Pediatric Hospital Bombed in Kharkiv
They covered their children. How a children’s hospital in Kharkiv worked under shelling
DMYTRO KUZUBOV — SUNDAY, JULY 16, 2023, 05:30
Until February 24, 2022, children with “peaceful diseases” were treated in Kharkiv Regional Children’s Clinical Hospital No. 1. And repairs were made within the framework of the “Major construction” program, which was planned to be completed by June 1 of last year.
A full-scale war changed everything. The doctors had to live on the job, perform operations under fire and treat children with mine and explosive injuries, which they had not encountered before. And even four “arrivals” on the territory of the hospital did not stop the work of doctors.
In March 2023, the deputy director of polyclinic work, Oleksiy Savvo, who managed the hospital since the beginning of the full-scale war, received the presidential award “For the Defense of Ukraine”.
“Ukrainian Pravda” spoke with doctors about working in the hottest period, about new professional experience that they did not plan to acquire, and patients whose stories impressed them the most.
“On February 24, at eight in the morning, we arrived at work. Some of the staff could no longer make it. Those who remained worked around the clock , ” recalls Oleksiy Savvo .
“They covered the windows with mattresses and pillows, because there was shelling and cannonade all the time. I also drove employees around the houses, spent the night at home, and on February 25 I didn’t go anywhere (from here). (I lived in the hospital) above the basement,” says the deputy director of polyclinic work.
Savvo has been working at the Regional Children’s Clinical Hospital (until December 2022 – ODKL-1) since 1993. It is a multidisciplinary medical institution consisting of 28 departments and five laboratories. The hospital is the only state medical institution in Kharkiv with children’s surgery.
The hospital building was built in 1976. Nominally, there is a room for a bomb shelter with an area of 500 square meters, but in Soviet times, the doctor says, it was never put into operation, and in 1991 it was completely written off.
Some patients were transferred to basement rooms. During the shelling, says Savvo, “the hospital was walking,” so it was calmer there. However, it was impossible to transfer the children from the two intensive care units on the second and third floors to the basement. Therefore, they remained in the wards under the supervision of medical personnel.
“There were children there who were on constant oxygen therapy and on ventilators for half a year to a year, “ explains Savvo. ” There was no oxygen point in the basement, and it is technically very difficult to do, it was impossible even to roll these devices out of the load-bearing walls.” .
We also had many children in oncology. They were in the basement, but it was difficult to drip chemotherapy in such conditions. Therefore, these children went up to their department for a while, dug themselves out and went down.”
On February 25, 2022, the Russians attacked the hospital. About 100 windows were broken in the medical facility, and doctors counted 23 funnels from cluster shells on the territory, and they also found carriers from “Hurricanes”. Within a few days, there was a second shelling.
“On March 1, something powerful was dropped, the door in the intensive care unit was torn to pieces like paper,” recalls the deputy director of the hospital. ” It was next to us, a child with appendicitis was being operated on upstairs – they fell, stood up, operated and were lowered into the basement.
In intensive care units, when there was shelling, they simply covered the children. And then there was another failure, the sockets stopped working in the intensive care unit. Everyone went up there, and the doctors manually pumped (oxygen) with ambushes ( Ambu bag, manual apparatus for artificial lung ventilation – UP) .
As a result of the first two shellings, says Savvo, the electrical equipment temporarily failed in one of the buildings, which is why the medicines stored in the refrigerators spoiled. However, there were still enough stocks. The Department of Health, volunteers and ordinary citizens also delivered everything from food for employees to diapers and antibiotics for children.
At the end of February – beginning of March, due to constant shelling, some of the children who could not be discharged earlier were sent to other medical facilities in the city, in particular to the regional clinical hospital. Others – on the evacuation train, with which the Kharkiv Regional Military Administration helped, to the Dnipro.
“The children’s surgical service was deployed at the base of the regional hospital, and already on March 3, they began to transport our surgeons there,” says Savvo.
At that time, Kharkiv resembled a ghost town, there were neither people nor cars on the streets, broken KamAZs stood near ODKL #1.
