Dark, damp and deathly: inside a hospital on Ukraine’s front line

The crackle of the radio spurs the doctors to action. They don surgical gloves and pick up scissors, ready to cut through bloodied uniforms. Then it comes, the distinctive rumble of the armoured vehicles’ engines. The walking-wounded stumble out first, then paramedics carry out those in need of stretchers. Finally, there are the body bags, which will be taken to a mortuary. Military commanders bark orders at the drivers to hide their vehicles before they’re targeted by the Russians.

Inside the infirmary, the mood is calm. The medics are focused on the job in hand, and the wounded soldiers rarely scream; they’ve often already waited for hours to be collected from the front. Instead they let out exhausted moans or, worse, they wheeze and rattle through laboured breaths. It’s a terrible sound. Once the painkillers kick in, soldiers missing chunks of their body begin to talk. One guy who had stepped on a mine asked me for a selfie; another, who had just lost his arm and was about to have his leg removed, sat up, looked me in the eye, and told me to take his picture.

There is no typical day at this stabilisation unit, a small hospital based in a partially ruined building a couple of miles from Ukraine’s eastern front. Soldiers come here for first aid and life-saving procedures before being transported to a proper hospital farther away from the front line. Some days there are only a couple of walk-ins; during intense periods of fighting, as many as 100 wounded soldiers pass through every day. I’ve been embedded with the unit since August 2022, photographing the medics as they battle to do their jobs under gruelling conditions.

The infirmary itself consists of two rooms and a hallway on the ground floor of the building. It’s here that the team of around ten doctors and nurses apply tourniquets, remove shrapnel and sew up wounds, or at least clean them as best as possible. They have to make difficult decisions quickly. If 15 injured soldiers come in at once, the medics assess who’s in the most pain and who’s in danger of bleeding out. As a piece of shrapnel was removed from his arm, one young soldier, who used to work in IT before the war, compared the unit to a pitstop in Formula One. Like so many who come through the unit, he was in surprisingly good spirits, thanks to a mixture of adrenaline, shock and pain relief.

The damp basement is where the medics eat, sleep and relax – not that there’s much time for any of that. There’s no hot water and few creature comforts. Most of the furniture and decor has been scavenged from bombed-out buildings. Their beds are thin mattresses on wooden crates. Someone found a set of kitschy paintings in an old office, and “signed” them with the names of famous artists like Dalí and Van Gogh.

They try to keep the mood bright as it can get pretty dark in here. The windows are blacked out and it’s often too dangerous to go outside, though sometimes we risk it. Recently, one of the medics spotted a beautiful sunset and a few of us decided to go for a walk. We sat on a rooftop and watched the night draw in over the war-torn landscape. Someone took a selfie and, just for a moment, things felt normal again.

Sviatoslav, a 46-year-old colorectal surgeon, signed up at the start of the war but was told there was no need for doctors with his specialism. Three months ago, he was finally called up. “I knew it would happen sooner or later and I was psychologically ready,” said Sviatoslav, who until he got his papers worked in a private hospital in central Ukraine.

He attended lectures in emergency medicine at a military hospital before being sent to the stabilisation unit. It’s taken him “several weeks to acclimatise” to his new surroundings. “In a hospital, there are procedures, and you can send patients for various consultations. Here you have just a few minutes to make a decision and you’re often [making] it yourself.”

Sviatoslav often wears a bulletproof vest, even during operations. “You can’t dry your clothes and shoes properly. You are constantly cold and damp,” he said. “The sun, light and wind you only see through the crack in the door that you can only have it open for a few minutes – it’s scary.”

What bothers him most is the lack of hygiene. Sometimes, said Sviatoslav, there’s no time to wash his hands before an operation, or to find a pair of scrubs. Personal hygiene is also hard to maintain. He can’t remember the last time he had a bath and has had only three cold showers since he got here. Instead, he uses wet wipes to clean himself. “I understand how [hospitals] should be – clean – and in these conditions, there’s none of that. It’s hard for me.”

Pasha, 33, used to work as a medic in trauma units in Kyiv. He was on holiday abroad when Russia invaded and rushed back to sign up. “I wanted to make myself useful to our armed forces,” he said. Along with a driver, Pasha helps evacuate injured soldiers from the front line to the stabilisation unit. “My job is very similar to that of a normal ambulance driver; it’s just that it happens under constant shelling.”

His shifts can last up to 26 hours and he often has to work through the night. He’s had two weeks off since March 2022, the standard amount of leave for army personnel. He said the doctors at the stabilisation point have become like a second family to him, drawing emotional support from each other. Like all families, they bond through humour: “You wouldn’t like the jokes we tell, medics’ jokes are pretty dark.”

Last autumn, on their way to pick up some soldiers, they found the wreckage of a helicopter crash. They extracted the three pilots and treated them on the side of the road, before taking them to the unit. Six months later one of the pilots texted him to say thank you. “I don’t expect thank-yous for my work, but it was really nice to get that message,” said Pasha. ■

Christopher Occhicone is a photojournalist working in Ukraine. He was speaking to Arjun Dodhia. Isobel Koshiw is a freelance journalist based in Kyiv