The hospital train helping Ukraine’s sick and wounded

It is 10am on a Tuesday morning in July, and a train has just pulled into a station in the western Ukrainian city of Lviv. As the door to one of the carriages creaks open, paramedics on the platform gingerly lift two young men down the stairs and onto stretchers. The day before, both men had been wounded by a bomb blast in the city of Bakhmut in the eastern Donbas region, where Russian forces have been mercilessly shelling for months. One of them is in a jocular mood, cracking jokes with the medical personnel as they gently wheel him to a waiting ambulance. But his pallid face betrays the severe femur injury he has sustained.

Descending the train for a quick break is 35-year-old Nataliia Kyniv. She has been working for the last 17 hours since the men, along with other patients, were transferred from front-line cities. A doctor with the international humanitarian aid organisation Doctors Without Borders or Médecins Sans Frontières (MSF), Kyniv has been caring for the sick and injured on these weekly medical evacuations by rail since March 23.

MSF currently runs Ukraine’s only known specialised medical train, carrying patients from hospitals in the embattled east to hospitals in the west that are considered safer. The train’s carriages have had the seats removed and been refitted with beds, generators for oxygen and medical devices and an intensive care unit.

“Today, we had to drop off a woman in Dnipro before we came here. She was losing too much blood,” Kyniv says, referring to the city in eastern Ukraine located about 240 kilometres (149 miles) from the nearest front line. The decision was made en route, when doctors realised that surgery on the woman’s mangled foot could not wait until they arrived in Lviv.

Kyniv vividly remembers several patients she had met on board the train recently, all from Donbas. “There was a woman from Mariupol with a heavy injury to her face, she had lost her eye. And some children from Kramatorsk who had lost their limbs because of a missile raid near them. Each time I see people moving east to west, they’ve lost something – their homes, their families. For me, this doesn’t feel like just a job. It’s emotional too,” she says.

But she has also witnessed many tender moments, such as when patients who worry that they cannot take their pets with them are overjoyed to find out that the animals are allowed on board. “Yes, we take everyone,” she laughs.