In early October 2022, Rachel Clarke hurried into Kyiv’s bomb shelters with hundreds of Ukrainians. The UK-based National Health Service (NHS) doctor and author was visiting Ukraine to provide support and training to doctors caring for the dying at hospices around the country. However, the visit to the capital came just as Russia was bombarding the city’s power infrastructure with missiles.
“You didn’t just hear the missiles landing, you felt that they reverberated in your chest,” Clarke explained at WIRED Health in London this March. Above ground, windows were blown out. Shattered glass lined the streets. “I was terrified,” Clarke says. “The Ukrainian people have endured this for months.”
Since Russia’s full-scale invasion started in February 2022, the whole of life in Ukraine has been impacted, including its health care system. Hospitals have been destroyed and damaged, medical facilities have been looted, and landmines have been found inside functioning Ukrainian hospitals that Russian forces had briefly occupied, according to the charity Médecins Sans Frontières. Those who lived in occupied areas had essential medicines and treatments restricted, the charity says.
Throughout the war, millions of people have been displaced from eastern Ukraine, and the continued fighting has been putting further strain on the country’s medical infrastructure at all levels. Surgeons operating on patients have learned to continue with procedures when air raid sirens start, Clarke says. Ambulances carrying people have been dug out of mud and snow after getting stuck.
Among the widespread disruption, the war has curbed the care that can be provided to those who are terminally ill—including soldiers wounded on the front lines. Clarke, a palliative care doctor within the NHS, says patients and those who care for them need more support. One hospice she visited, a three-story building that cares for up to 30 patients, couldn’t afford a lift, so those who couldn’t make it down the stairs were stuck inside. Similar scenes are repeated across the country’s hospices. One patient who is living with a terminal lung condition and cannot afford to donate to the hospice has been knitting socks for the doctors and nurses caring for her, Clarke says.
Greater supplies of morphine and pressure-relieving mattresses are two “low-tech interventions” that could help support people, she says. Clarke and neurosurgeon Henry Marsh have now set up a new charity, Hospice Ukraine, to provide further training for staff and fund further supplies. It will work with “trusted local partners” to improve care, Clarke says. The aim is to help provide some relief for those dealing with the deadly consequences of war. “Health care in Ukraine is being deliberately targeted as a weapon of war,” Clarke said as the charity launched. “If you maim a doctor, you are also harming all the other people that doctor might have treated.”
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