In March, approximately 50 employees remained in the hospital, as well as members of their families and patients’ families – a total of about 100 people. Even under such conditions, the hospital had an outpatient reception. Help was given to everyone who applied for it.
“On some days, there were 10-15 appeals, ” emphasizes the head of the Department of Anesthesiology and Intensive Care, Vadim Ionin . , and traumatologists”.
There were opportunities to provide assistance in the hospital at that time as well – 98% of the equipment was kept intact due to the fact that it was hidden from shelling in safe places – in basements and between walls, away from windows.
” We have very expensive equipment – laparoscopic stands, anesthesia and breathing apparatus, infusion pumps, ventilators,” Savvo lists . there would be nothing.”
On April 7, there was a third “arrival” at the hospital, which caused the greatest destruction of all time. The Russians hit between three hulls from the “Hurricane”. More than 500 windows and interior doors were damaged.
Already in July, children and some doctors began to return to ODKL No. 1. On the night of August 24, the medical facility was shelled for the fourth time – “Hurricane” hit in front of the reception department.
At the beginning of September, all surgical services returned to ODKL #1, the hospital resumed its work in full.
“They (surgeons – UP) went to the regional hospital “on adrenaline”, we took them out in ambulances, in the personal transport of employees, – recalls Savvo. – And when they were brought back, they barely got into two ten-ton cars. And here everything was needed immediately deployed, so that if, for example, children with appendicitis arrive, they can operate immediately.”
“People’s bodies fell from the sky”
The head of the department of anesthesiology and resuscitation of newborns, Olesya Zorya, was on vacation due to the full-scale war. At 10 o’clock in the morning, she returned to work – the person who performed her duties left the hospital.
“Prior to the evacuation of the children, those who were here since February 24 were at their workplaces, the department was working as usual. We continued to prepare patients for operations, carried out the necessary examinations and treatment,” says Zorya .
When the shelling became (happened) more often and more frighteningly, only our intensive care unit and others remained on the ground. At that time, we had 10 children on artificial lung ventilation – unfortunately, they are critically dependent on the equipment. That’s why we couldn’t move and abandon the children.”
Zorya says that the most terrible thing for the whole time was not understanding what would happen next, and anxiety for relatives. But she did not think about leaving Kharkiv – she says that she was motivated to stay, most likely, by the “particularities of the profession”.
However, many young doctors left the city, so due to the shortage of staff, the doctor also had to deal with emergency care. Under fire, they and their driver delivered newborns to the hospital in an ambulance from various districts of Kharkiv and the region – with the exception of those occupied by the Russians.
On the morning of March 1, 2022, in this car, they were on their way to maternity hospital No. 3, located in the central part of the city. A child was born there with a congenital pathology that required urgent surgical intervention. While driving through the center of Kharkiv, a Russian rocket hit the regional administration building.
“We went to pick up (the child) because the bill was running for hours and we needed to do it as soon as possible, ” the doctor recalls.
They were driving along a parallel street when the regional administration was blown up. People’s bodies just fell from the sky ( 29 people died at that time , including members of the terror defense and volunteers – UP) , I don’t know how it was technically possible… We tried to help people, but, unfortunately, there were no options.
We managed to get to (the maternity hospital), pick up the child, transport (to the hospital).”
Zorya also remembers how at the end of February – beginning of March they were taking a newborn child from Chuguyev. Her family miraculously escaped to this city in Kharkiv Oblast from Kupyansk, which was then occupied.
“Dad-mom-children-dogs-cats sailed on an inflatable boat for several days,” says the doctor. ” Mom was pregnant, she went into labor on the way. They swam to Chuguyev, came under fire. We went to help the doctors in Chuguyev and took this the child to us. Of course, she was extremely difficult, but she survived.”
At the beginning of March, the children from the Zori intensive care unit were transferred to the regional hospital and perinatal center. The move was difficult, several children with all the equipment were transported at the same time.
