At a hospital in a pulverized village on the front lines of the Ukrainian war, most of the buildings lie in ruins.
The compound, mere kilometres from the Russian border in the northern Kharkiv region, has come under direct attack more than five times – taking out the morgue, the dentist’s office, a therapeutic centre and the heating building, and damaging the main block.
And yet, for five months, a small group of civilian doctors have remained holed up in the hospital’s war-scarred main block, treating injured soldiers and the village’s remaining residents as rockets continue to land around them. They know the next direct attack is a matter of when, not if.
“At the beginning of the war I wanted to leave, but then I understood that each person has their own calling and everyone does what needs to be done to win,” says hospital head physician Ilona Butova.
“And when our soldiers come in, they are mostly around 20 years old, and when you ask, ‘Aren’t you afraid?’ they answer, ‘No, because we are on our land, protecting our parents, protecting our land.’”
This week, Global News was granted special access to the village, which is usually only accessible to military or local villagers due to the intensity of the incoming attacks. We cannot name the hospital or the village it belongs to, due to fears it will be targeted.
The second-largest city in Ukraine, Kharkiv was the site of heavy fighting in the early days of the war. The battle for the strategic city has left parts of it and its surrounding villages in ruins, with large swathes of the countryside to the city’s east now considered contested territory.
The city, and the villages around it, continue to be shelled constantly every day.
Butova’s hospital sits on the cusp of contested territory, in a village that has experienced widespread devastation. Fifty-eight people have been killed and 800 buildings destroyed, according to council data.
When we visit, Butova exits the hospital looking tired and drawn. But her exhaustion, and the war waging around her, doesn’t mean she’s stopped caring about her appearance – she’s still wearing makeup, gold earrings and a perfect manicure.
Butova says in the early days of the war, she used to routinely drive 50 kilometres into Kharkiv with her cardiologist so they could get their nails done, but they have now found a manicurist in the village.
“We still try to take care of how we look,” she laughs.
From 27 doctors to five
Before the war, Butova oversaw a staff of 27 doctors at the hospital. That number dropped to five after the Russian invasion on Feb. 24 – a laboratory assistant, a radiologist, a dentist, an infectious disease specialist and a neurologist.
While more staffers have since come in from other locations to provide support, the roster remains stretched. When injured soldiers are delivered from the front lines – sometimes up to 10 at one time – their injuries must be prioritized because they can’t all be seen at once. Those with less severe injuries must wait.
Staff work seven days a week, for as many hours a day as there are incoming patients, sneaking in some shut-eye for a couple of hours at a time where and when they can. They sleep inside the hospital and rarely leave the building.
Butova leads us around the hospital compound, pointing out a 100-year-old building that was blown to smithereens in June by a rocket attack, its insides now spilling out over a concrete path.
The grounds are overgrown, trees have been felled by rockets, debris and shattered glass are now strewn across the carpark and the concrete is cracked in several places by the force of the blasts.
“This all used to be flowers,” Butova says sadly, pointing at the towering weeds that now frame the destruction.
Butova, a local, arrived at the hospital two years ago at the beginning of the COVID-19 pandemic, after eight years working and studying in Kharkiv. At the time, she was readying documents to move to Canada.
Instead, when war broke out, she moved her two daughters, aged five and 10, and her husband, who can’t serve in the military due to a health condition, to safety in western Ukraine.
She stayed behind, prepping the hospital for war. A state-of-the-art operating room on the third floor moved to the first room – the unit, with its wide, floor-to-ceiling windows, wouldn’t otherwise withstand a Russian attack and was within sniper range.
The hospital now serves as a stabilization point for injured front-line soldiers before they are transported to hospitals in Kharkiv, as well as remaining open for local residents with shelling injuries or other ailments.
“We had some cases where civilians were brought in with great damage (due to shelling) – we had to provide help in the corridors,” Butova says.
“We had no light, nothing. We stood in the corridors with flashlights.”
The day we visit, the generator is on, supporting the refrigerators storing medicine and blood supplies in case the overnight shelling causes electricity outages.
That generator must be used sparingly, however, because when it’s operating, it drowns out the sounds of nearby explosions – leaving doctors with no indicators of when they need to seek shelter.
There are no working air raid sirens in the town, so staff rely on audible cues to know when to seek shelter.
“If it’s close, we lie down, count the seconds and then go down,” she says.
