'We were unconsciously transformed into a military hospital'

Alexandr Demyanov (left, in blue) is waiting with his colleagues the wounded from an explosion in Mykolaiv. April 2022. (Credit: Facebook/Alexandr Demyanov)

The Mykolaiv City Ambulance Hospital was under shelling virtually from the very first days of Russia’s all-out war in Ukraine. The establishment had to rethink its work and now operates as a military hospital. Interview with Alexandr Demyanov, its director.

GS News: Alexandr, how did your work change at the beginning of the war?

Alexandr Demyanov (AD):
Our hospital was always a peaceful establishment that provided surgical help to the population. But it had to happen, and we are now a genuine military hospital.

The first days of war, were very tough and stress-tested our hospital and facilities. I wouldn’t say that they were good, far from it, but in relation to our staff, I would say one thing: I would go on any reconnaissance mission with them.

First of all, not a single staff member left Mykolaiv. On the first day (24 February - ed.), 70 out of the 74 wounded people admitted within three hours. It was hard, but we managed. It made me think of the Japanese attack on the US base Pearl Harbor. The Russians behaved in the same way. It was a nightmare. Passenger cars, KrAZ trucks (from a factory in Ukraine -ed.), Hummers, anything that could drive were dropping wounded soldiers. It was especially challenging for the nurses and hospital attendants whose husbands were also on the frontline. They provided maximum support for the unknown soldiers in Ukrainian military uniforms and with such care, as if they were their family members.

The hospital attendants struggled to let go of the bodies of Ukrainian soldiers who died on the field. They didn’t want to believe that such handsome young men could be dead. They forced the doctors to climb onboard the trucks and declare them dead. Then we became more confident as to our capabilities.

GS News: What drove this increased confidence?

AD: Firstly, our facilities were strengthened thanks to the aid delivered from Europe, the US, Australia, and the rest of the world. It made us feel like we weren’t alone. So, the subsequent mass-scale attacks on us weren’t as impactful as the ones in the first days. We continued to do our work in a thorough and harmonised fashion.

Then the regional administration was targeted, and we got around 40 new patients. A barrack where one of the brigades was based was demolished, and we got another 54 patients in a short time. We then started getting more and more civilians every day who were injured after rocket and cluster bombings. And so, we unconsciously became a military hospital. We organised our work accordingly and joined our city’s initiative of carrying out staggered evacuation.

GS News: What are the main processes of a military hospital in comparison to a civilian hospital?

AD: We are constantly on standby for more patients. This is how it works: we receive a patient, provide them with intensive care, stabilise their state, perform surgeries and provide surgery-related care.

Day 3 and 4 are normally spent transferring the patient to a hospital that isn’t being shelled. Their treatment is completed there and they can start recovering. We think we’ve succeeded in our goals and have helped over 700 wounded patients.

It’s also worth noting that we have changed how we treat combat-related injuries. We learnt from our counterparts in other Ukrainian cities and outside the country, who faced the challenge of treating many people at once in the past. We heard about their experience, their best practices, and we cut out things that weren’t productive for our work. And this is what made us what we are today.

GS News: Has the nature of visits, as well as people’s diagnoses, changed? For example, maybe there are now more infections or stress-related diseases?

AD: Our hospital doesn’t really provide therapy and usually other clinics handle neurological and psychiatric disorders. Our realm is strictly within surgery work. That being said, our patients, especially civilians, who are admitted following  bombings and shelling attacks, usually need a psychologist too. We have one helping our hospital. He talks through all the issues with the patient in order to help them manage their nervous system disorders. As to the disease dynamics, the usual illnesses haven’t disappeared.

If all we did was evacuate soldiers, we would have had around 10-15 patients today, no more. But we currently have 140 patients in the hospital, and surgical work is still very much in demand. We have to continue doing what we do best, such as stomach and colon surgery and everyday injuries. We handled these at peaceful times, and we continue treating these today. The only thing we had to pause is planned surgeries that can be be postponed until safer times. We learnt this approach from other clinics that served people injured during air strikes and bombings. Dealing with unexpected things and force majeures of various levels helped us understand these circumstances better. I think every hospital will tell you now that the times when COVID-related cases were the only urgent ones seem funny now.

GS News: And what’s happening with COVID now?

AD: Our hospital is very cautious about spreading coronavirus in the surgical unit as this disease is very dangerous for the patients who are still weak after an operation. So, we send positive patients to a specialised hospital.

GS News: What are you most in need of now? Medicines, equipment, materials, food – anything?

AD: We have enough medicine, and that’s not just us, but others in the region too. Thankfully, we also have everything we need in case of  emergency. I’m very grateful to media for the work that they are doing in communicating our needs to foreign partners. We receive things like suture packs, pills, and clothes for employees and patients.

GS News: How did you survive the problem with water supply, when there was none in the city for a month?

AD: Thanks to an initiative by the mayor, we were the first hospital that had a borehole drilled. We didn’t have to go a single day without water. Of course, we had some issues with ensuring direct water supply to a specific unit on a specific floor, but we always had enough water. And we shared it with local residents too. So in this regard, we were pioneers thanks to the city council’s speedy reaction.

GS News: Anything else that you think is important for our readers to know?

AD: I think the fact that the Russians were stopped just before Mykolaiv turned the city into a sort of fortress that defends all of southern Ukraine. This situation made some people complacent. I want to remind everyone that the war is ongoing, and civilians and soldiers die every day. We have to do everything we can to reduce the number of casualties. That’s why I support the prolongation of martial law and curfews because most of our patients – especially recently – are wounded during curfews. Instead of staying home as they were supposed to, they were on the streets.

We continue working in the same capacity as we did during the most difficult days. That being said, we  are prepared for more difficult days, including morally and emotionally.

Editor’s Note: As this article was being prepared, we learnt that a mobile hospital is being set up in the Mykolaiv region. That medical unit will be fully autonomous and able to work without electricity by using generators that can last up to a year. Thanks to the internet connection provided by StarLink, doctors will be able to communicate with counterparts outside Ukraine.