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From the front-line zone to the west: how a special sanitary train transports the sick and wounded

A special sanitary train has been running through Ukraine for seven months. It takes people from front-line towns and villages to hospitals in the west of the country. We traveled this route to tell the difficult stories of its optimistic passengers

Photo: Andrii Boiko / Babel

Since March, a sanitary train has been running through Ukraine. It was launched by the international organization Doctors Without Borders. In seven months, it has already transported 2,000 people. These are victims of shelling or seriously ill people who cannot receive proper medical care at home. Journalist Yuliana Skibitska and photographer Andrii Boiko spent a night on this train. It went from Pokrovsk, a city in the Donetsk region, to Vinnytsia on the right bank of the Dnipro River. And this is what the road was like.

The train

October 28, 6 p.m. The railway station in Dnipro is unusually dark and uncrowded for a transport hub in a big city during rush hour. On the first platform, the ambulance beacons are flashing along with the dim cigarette lights. Several drivers smoke there while having a small talk:

“When will it arrive?”
“In time – probably at 6:30.”
“For how long [will it stay here]? What do you think?”
“Well, until it gets loaded, maybe for 20 minutes. There are not many people.”

Photo: Andrii Boiko / Babel
Photo: Andrii Boiko / Babel

We are waiting for the sanitary train that leaves Pokrovsk. Here, in Dnipro, it will pick up a few more patients and go to Khmelnytskyi. The whole trip will take a little more than a day.

The train is as dark as the platform. The windows in most carriages aren’t transparent, so it’s impossible to see what is happening inside. Some of the windows have stickers with a crossed-out machine gun, which means that the train is carrying civilians. The coordinator of this train is Albina Zharkova – short and dark-haired, she looks a little over 35 years old. Together with the ambulance workers, she monitors how patients are put on the train. Today, wounded children are also here.

“You will sleep here,” Albina leads us into an empty carriage. There are several hospital beds in it, bolted to the floor so that they don’t shake on the way. Near the exit is a device for measuring blood pressure and pulse. “This train is half-empty for us, because we hardly picked up any patients on the way [from Pokrovsk]. That’s why we’re giving you a whole car.”

Photo: Andrii Boiko / Babel

“I thought the ill people would come in now, but they are completely healthy,” conductor Mykhailo, who is in charge of the carriage, looks at us and laughs. He has been working here since the first day of the full-scale invasion. “There were different people here,” he continues. “Once it was impossible to enter the carriage. Others ran past it without stopping.”

“Why?” I ask.

“There were people with gangrene. It was summer, hot weather. We bandaged the wounds, but then you need to do the procedures, wash them. It is necessary to untie the wounds again. Can you imagine what the smell was like? But what can you do? You won’t throw them out of the train, these are our people.”

There are eight carriages in the train. Patients occupy only three of them.

“Every time it’s different,” explains Albina. “Sometimes they carry more people, sometimes less. Much depends on the situation at the front and with shellings. For example, [on April 8], when the Russians shelled the railway station in Kramatorsk [and 61 person died], the train took dozens of people. Many of them were with children.”

Photo: Andrii Boiko / Babel
Photo: Andrii Boiko / Babel

“In the beginning, we worked non-stop,” explains Albina, showing us the train. “On the first trip, we had only three doctors. One trip ended, and we immediately went to a new one. There was no rest. Now it’s easier, we have enough people. The train runs according to the schedule twice a week.”

The carriages are completely converted to meet the patients’ needs. Instead of the usual compartments, there are wide hospital beds. In another carriage, half of the space is occupied by the kitchen, where the doctors can eat. Another carriage has a huge generator for the uninterrupted operation of ventilators and resuscitation equipment. The resuscitation carriage is at the end of the train. Today wounded children from the Donetsk region are being transported there. Part of the carriage is covered with a white sheet and we don’t go there. In the part that is open, there is only one bed with a very pale six-year-old boy. Next to him is his mother, who gently caresses his hand. I wink at him as I pass by – the boy barely smiles with pale lips. Worried doctors in green medical suits and reflective vests constantly walk between the beds.

“Do you take out only the wounded people?” I ask Albina.

