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How a Ukrainian hospital, still recovering from COVID, pivoted to a new crisis: war


And I'm Scott Detrow in Lviv, Ukraine, where the war has sent ripples through Ukrainian life. In the center, of course, the direct victims of Russia's attacks, but beyond that, there are people who can't access medical treatments they need anymore because of disruptions. This weekend in the city of Ivano-Frankivsk, we spent 24 hours with a doctor doing everything he can to help.

ROMAN FISHCHUK: So, yeah, this is the hospital.

DETROW: The first few hours of the war were chaotic for Dr. Roman Fishchuk - and, to be fair, just about every other Ukrainian. Ivano-Frankivsk is in the west, far from the fighting, but has a heavy military and industrial presence, which attracted early missile strikes.


DETROW: That's a video of a strike just a mile away from Central Clinical Hospital, where he works.

FISHCHUK: So when the war started, you know, and Ivano-Frankivsk was bombarded in the first day, you know, everyone got to the basement.

DETROW: The hospital, still trying to recover from multiple COVID waves, suddenly had to pivot to a whole new overwhelming crisis. The staff fortified the hospital with sandbags and started moving patients.

FISHCHUK: This building, this building...

DETROW: Roman is 35. He's an ear, nose and throat specialist, but walking through the hospital with him, he seems to have his hand in just about every department there, too.

FISHCHUK: Dialysis department, intensive...

DETROW: Roman guides us through the facility, pointing out everything from display cases of awards to the chemical weapons training that just wrapped up in the parking lot.

FISHCHUK: We have to be ready for it because it's a real threat.

DETROW: In the basement, he shows us what used to be a conference room, now filled with hospital beds of sleeping patients. It's now the intensive care unit.

And how long after the air raids began did you realize it made more sense just to keep them down here all the time?

FISHCHUK: Three to four days, I think. It was done very quickly because the air raid sirens were so frequent, so the staff was struggling with taking people downstairs, upstairs all the time. Yeah, so this is new reality.

DETROW: Roman is military-age. He says he thought about joining the army but figured he didn't have any experience with weapons. He says many people told him, you can do more good here at the hospital continuing your work. You get the sense watching him work so hard and so quickly that's something he tells himself a lot.

Down the hall, Roman shows us the room where he coordinates the hospital's clinical trials. Right now, they're all on hold and, he worries, increasingly worthless. Data isn't being collected. Supplies aren't coming in. And most importantly to Roman, patients aren't able to come to the hospital for regular treatments. He points to a whiteboard behind a desk.

FISHCHUK: So that's the schedule we had for the month of March.

DETROW: It's scribbled with dates and the names of big pharmaceutical companies.

FISHCHUK: ...With all the visits from different company representatives.

DETROW: And none of these happened?


DETROW: None of these happened? That's one, two, three, four, five, six, seven, eight, nine, 10, 11, 12, 13.


DETROW: At one point during the pandemic, Central Clinical Hospital had more COVID patients alone than it did beds.

TARAS MASLIAK: (Through interpreter) COVID got scared because of war.

DETROW: That's the hospital's director, Taras Masliak. The joke gets to the blunt medical reality. With the war in the country, COVID just wasn't the top-level medical concern anymore for many people. Once again, the hospital and staff has figured out how to keep moving, to keep working.

MASLIAK: (Through interpreter) You cannot get used to war, but you have to adapt. You have to live your life. You have to go back to work even though keeping in mind that something can hit you.

DETROW: In an office upstairs, you can see that flexible mentality in action. That's where Roman volunteers for a nationwide medical hotline set up by the Ukrainian government.

FISHCHUK: That was actually the hotline that was created for COVID initially, but then they readjusted it to the war.

DETROW: Doctors field calls from patients all across Ukraine. Many are calling because they just can't get to their regular doctors anymore. The software on Roman's desktop computer shows an incoming call.

FISHCHUK: So you see - and they see this is a call for a pulmonologist, but - yeah, right. (Non-English language spoken).

UNIDENTIFIED PERSON: (Non-English language spoken).

FISHCHUK: (Non-English language spoken).

DETROW: He's able to quickly link her with someone who could be more helpful than he can as an EMT. In this moment, Roman feels useful. That isn't always the case working the hotline. Very early on, he got a call from a woman whose adult son had been shot in the head. He was in a hospital, but he needed more serious treatment.

FISHCHUK: He's just dying in front of her. They won't transport him from the intensive care unit because they say that the risk is too high, that he will die. And she's asking, what do I do; what do I do? - tell me what to do.

DETROW: Roman had no idea. He gave her numbers for local hospitals. He tried to help her reach out to private medical facilities. He logged all the details so other people who work on the hotline could see them.

FISHCHUK: I think it will stay with me for the rest of my life because, you know, I've experienced this as the operator on the hotline. I'm not that person on the other side of the line because that's, you know - this is the first time probably in my life when it's difficult for me to find the words.

And so right now it's Saturday morning. Yeah, we didn't get much sleep because of the air raid siren during the night.

DETROW: It's the next morning, and Roman is driving an hour and a half outside the city to give an injection to a patient in one of his clinical trials. This would usually be done at the hospital, but since the war has started, those patients aren't allowed there, so Roman goes to them. If they miss a dose, their treatment stops.

FISHCHUK: You see (laughter).

DETROW: Stepan Tomaschuk is 66 and has obstructive pulmonary disease. He lifts his shirt, and Roman swabs his stomach with alcohol before giving him an injection. Stepan's wife Halyna brings out instant coffee. The war has affected her medical treatments, too. She needs thyroid replacement therapy, which is in short supply at pharmacies right now.

HALYNA: (Speaking Ukrainian).

DETROW: So her son has been trying to get them from Poland. For now, she and Stepan say they're doing OK. They go to church every day at 3:00 to pray, and they're able to enjoy the little things, too, like cognac in the morning.

STEPAN TOMASCHUK: Hey, hey, hey. (Speaking Ukrainian).

FISHCHUK: For peace and friendship.

DETROW: Roman, who does not partake, will be back in a few weeks for the next injection. Right now he's got to turn around and drive another hour and a half. He has more appointments to keep.

By late afternoon, he's back in his car yet again, this time doing something a little less medical - delivering cigarettes to soldiers. He bought them with his own money.

FISHCHUK: I will not start lecturing them on how smoking is bad for your health at a time when you can die because of the airstrike, you know?

DETROW: He pulls into a parking lot next to a military base. A pickup truck with two Ukrainian soldiers pulls up. They hop out and pass off cartons of cigarettes to the back of the truck. And then he's off again.

FISHCHUK: Yeah, that's, like, monthly worth of my salary, and that's just in those cigarettes.

DETROW: But for Roman, it's worth it.

FISHCHUK: You know, that's one of the ways I can support the guys who are in the military. I mean, I'm not there myself, so I try to help as much as possible being in the (speaking Ukrainian).

DETROW: He says the Ukrainian word for the opposite of the front line.

FISHCHUK: The back line, or something like that. As a doctor, I try to do things that I can do. And as a regular citizen, I try to help the soldiers and provide them with what they need or want.

DETROW: For Roman and a lot of other Ukrainians, that so-called back line is a busy one. He drives back into town. Another air raid siren goes off. Dr. Roman Fishchuk will keep working for the rest of the weekend.



That was our co-host Scott Detrow in Ivano-Frankivsk. He'll be hosting from Ukraine all week.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Scott Detrow is a White House correspondent for NPR and co-hosts the NPR Politics Podcast.