Editor's note: This story was sponsored by U-LEAD (Ukraine – Local Empowerment, Accountability and Development Program), a partnership of the Ukrainian government and the European Union and its member states Germany, Poland, Denmark, and Slovenia, to support the establishment of a transparent, accountable and responsive multi-level governance system in Ukraine.
PERESHCHEPYNE, Dnipropetrovsk Oblast — Until recently, 69-year-old retiree Zinaida Maznytsia had to travel 50 kilometers from her hometown of Pereshchepyne for a medical checkup. She either had to ask her son to take her there, call a costly taxi, or simply skip the visit as she couldn’t travel that far on her own.
However, in January, Maznytsia’s life became much easier as a new modular polyclinic opened in Pereshchepyne, thanks to Ukraine's cooperation with Germany.
"First and foremost, this is a colossal breakthrough in the development of healthcare," says Pereshchepyne Mayor Yaroslav Tsvirkun. "Healthcare in our region is a priority, as we have lots of pensioners, people with disabilities, and vulnerable groups who need quality medical care."
Pereshchepyne is a small town with 9,000 residents located in the central Ukrainian region of Dnipropetrovsk, which borders four regions with partially occupied territories and ongoing hostilities.
Though it has faced only a handful of Russian attacks since 2022, the town has been impacted by the war in many other ways, seeing an influx of internally displaced persons (IDPs) and long blackouts due to Russian strikes against Ukraine’s energy infrastructure.
To cope with these challenges, local authorities turned to international partners for support.
While it has greatly improved the lives of Pereshchepyne’s residents, the opening of the modular polyclinic also addresses a pressing issue caused by the war: Since Feb. 24, 2022, almost 1,900 medical institutions have been either damaged or destroyed by Russian attacks across Ukraine. This has increased the burden on the entire medical system and made it harder for many Ukrainians, especially those in small towns, to receive timely healthcare.
Constructing modular hospitals in regions heavily affected by the war helps to curb the war's negative effects on Ukraine's healthcare system, says Health Minister Oleh Liashko.
Past meets future
Pereshchepyne is nearly 200 kilometers from the front line, a five-hour drive, but it hasn’t been targeted by Russian attacks as often as the neighboring city of Novomoskovsk or the regional capital of Dnipro.
Life here is seemingly peaceful and quiet – except for the frequent wailing of air raid sirens.
Due to its location, Pereshchepyne became a transition point and a home for thousands of Ukrainian IDPs escaping the active war zone after Feb. 24, 2022. Accommodating and providing them with various forms of assistance became one of the most significant challenges for local authorities.
“We’re situated at the crossroads of several other settlements of neighboring territorial communities,” says Tsvirkun. “This area has a large number of pensioners, and on the other hand, many IDPs who need psychological support, as well as rehabilitation and physical treatment. So improving medical services has been a priority for us.”
Tsvirkun says they were among six territorial communities in Ukraine to receive modular polyclinics from the German development agency for international cooperation GIZ.
The modern one-floor building made of easily installed prefabricated modules stands right in front of the dilapidated Soviet-era inpatient ward hospital, highlighting the contrast between Pereshchepyne's past and potential future.
The polyclinic brought essential changes to the community of over 20,500 residents (the town and surrounding villages) and nearly 2,500 internally displaced persons (IDPs). Now it employs specialized doctors, including gynecologists, an ophthalmologist, and an ultrasound specialist, whom locals previously had to travel long distances to see.
"If it weren’t for this polyclinic, we would have to travel 50 kilometers to the Central District Hospital (in Novomoskovsk), and I can’t travel," says Maznytsia. "So it’s good that they built a polyclinic here, close by and with everything (needed)."
The polyclinic receives nearly 25 patients daily from the community and other settlements in both Kharkiv and Dnipropetrovsk oblasts.
"We’ve become a certain support point for a 50-kilometer area around," says polyclinic administrative staff member Oleksandr Vashchenko.
"Now, many IDPs who have suffered war-related injuries are turning to us... Conscripts and military personnel also turn to us, so we’re open to everyone," says the head of the hospital Nataliia Vashchenko, originally from now-occupied Mariupol.
She is one of the IDPs from war-torn Donetsk Oblast working at the polyclinic, as is Nataliia Kotova, a gynecologist from Kurakhove, a city just several kilometers from the current front line.
"It was really important for me to continue working and helping women," Kotova says.
"Currently, we have doctors who work in regional centers and come to us, and they’re happy that our small town has very modern equipment," adds Vashchenko.
In light of Russia's relentless attacks on Ukraine's energy system, the polyclinic was built to be energy-efficient and equipped with a power generator and solar panels: "This is important because blackouts often occur, which slightly disrupts everyone," says Vashchenko. "When we are energy-independent and in energy-efficient conditions, we can provide medical care regardless of external factors."
"International support gives us new impetus and a new boost to our community’s livelihood," says Tsvirkun.
Small steps matter
Pereshchepyne’s rapid progress started nearly four years ago when the territorial community was formed under Ukraine's 2014 decentralization reform, which granted more economic and political freedom to small villages and towns.
"Decentralization reform gave us a chance to be independent, and it paid off when the full-scale war began," says Tsvirkun, adding that it allowed communities to seek support both within and outside Ukraine without waiting for the state.
“I fully understand how many problems we have in Ukraine, considering the martial law and full-scale invasion...” he says. “Therefore, the strategy at the state level is to make communities self-sufficient economically and financially, precisely through partnerships and investments from abroad.”
Opening a brand new Administrative Services Center with the help of U-LEAD, Ukraine Local Empowerment, Accountability, and Development Program, was among the first significant improvements for the community.
It now allows locals to do all necessary paperwork in one place. When the full-scale war broke out, the center also became a welcoming point for all IDPs coming to Pereshchepyne, the mayor recalls. The program also helped them launch a "mobile invincibility point," providing residents with a place to warm up and charge their gadgets amid the cold winter with blackouts.
Thanks to U-LEAD, Pereshchepyne’s police officers and first responders received power generators at the start of the full-scale war: "It was one of the first generators our unit has received…Back then, receiving it was crucial for us," says Eduard Obukhov, deputy head of the 49th fire rescue unit based in Pereshchepyne.
The international partners also have helped establish co-working spaces and launched computer literacy classes for the elderly and IDPs, among other projects aimed at improving the quality of life for residents and encouraging them to stay in the community.
"To hold various democratic discussions, to involve the population in discussions and decision-making, we simply need locations," the mayor says. "Because all of our venues were outdated due to the lack of funding, leaving us with no place to gather people."
"I understand that these may be small projects, but they’re crucial for us," he adds.
Tsvirkun recently returned from a trip to Slovenia, where he spent three weeks learning from local authorities under the "Bridges of Trust" program by U-LEAD. It inspired the mayor to create a strategy for Pereshchepyne to preserve its cultural heritage and implement recycling and waste management.
They are now looking for donors to help them renovate the old hospital and launch a rehabilitation center, among other efforts.
"If we live in sufficient comfort at home, there will not be many refugees going to Europe, and people will not be relocating to EU countries," Tsvirkun says. "If we have good conditions here, such as proper water supply, medical services, and educational processes, then even the European countries will benefit."
"They help us because they have genuinely big hearts, assisting us in our time of need, but also because it reduces the influx of refugees to their countries," he adds.
"We need to improve international cooperation and be useful to each other."
Dominic Culverwell
