. She was brought here from the front line town of Bakhmut, where she developed a gastrointestinal condition that eventually required surgical intervention.
She started feeling very bad in the evening but an ambulance was only able to come get her in the morning, giving the couple a harrowing night.
“She said to me ‘maybe I should just die so I’m not a burden to anyone,’” said Oleksandr, who declined to give his last name, as people often do in the front-line areas, fearing for their safety. “I told her ‘don’t say such stupid things.’”
The volume of war-related trauma that the hospital sees has “undoubtedly increased” in the past several weeks, Krikliy said.
“As a rule, we send them west” after surgery, said Volodymyr Kochergin, one of the three remaining shift doctors in the center. “Then it’s determined whether they are sent to Dnipro or elsewhere in the region.”
According to Ihor Peskov, the press secretary of Kramatorsk Mayor Oleksandr Honcharenko, about 60% of the city’s doctors remain active. Still, medical staff shortages are a significant challenge in Kramatorsk, which had a pre-war population of 157,000 people.
According to Kateryna Onyshchenko, who leads an association of charity organizations that provide humanitarian aid, much of the city’s medical resources have been moved west or folded into the military hospital’s capacity. The Kramatorsk military hospital did not provide access to the media.
Onyshchenko said that the people left in Kramatorsk, most of whom skew older, are also forced to deal with shortages of medication, especially for things like blood pressure and insulin regulation.
The city’s civilian surgical capacity has been concentrated in the first city hospital, according to Andriy Petrichenko, Kramatorsk’s top healthcare official.
The surgery center has about 25 patients at a time on a normal day. However, sometimes it spikes when an attack hits many people at once, like the missile strike on the Kramatorsk train station on April 8, which killed 59 people. A black scar now marks the pavement where it struck, a reminder of the dozens of bodies that once laid scattered around it.
“When the missile exploded at the train station, we had 56 people over the course of three hours,” said Krikliy. “It was colossally difficult, we wouldn’t have been able to handle it if our colleagues didn’t come help us out.”
This number doesn't include the many lighter injuries that didn't require hospitalization.
Surgeons from Slovyansk and Druzhkove came to help out with the load, as well as staff from the city's military hospital.
"It's hard. It's hard to see a child with their legs torn off, a child with an arm torn off," said Kochergin, recalling that day. "When a child's intestines have fallen out and he's dying in front of you and you can't do anything."
"There were children who were killed and children who will be cripples for their whole remaining lives," he added. "Children who are six to eight years old. It's hard."
The surgery center has 90% of the supplies it needs, Krikliy said, thanks to the city’s health care department and the “huge help” of the volunteer movement. The center is in daily contact with volunteers, who take down its needs and deliver the goods.
But there are things the hospital needs like the medications sandostatin and glutargin, Krikliy said. These are used to treat severe pancreatitis or wounds to the pancreas — their absence “sharply worsens the prognosis,” he said.
The hospital also needs supplies that stop bleeding, such as hemostatic sponges. These dramatically increase the survivability of people with kidney and liver wounds, Krikliy said.
As Russia’s grinding, protracted offensive in Donetsk Oblast hurts more people, the hospital’s burden may only grow heavier. As of now, 397 civilians have been killed and 1,109 wounded in Donetsk Oblast, not counting massacre hotspots like Mariupol and Volnovakha, where tens of thousands are estimated killed.
But the Kramatorsk hospital staff said they don’t have time to reflect on it.
“We feel fine,” said Krikliy. “There’s no time to pay attention to how we feel, we have a mass of other problems.”