“You start to have an idea of the scale of the suffering”

The MSF team and Ukrainian paramedics transfer a patient severely wounded in the war from an ambulance stretcher to a bed inside the intensive care unit of the MSF medical train. Ukraine, 2022. © Andrii Ovod

Artur Struminskyy Nurse aide Ukraine

In 2022, Doctors Without Borders/Médecins Sans Frontières (MSF) medical trains evacuated 2,560 people from hospitals in eastern Ukraine to health facilities farther away from the ongoing war.

I am both Italian and Ukrainian. I moved with my family to Italy as a teenager. I came back to Ukraine on Feb. 23, 2022. I knew about the risks of war but I had to take care of urgent family matters. I stayed in Brody, a small city in Lviv district. At four in the morning, I heard many jets circling over the city. Then the first news came in about massive attacks on Kyiv and Odes- sa. At seven in the morning, our city was under missile attack.

I gathered my aunt, my little niece, my grandmother and my mother and brought them by car to the Polish border. The situation was chaotic. There were thousands of people, impossible to count. We stayed on our feet for around 30 hours in the cold. I knew I would not be able to cross the border as a male Ukrainian citizen of military age. I returned to Brody and asked myself what I could do.

I have worked as a humanitarian for the past 18 years. I believe in a situation like this, everyone has their role. I saw MSF was looking for medical staff for its [medical] train project. I sent my resume and they asked me when I could start and I said, straight away.

MSF’s highly medicalized train has a setup very similar to a hospital with an intensive care unit (ICU). On my first trip, I supported- ed the team in the ICU. In the beginning, I was a little anxious. Even though I had extensive experience working in emergency settings, I had obviously never worked on a medical train before.

We see different types of patients on the train. The elderly with chronic diseases trapped in the conflict as well as the children with multiple traumas. It is hard to imagine how many civilians become victims in this conflict.

Until you end up in an armed conflict yourself, you cannot believe how many victims it creates. But trip by trip you see all these people with blast injuries, bone fractures, amputations… You start to have an idea of the scale of the suffering inflicted on people.

On one trip, we had a 15-year-old girl with extensive damage to her abdominal area as well as fragmentations of her spinal cord as a result of a bomb blast. Even though we all knew what she had been through, she kept a positive attitude and smiled at me and the other medical staff every time we checked on her or passed by her bed. She showed me what resilience can look like even when you’ve been heavily injured. This was a pretty strong experience and very rewarding.

During another trip, we had a man on the train together with his eight-year-old daughter and his grandmother. He was in a lot of pain as he had an amputated leg and the other one was broken.

“I have two problems,” he said. “I am in a lot of pain with my leg.”

“No problem,” I replied. “We will manage your pain with medication. And what is the other issue?”

“As you can see, I have my daughter with me,” he said. “I still haven’t found the courage to tell her that her mother died. I was with her when it happened. I saw her dying next to my side.”

They were grocery shopping together when an artillery attack happened at the supermarket. This man saw his wife die and struggled in all his pain to tell his daughter her mother had passed away.

There was another intense moment when I treated a woman with a blast injury who was accompanied by her adult son.

I asked her what had happened to better understand the cause of the trauma, so we could make sure she gets the best possible care on board the train. She told me how she came under bombing and she saw her other son and her husband dying. There are no right words that you can say in this moment. All you can do is give a hand and a compassionate look and stay with her until she disembarks.

The work on the train has made me appreciate the peace I took for granted before the war. Now I understand what a clear sky means – a peaceful sky. Maybe in the past I was a little egoistic. I was thinking about my development, about my future. This experience taught me that war is everywhere. Next time you could be the person that needs help.

MSF nurse aide Artur Struminskyy aboard the medical train during a trip to the eastern city of Pokrovsk, where the team picked up people
wounded in the war and transferred them to hospitals away from the frontlines. Ukraine, 2022. © Andrii Ovod