“Given the extreme severity of the children’s condition, they were on ventilators, they breathed with Ambu bags, they carried oxygen cylinders with them,” explains the doctor. explode”.
After the evacuation of the children, Zorya got a job at the ambulance substation No. 2 and continued to travel around Kharkiv region. She returned to ODKL No. 1 at the beginning of June. Also, she still works half-time at an ambulance, because she is grateful to the people who employed her in difficult times.
Currently, 12-15 of the 40 employees who were listed in the doctor’s department until February 24 remain, so it urgently needs personnel.
“When you work five days in a row, you stop reacting to shelling”
Since the beginning of the full-scale invasion, the doctors of ODKL No. 1 helped 95 children with mine and explosive injuries.
The first injured child arrived at the hospital already at 8:20 am on February 24, recalls Nataliya Romanova, head of surgical department #4 . The boy, says her colleague Vadym Ionin, had a huge loss of blood, he almost died.
“The first wounded person came from the village of Borisivka, five to seven kilometers from the border (with the Russian Federation), 14 years old, a teenager, Sashko, he was serious,” says Romanova, who at that time was acting as the deputy general director for surgical work.
“There was a hit in their house, he had a penetrating shrapnel wound in the chest with damage to the lung and sternoclavicular joint. He was discharged sometime on March 10,” the manager recalls.
The second victim, a teenager named Maksym, was admitted to the hospital the next day.
“There was heavy shelling from “Grad” on Buchma Street. A 16-17-year-old boy was driving in a car and covered his sister, the doctor recalls. ” And he also received a penetrating wound to the chest with damage to the vertebra and lung. (He was discharged) closer until the end of March”.
During the first two shellings of ODKL #1, doctors performed operations. The wounded were received in the basement, but operations were also performed upstairs.
“When our territory was shelled with anti-aircraft missiles on February 25, the brigade was in the operating room, ” says Romanova. ” And when there was shelling on March 1, too. They literally sat down (in the operating room).
The first week was terrible because of its uncertainty, shelling constantly – you never know when it will arrive. Then – not that you get used to it, but when you work for four or five days in a row, you stop reacting to shelling. You have other problems in your head, specific work issues.”
On March 3, after the surgical children were transferred to the regional hospital, a surgical service was organized there in a separate building. They worked in shifts, at least two or three days at a time, staying in the hospital all the time. Some of the doctors moved their families there.
The surgeons returned to ODKL No. 1 on September 6. They stayed in the regional hospital for so long because they were closely connected with its specialized services and specialists.
“Our experience has shown that care for the wounded should take place in the conditions of a multidisciplinary hospital,” says the doctor . services, X-ray, CT, laboratories. You can transport to a clean field, but what will you do there without diagnostics?”.
Although the shelling of Kharkiv and the region did not subside, all the time the surgeons mostly dealt with children with “peaceful diseases”. During the first six months of the full-scale war, they treated more than 1,200 children, of whom about 60 were injured. First of all, with mine and explosive injuries, bullet and shrapnel injuries.
“There were a couple of children who were injured as a result of the collapse of buildings,” says Romanova. ” Among those who were blown up, a six-month-old child was one of the first to be brought: in March, she was riding in the arms of her parents in the Chuguyiv district, and came across a mine. (Generally) in autumn/winter there were more children who (exploded) on mines. For example, one in the region went fishing and stepped (on a mine).”
The doctors had almost no experience of working with mine-explosive injuries. So I had to learn in the process.
“The grandparents died on the spot, the mother died in the hospital, the boy survived”
Before the full-scale war, Vadym Ionin was an ordinary doctor, with the beginning of hostilities he became head of the department of anesthesiology and intensive care.
“The war caught me at work, it was just the (night) shift, ” he says. ” On February 24, we performed morning procedures and manipulations under a barrage of explosions.”
Ionin did not leave his workplace until March 2, until all departments were evacuated to other hospitals. After that, he moved to the regional hospital, worked at two medical institutions. He finally returned to ODKL No. 1 in September.
