In the hospital closest to the front line in Bakhmut, doctors are living in a permanent war in which they have treated twelve people bombed in less than an hour

La otra guerra de Ucrania: luchando por salvar la vida de los caídos bajo las bombas de Bajmut

PHOTO/MARIA SENOVILLA - A man injured during shelling in the town of Bakhmut is treated at Hospital Number 5 in Konstantinivka (Donetsk)

They fight like wild beasts on both sides of the stretchers on which they place the wounded, who often arrive in volunteer vans, because there are never enough ambulances on the front lines. They are Ukrainian doctors and their trench is in the emergency department of Konstantinivka Hospital Number 5. 

They call it a "quiet day" when they only see two or three people who have been shelled. "We have even received 12 patients in less than an hour," says Dr Yaroslav, an anaesthesiologist at the hospital.  

Nevertheless, when several wounded people gather in the triage area at the same time, it is surprising how quickly the medical staff coordinates their care. Being only 25 kilometres from the contested town of Bajmut has made them specialists in working under pressure.  

The battle for Bakhmut still concentrates most of the war effort in this war, and the collateral damage can be seen on the stretchers in this hospital. Zelensky has decided to contain the Russian Army's advance across the Dombas here - thus buying time to shape the expected spring counteroffensive - and the fighting is now fierce. 

The city, which had been considered lost for weeks, is still holding out thanks to reinforcements from across Ukraine. But among the thousands of soldiers massed in Bakhmut, there are still an estimated 2,000 to 3,000 civilians who have refused to be evacuated. And although they practically live in basements, it is when they move to get water or food that they are most often wounded. 

02_MARIA SENOVILLA_ box mujer herida Hosp Konstantinivka

When that happens, rescuers and volunteers risk their lives to get them out of the city - amidst the bombs - and drive at full speed on impassable roads to reach the hospital. It's an obstacle course to try to save their lives, which continues when they reach the emergency room and are handed over to the medics. 

Volunteer doctors on the front lines

Dr. Yaroslav started working in Konstantinivka last December. When he saw the number of dead and wounded in this part of the Dombas, he decided to take a leave of absence from the Kiev hospital where he was working and join the Doctors Without Borders programme that runs the emergency department there.  

"I want to help people, it's as simple as that; there is also a need for doctors in Kiev, but more so here," he says. As we talk, a wounded woman arrives from Bakhmut. She has shrapnel in her abdomen and also in her head. Her moans are heart-wrenching. 

The anaesthetist explains the protocol for treating the wounded in the bombings. "First you have to stop the bleeding and stabilise the patient, which has to be done by the paramedics at the place of origin or in the ambulance on the way," he explains. "Here in the emergency room, the first bandages, fluids, antibiotics and intubation are applied if necessary". The most serious cases are transferred to the hospital in Dnipro.

03_MARIA SENOVILLA_ Yaroslav y Yuri en el Hosp Konstantinivka

The woman who has just arrived is attended to by a veteran, Dr. Yuri - who has been working here for 37 years. Together with his nurses, he examines her carefully and starts to treat her. The sound of scissors cutting through strands of hair mingles with the woman's sobs as she tries to answer the doctor's questions through her tears. "The abdominal wounds are very painful," says the anaesthetist in a low voice.

After the first examination, the nurses continue to work around the stretcher while Dr. Yuri sits at his computer to carefully review the woman's x-rays. Her life is not in danger. "Since the Russians encircled Bakhmut," says the doctor, "the trickle of patients arriving under bombardment is daily, but before that they came from Lisichansk, then from Soledar... since June last year we haven't stopped". 

Hospitals at war

The bright golden thermal blanket, in which the woman was brought wrapped, lies on the floor. Bloodied. At the door of the ward where she is still being treated. Although all hospitals are the same on the inside, in those close to the front lines, you can feel something different. You can feel the war.

Nearly all the windows are covered with sacks of earth, and strips of cellophane are glued to the glass so that, in the event of bombing, the glass does not fly inwards in a thousand pieces, cutting the people who are there. 

04_MARIA SENOVILLA_ médico anestesista Yaroslav Hosp Konstantinivka

The emergency room on the ground floor is not normal either. This part, which has been run by Médecins Sans Frontières since last summer, is a huge triage station. Along the white corridor, you can see coloured cardboard pasted on the doors of each treatment room. 

Red, yellow, green and black. Depending on the severity of the patient, he or she is placed in one room or another. On "quiet" days when they do not receive many patients at a time, this classification system is not relevant. But when more than ten wounded arrive in a row, it is key to saving as many people as possible.

In addition to the earthbags covering the windows, in many hospitals they have to deal with power cuts. So they are forced to have generators to be able to work. And in addition to these difficulties, there is the most difficult one to overcome: many doctors and nurses have left, especially those who are parents of young children.

Some are displaced to safer cities in the west, and others - mostly women - are now living as refugees outside Ukraine. As a result, there are hospitals where they are working with only 50 per cent of staff. 

05_MARIA SENOVILLA_ Boris en la sala de triaje del Hosp Konstantinivka
Fighting continues

The second casualty of the day in the shelling of Bakhmut bursts through the emergency entrance. It is a man this time, and he comes in conscious. But when the doctors begin to treat him and see the severity of his wounds, they decide to anaesthetise and intubate him.  

The massive trauma to his head, the blood pouring from his mouth and the numerous shrapnel wounds in the left half of his body are serious. His name is Boris, he is 45 years old, and he will have to be transferred to Dnipro to be assessed.  

"Until he has a CT scan in Dnipro, we won't know the extent of the damage, but he is in serious condition," Yaroslav adds as he checks the drains next to the stretcher. The man is hooked up to a monitor and Ekaterina, a young nurse, covers him with a blanket. 

They have barely finished stabilising Boris when they feel the rush down the corridor towards the emergency entrance. Two rescuers in military uniform bring in a young man, wrapped in another thermal blanket. His wife enters behind him, very nervous, unable to hold back her tears. 

06_MARIA SENOVILLA_ sala triaje Hosp Konstantinivka.jpg

Her name is Galina, and she explains that her husband Anton, 36, was chopping wood for the elderly in their street when he was hit by a Russian shell. There are no open wounds like Boris', but his chest hurts a lot.  

They live in a small village called Zalizne. Galina shows me the location on the map on her mobile phone: they are an hour away from Konstantinivka, but this is the nearest hospital. "The attacks in our area have multiplied in the last few days," she admits. 

With Russian artillery firing indiscriminately on all the towns in the Bakhmut rear - from Chasiv Yar to Kramatorsk - reaching doctors is becoming increasingly difficult. The roads are destroyed, pockmarked with shell holes. And to reach the most remote villages, sometimes there are no roads at all. That's why so many people die before they reach hospitals. 

Yaroslav and Ekaterina take Anton for tests. He is sitting in a wheelchair, conscious. He gazes at his wife as he passes her, trying to reassure her with his eyes. But it is difficult to regain your composure after being bombarded.

07_MARIA SENOVILLA_ Hosp Konstantinivka

Galina stands in the corridor by the emergency room door, waiting. She clings to Anton's clothes, a dark sweatshirt that she hugs with bated breath. The doctors will fight for him, and for Boris and those who come after him. It is their war, and they are not prepared to lose it.