A `terrible nightmare': Treating Ukraine's wounded civilians

POKROVSK, UKRAINE » In wheelchairs and on stretchers, in ambulances and on train station platforms, they wait. Medical workers pull out ramps and wheel the patients onto the specially equipped train that will carry them westwards, away from the fighting raging in eastern Ukraine.

Run by the aid organization Medecins Sans Frontieres (Doctors Without Borders),

the train is a lifeline for the overwhelmed hospitals in cities and towns near Ukraine's front lines that are struggling to cope with an influx of war wounded on top of their usual flow of sick patients.

“Since the beginning of the war, the hospital capacity in the east is under pressure,” said Yasser Kamaledin, MSF's emergency project coordinator for the medical evacuation train, which includes an intensive care unit.

“The idea of this activity is to support the hospitals that are closer to the front line, to empty some bed capacity so they can receive more patients from the attacks, the conflict, but also other chronic patients,” Kamaledin said.

Since it started running on March 31, the train has ferried nearly 600 people to hospitals in safer areas of western Ukraine, he said, including around 30 more people on Sunday.

They included 40-yearold Mykola Pastukh. He was wounded Saturday near Sievierodonetsk by a mortar shell that landed as he tried to ferry humanitarian aid into the city, which has been under fierce attack as Russian forces intensify their efforts to seize Ukrainian territory in the east.

There was still shrapnel inside him, he said as he stood on the train platform nursing his right arm in a sling under his shirt. He needed surgery but the hospital in Lysychansk, a city close to Sievierodonetsk that was also under fierce Russian attack, just couldn't cope. So he was being evacuated to Lviv in western Ukraine for the operation.

There are other, regular evacuation trains going west and onto which older people and the sick are boarded, but the MSF train is especially equipped to care for patients.

The pressure on Ukraine's eastern hospitals is most evident after an attack, when casualties arrive one after the other. Last week, medics wheeled a patient with severe head injuries into the hospital in the town of Pokrovsk as doctors, jaws clenched, triaged patients who were wounded when two rockets landed.

There were only a handful of wounded people. But the hospital is stretched. It has been operating with around half the staff it used to have, working with a backdrop of sandbags stacked up against boardedup windows.