'We are being attacked'
The reminders of the hospital’s proximity to war are constant. Smoke rises in the distance in plumes from the intense fighting in the border villages.
Loud explosions from the north are constant. But they barely register with Butova – she only looks in their direction once, after a long succession of louder “booms.”
She leads us through dim hospital corridors, where ill patients lie outside the few available rooms. Downstairs, a labyrinthine, dusty bomb shelter is lined with stretchers. They’ve had to treat people in here when the shelling was really bad.
For Butova, nothing much phases her anymore. But the hardest aspect of the job, she says, is treating soldiers – especially when five or 10 are delivered at the same time and there aren’t enough hands to treat them all.
At that point, doctors such as Anatoliy Sychev have to prioritize.
Sychev was sent in from Kyiv due to the staff shortage. He says the injuries they see are often critical – meaning amputated limbs, deaths en route or deaths inside.
“We don’t have time to help all the soldiers – some are waiting and die,” he says.
“Sometimes they deliver up to 10 people at a time. We divide them into critical, severe and mild. And our doctors are already making decisions about who will be the first to go to the operating table — who will be operated on and stabilized.”
All the while, doctors are treating people with little equipment and supplies brought in from other cities, Sychev says.
He believes many people, even fellow Ukrainians in safer locations such as Kyiv or Lviv, do not understand how dire the situation is in the east.
“I want (people) to somehow understand that we are being attacked, that our boys are dying, that our children are dying.”
Toll of months gone by
Five months into the war, the village is unrecognizable. The town centre bears the marks of countless rocket attacks. Buildings have been indiscriminately targeted – the only petrol station has been completely obliterated, but the town’s only grocery store remains standing. People bring fuel in from Kharkiv and sell it in containers in the centre square.
The town hall has been hit, but council staff continue to operate from inside. Men ride bikes over crater holes in the road, and the few remaining cars rattle every so often down the main street.
The toll of the past five months is visible on the faces of the hospital staff. But many of them, Butova says, don’t even realize the time is passing.
“Our day and night flow smoothly from one to the other. Sometimes you don’t even remember what day of the week it is,” she says.
While the hospital is still operating on government support, Butova worries for the coming winter with a damaged heating facility.
She misses her children and doesn’t know when she will next see them, though she speaks to them on video calls daily. They have Elon Musk to thank for that – a Starlink satellite dish pokes out from among the weeds in front of the hospital.
When asked why it was so important for them to stay, Butova says it was her calling. The hospital cardiologist, who did not want to be named, says: “Maybe it’s our contribution to our victory.”
Locals say they are indebted to that contribution.
Villagers reliant on local hospitals
Tetiana Goloborodko’s husband is currently in the hospital due to diabetes complications. She sits outside in the shade of a tree — a brief reprieve from tending to him.
He is in “bad condition,” she says, and she isn’t sure how long he will need to stay. They live in a village 20 kilometres away; this is their closest hospital.
Living on the cusp of the war does not faze Goloborodko, whether her husband had health issues or not. The couple fled to nearby Poltava for six weeks at the onset of war, but have come back to “wait for our victory.”
“Where else will we go? We have to come home, this is our land,” she says.
Listening to the loud overnight shelling from a hospital cot was scary, she says, but she is grateful for “such good people saving us” – both the doctors and the soldiers on the front lines.
“I’m very grateful to the doctors. They are so young and smart for staying.”
As we prepare to leave the hospital, there’s a commotion at the front entrance. It is Butova’s husband, carrying two bouquets of flowers. Butova clasps her hand over her mouth in surprise – she hasn’t seen him in more than four months. They were due to meet in Kharkiv that weekend, but he’s arrived here early to surprise her.
The couple embrace emotionally, him lifting Butova off her feet and handing her the flowers. Despite her prior stoicism, the sacrifices of the past five months are clear as Butova shows the first signs of emotion since we arrived.
The second bouquet goes to the cardiologist, who also gets a tight hug.
As we leave the village, several kilometres past the military checkpoint, we pass the smoking remnants of a freshly exploded Grad rocket – a large scorch mark on the road, a patch of shrubbery smouldering nearby.
Newly built military fortifications are visible in several locations nearby, in anticipation of another Russian advance on the town.
Because, like the artillery launching rockets at the villagers here each day, the threat of a full-scale Russian takeover is only ever a few kilometres away.
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