“No, not only them,” she answers, straightening the sheets on one of the patients’ beds. “We have several groups of people. These are the wounded, non-walking patients, and people with serious illnesses. Also, there are so-called social patients – elderly people who don’t have relatives or a home. We have a large network of volunteers in different Donbas cities. They pick up people who need help and bring them to Pokrovsk. From there, patients get on the train. And then we take them to the west of Ukraine. We are constantly in contact with the Ministry of Health in order to understand where there are vacant places in hospitals. We try not to overload them. For example, if the last train was to Lviv, then the next one will be to Khmelnytskyi.”

People

We get into another carriage. There are six people in it. I ask the doctors who I could talk to. They laugh.

“Go to number 18,” says the young doctor. “She is always willing to communicate with everyone.”
“She’s a positive person,” adds another doctor. “She will cheer you up now.”

Photo: Andrii Boiko / Babel

Number 18 is a 70-year-old woman. At first glance, she seems thick, but then we realize that it’s a bandage on her stomach. The woman smiles kindly with her toothless mouth as we approach. Her name is Tetiana Ivanivna , she is from Kramatorsk. Tetiana came under fire on September 17.

“I was standing right next to the bank,” tells Tetiana Ivanivna. “And here is the rocket.”
“Why did you walk the streets during the air raid alert?” I ask.
“How сould I not! Who will buy the products? Who will go to the pharmacy? I was just going to the pharmacy.”

Tetiana Ivanivna lives alone in Kramatorsk. She has neither children nor husband. She has lived there all her life. During the shelling, she was wounded in the stomach. I ask why didn`t she leave the city.

Photo: Andrii Boiko / Babel

“There’s nobody waiting for me anywhere! As people always said in our country, you come in handy where you were born.”

“Weren’t you afraid to stay in Kramatorsk?”

“I wasn’t afraid! What should I be afraid of? Walking around my city?” she answers.

Another woman with a short haircut is on the bed behind us. She listens to our conversation and smiles. “I tell everyone – I will return to Kramatorsk in the spring. And no one will stop me! Where I was born – there I will die. However, I’m not planning to die, don’t think so. They put a bandage on my stomach and now I feel better than anyone else!”

I come to a woman with a short haircut. This is Kateryna Pavlivna from the village of Rubtsi near Lyman. She is 71 years old, thin, in a blue dressing gown that seems to be several sizes bigger than needed. Wrapped in a woolen blanket, Kateryna half-sits on the bed. She holds a plastic bowl with leftover porridge that was for dinner. Seeing us, she puts the dish away and smiles. On September 14, when there was fierce fighting around her village, during the shelling, the woman fell into the cellar and broke her hip.

Photo: Andrii Boiko / Babel

“I have laid at home for a month and a half alone,” says Kateryna Pavlivna and begins to cry. “Then the Red Cross came and took me to Kramatorsk. I spent two days in the hospital there. For now, I am going to Lviv.”

Kateryna Pavlivna has a large family. There are two sons, two daughters, five grandchildren, and a great-grandson who was recently born. Almost all of them are now in the temporarily occupied territory of the Donetsk region. When hard fighting began in the Lyman district in September, the family left. Now they cannot return: they say, occupational authorities don’t let them. Kateryna Pavlivna did not want to go. She stayed to look after the house, also she didn’t want to leave the dogs.

“There were terrible battles, so terrible,” the woman continues the story. “Back when the Russians came [on May 26], it was loud. But we knew that now it would be worse, because they [the Russians] would not want to leave. And that’s how it turned out. They [missiles and projectiles] were constantly flying over my house. Then there was a loud bang, and I fell. Was laying there alone for two days, without water, without food, and unable to move. I heard the dogs whining and crying – but I couldn’t get up. I just listened to them.”

Kateryna Pavlivna wipes her tears. Her hands are shaking. I take her hand, the woman calms down a little and then continues.

Photo: Andrii Boiko / Babel

“Then the neighbor came and found me in the cellar. She carried me to the house and then came to me once a day ― to check my condition and give me food. I asked her to feed the dogs. I don’t know if she fed them or not, but my dogs are gone… Then the volunteers found me. Dima and Taras, such good boys, saved me. God bless them. I think – how did I survive? Why did God leave me here?”