“The last shelling I saw was here on the night of August 23, ” Ionin recalls. ” There were quite a few children at that time, the intensive care unit was working. I was on duty here, it was my birthday and almost like my second birthday.”
Operating on children with mine-explosive injuries, the doctor says, has its own specifics. It is often not possible to operate on such a patient as soon as he was admitted to the hospital.
“Children with mine-explosive trauma are almost always painful shock, quite a lot of blood loss and in most cases – polytrauma, ” explains Ionin.
If, for example, a person falls and breaks a limb, doctors treat this fracture. And with fragmentation injuries, different parts of the body are usually affected, and the nature of the injury is different. Therefore, before operating on a sick child, it is necessary to stabilize and restore vital functions.
If (the patient) is very serious, first it is the work of the anesthesiologist-reanimatologist, then the surgeon, then the anesthesiologist-reanimatologist again, because after such operations the condition (of children) is very difficult and it is quite difficult to get them out of it.”
During his work in the conditions of the war, the doctor had many difficult patients. Most of them were injured by debris. There was only one with a bullet wound.
However, says Ionin, what you remember is not the gravity of the case, but the child and her story. The doctor remembers a six-year-old boy who was brought by an ambulance after the shelling of the HTZ district in April 2022 . There were many dead and injured then.
“The boy came out with his grandmother, grandfather and mother, ” Ionin recalls. ” They had been sitting in the basement since the first day of the war. My grandmother said: ‘Until all this is over, I will not leave the basement.'”
It was already April, her neighbors told her: “Go out and breathe the air, it’s easier now, there is no storming of the city.” And she went out for the first time since February 24.
They reached the playground, and a rocket flew by. The grandmother and grandfather died on the spot, the mother received non-life-threatening injuries and died in hospital. The boy suffered injuries to his limbs and chest, but survived. After some time, a friend’s grandmother came to pick him up, he has no other relatives.
Girl Kira, 17 years old, who was walking with a friend in Zeleny Gai park. This is the same shelling of KhTZ, but a little further. There are multiple injuries – limbs, stomach, chest, arm.
A very active girl, emotional, lively, cheerful, even despite all the injuries, she kept a positive attitude and a sense of humor. She was lying down for a very long time. Then she went to Germany for rehabilitation, I think.”
Approximately half of the patients with mine-explosive injuries from ODCL No. 1 were sent abroad with the consent of their parents. The approaches to rehabilitation there are different.
” In Germany, the rehabilitation program is scheduled for more than half a year, psychological support is a mandatory component there,” explains the doctor.
Unfortunately, there is still no comprehensive (approach to rehabilitation) (in Ukraine). Although we have psychologists from UNICEF working at the base of the hospital.”
“Now you just have to live and work”
From September until now, about 40 injured children have passed through ODKL No. 1. The last patient with a mine-explosive injury, Vadim Ionin recalls, was about a month ago (the conversation took place at the end of June – UP).
Almost all children who are currently being treated have “peaceful” diseases.
“Appendicitis, obstructions, hernias , – Nataliya Romanova lists the reasons for which patients end up in the hospital, and adds to the list other traumatic factors: – Dogs, scooters, trees.”
There are currently 11 children in Ionin’s ward – this, he says, is a lot even for peacetime. About 10 newborns arrive at the Olesia Zori department every day.
When asked if the war changed him, Ionin replies that it changed everyone, and he is no exception. But you will understand yourself after its completion.
“If you obsess over it, you can go crazy. Now you just have to live and work,” sums up the doctor. But when we are heading for the exit, he stops us and adds:
“Apparently, the attitude towards people has changed. You no longer pay attention to what people say, but to what they do.
During one of the shellings (in March), I walk down the corridor, everything explodes. I pass by the ward, and the nurse is lying on top of the child that we couldn’t take out, she just covered it on top. She understood what she was doing, it was almost self-sacrifice.
Everyone is alive and well, but it’s about the kind of attitude you don’t expect from people.”
Dmytro Kuzubov, photos by Kyrylo Gonchar and from the hospital archive
