Clinics in bedrooms: how local volunteers help MSF to reach patients in southern Ukraine

MSF works in several towns and villages in southern Ukraine that for months were on the frontlines or under Russian control. In many of these places, our teams witness massive destruction, including of healthcare facilities, and people report that access to healthcare has been extremely limited for a very long time. MSF teams here rely on local volunteers to reach out to the residents who survived the ordeal, and sometimes for something as practical as finding a place to carry out consultations.

After eight months of fierce fighting, the village of Posad-Pokrovske in Kherson’s region is in ruins. A small outdoor kitchen is the only part Natalia Chorna’s backyard that was left untouched by the war. Here she fries meat pies, called belyashs. Her dogs roam amid the debris. “Do you want a belyash? I have none for you”, laughs Natalia, talking to the dogs.

Russian forces never actually took control of this small village. But in March 2022, rockets rained down on Posad-Pokrovske every day. That’s when Natalia and her husband Valeriy decided to leave. “We took a couple of suitcases and our dogs, and we drove to Mykolaiv”, says Valeriy. The couple returned to Posad-Pokrovske in November, shortly after the counteroffensive that allowed Ukrainian forces to regain control of the area.

On 17th of November, a team from Médecins Sans Frontières visited the village for the first time. What they found was ruins, and a handful of people: of the previous 2,000 residents, less than 20 were still around. The level of destruction was such that not a single public building in the village could be safely used by the MSF personnel to provide consultations. The local healthcare facility had been hit by shelling and while some of the rooms had survived, they were unsafe due to the risk of unexploded devices. A local paramedic referred the MSF project coordinator to Natalia and Valeriy, whose house could be used as an improvised clinic by the MSF team.

“There was no network, so it was very difficult for us to contact Natalia”, recalls Robin Ehret, MSF Project Coordinator. “At some point we managed to briefly reach her. She told me we would not be able to reach her again, hence she would set some tyres on fire for us to identify her position. We followed the black smoke and that’s how we found her house.”

The consultations were carried out in Natalia’s and Valeriy’s bedroom. “Without local volunteers, we would not be able to carry out our activities like we do.”

A secretary turned country doctor

Tetiana Borysova is from Myroliubivka, a village in the Kherson region. She always wanted to be a doctor but couldn’t afford to study. As much of the medical staff left the village when Russian troops advanced in the region, war turned into a crash course in nursing care for her.

“I found myself giving intramuscular injections,” says Tetiana. When Russian forces captured her village in the spring of 2022, Tetiana and her family had decided to stay. They were afraid of being shelled, had they joined an evacuation convoy. Tetiana, then a secretary in the local outpatient clinic, continued to work together with a medical registrar, nurse aide and a driver.

“We did dressings here. I even removed the stitches for one person. It was scary but we had to help people”, says Tetiana. Obtaining medicines was a real struggle though. “[Russian soldiers] sold them on the street, but people could not afford them,” says Tetiana. 

In early November, Ukrainian forces retook Tetiana’s village. Shortly afterwards, an MSF team arrived in Myroliubivka to provide consultations and distribute free medicines at the local outpatient clinic. Today, Tetiana and her colleagues help MSF teams to organise their work. Among other things, they inform local residents about upcoming MSF visits. “We post on social media groups, write announcements”, says Tetiana. “We tell people in the streets. That's how we find patients.”

Fleeing the shelling on bicycles

Worn-out bicycles rest against a wall in Blahodatne, a village in Kherson’s region. Only one or two cars can be seen on the streets. Bicycles, though, are everywhere. “No one knew when the shelling would begin”, says Iryna Zhomer, a local volunteer. “To be ready to move quickly, you needed a bicycle.”

Blahodatne once hosted about 800 people. When Russian forces took control of it, only about 170 residents stayed behind, Iryna and her husband among them. People who left tried to send essential goods back to their relatives in the village. The delivery was difficult to organise, partly because poor mobile and landline connection made communication complicated. “I live in a place where there is more or less good connection”, says Iryna. “People could reach me. I received calls from Ukrainian refugees as far away as Germany and Portugal : they asked me to deliver whatever they sent me to their relatives, because they couldn’t reach out to them.”

Now Iryna also receives calls from Médecins Sans Frontières. For the first time, an MSF team visited the village in November, shorty after it was retaken by the Ukrainian forces. “They come almost once every 3 weeks”, says Iryna. “They bring medicine and provide aid. It is good.”