I say that the worst is over. Kateryna Pavlivna shakes her head affirmatively.

“My great-grandson was born. I immediately called my daughter, and he muttered something into the phone. I want to hold him at least once.”

Hope

The carriage where the doctors and conductors rest is the only one that looks like an ordinary passenger train. There is almost no one here in the evening. Doctors are busy with patients. One old man complains of stomach pain. The doctor measures his blood pressure and temperature. Albina and I are sitting on an empty bed. I ask how she deals with her emotions after each such trip.

Photo: Andrii Boiko / Babel
Photo: Andrii Boiko / Babel

“I remember my first one very well. There was a big family from Mariupol – a husband and wife, a child, and their parents. When they tried to leave the city, the convoy [in which they were going] was fired upon. The child was in the grandfather’s arms, in the front seat. He covered the baby with himself, so the kid was almost unharmed. All other people suffered greatly. And you listen to these stories and understand how close it is to you. Back then, at the very beginning, when we worked every day without rest, there was no time to think. You know what you are doing and why you are doing it. And this saves you.”

Albina is from Sumy. She graduated from a medical university, worked as a doctor and taught. At the beginning of the full-scale invasion, Sumy was surrounded immediately. Albina managed to leave the city in three weeks. She came to Uzhhorod and then had to go abroad.

Photo: Andrii Boiko / Babel

“I said to myself every time – well, I’ll spend one more day in Uzhhorod,” smiles Albina. “Then one more day and another day. I was supposed to leave for Latvia, already had a ticket in hand and everything was arranged. But I arrived at the border and realized that I just can’t go. Then I saw that Doctors Without Borders was looking for staff workers in Ukraine. I was always interested in working for an international organization, so I sent an application and was accepted.”

She quickly replies to someone’s message and continues.

“When I talk to foreign colleagues, they are often surprised by how calm I am. They don’t understand: we have a war, but we smile and behave as usual. You have to go on living, life isn’t over.”

It’s 9 p.m. and almost all the patients are asleep. In one of the carriages there is a family ― a man, a woman, and two sons. They are from Bakhmut, the Donetsk region. The Russians have been unsuccessfully trying to capture the city since July and are mercilessly shelling it every day. Because of these failed attempts, Bakhmut became so famous that even Elon Musk knows about it.

Photo: Andrii Boiko / Babel

The woman’s name is Yuliia, she agrees to talk.

“The projectile flew right into the room where we were sitting,” she says. I can barely hear her, because the train knocks monotonously and Yulia speaks very quietly. “I have a leg amputation and so does my husband. The older son was hit in the hand, the younger one has a concussion.”

“Why didn’t you leave Bakhmut?” I ask.

“You know how it is. We kept thinking: maybe this won’t touch us. The shelling was heavy, but it never reached us. I didn’t want to go anywhere, to leave our house. Our whole life is in Bakhmut. Now I blame myself so much that we didn’t leave earlier…”

Yuliia is crying. I awkwardly stomp on the spot. Then suddenly for myself, I say:

“You never know how it will turn out. I was told a story about a family from the Chernihiv region. They survived the occupation. As soon as our troops entered, they decided to leave for the west. And blew up a mine on the way, everyone died.”

Yuliia is silent. It seems to me that I said something frankly tactless, but the woman suddenly agrees with me.

“Yes. Probably, you are right. That’s how it is in life. At least we are alive. Unfortunately, there is nowhere to return. Nothing is left of the house.”

“But the main point is that you are all alive. Hold on.”

Yuliia barely smiles and thanks. She takes my hand in farewell and also wishes for strength. She says: “All of us need to stick together now more than ever.”

At 6 in the morning, we arrive in Vinnytsia. The train is still sleeping. Albina comes to see us off.

“Have you even slept?” I ask her.
“A little bit,” she shakes her head like very preoccupied people usually do.
“How was the night? Is everything okay?”

Albina again shakes her head uncertainly. I remember what conductor Mykhailo said at the beginning of the trip: patients here are different and not all of them are grateful to the doctors. And also Tetiana Ivanivna’s words that she will definitely return home to Kramatorsk. Most of the passengers of this train have nowhere to return.