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Badly damaged Ukrainian hospital struggles to provide emergency services

STEVE INSKEEP, HOST:

The World Health Organization says medical facilities in Ukraine have endured more than 90 separate attacks since the Russian assault began. One hospital in Chernihiv is working to stay open. NPR's Ari Daniel reports.

ARI DANIEL, BYLINE: On March 16, multiple shells exploded near City Hospital No. 2. One detonated inside. Vladislav Khuhar (ph) was there. He's the hospital director and a surgeon.

VLADISLAV KHUHAR: (Through interpreter) That was one of the first spring days. The sky was cloudless. It was cold, yes, but the sky was so blue. These explosions, it all seemed so unreal. We realized that we were the target.

DANIEL: The emergency department was instantly destroyed. The shockwaves shattered windows across all nine floors, showering everything with broken glass. Beds spun. Doors sailed down hallways.

KHUHAR: (Through interpreter) It was like an apocalypse. There was white fog of cement and dust in the building, in the hallways and rooms. There was an alarm sounding, the screams of patients and the medical personnel.

DANIEL: Like a photograph seared into his memory, Khuhar remembers a girl crying in the hallway. He raced to the operating rooms. His colleagues were still alive. Next, he ran to what little remained of the emergency department.

KHUHAR: (Through interpreter) We were trying to find all the wounded to prioritize them, to render them necessary aid, such as sedatives.

DANIEL: Within an hour of the attack, Tatiana Lebedieva (ph) stepped into the shell that was City Hospital No. 2.

TATIANA LEBEDIEVA: (Non-English language spoken).

UNIDENTIFIED PERSON: (Interpreting) It was very, very difficult, emotional moment.

DANIEL: Lebedieva is deputy director of the Chernihiv Health Department, and it's become her job to document the assaults on health facilities. Her daughter, based outside of Ukraine, is interpreting for her and gets upset when she hears her mother describe what happened that day.

LEBEDIEVA: (Non-English language spoken).

UNIDENTIFIED PERSON: (Interpreting) Because we - in our city...

I'm sorry.

(Interpreting) My job required me to drive around the city and check every hospital. And I was there after that happened.

DANIEL: The scene was overwhelming. This place of healing, she says, had been so beautiful.

LEBEDIEVA: (Non-English language spoken).

UNIDENTIFIED PERSON: (Interpreting) In this hospital, we have more than 300 doctors of more than 30 specializations.

DANIEL: In seconds, all that was gone, and they feared a further attack.

LEBEDIEVA: (Non-English language spoken).

UNIDENTIFIED PERSON: (Interpreting) The decision was taken very quickly to move all the patients who were able to walk, to move them to the - on the ground floors.

DANIEL: Those who had been recovering post-op were brought into the hallways, where it was safer.

LEBEDIEVA: (Non-English language spoken).

UNIDENTIFIED PERSON: (Interpreting) Everyone was very scared. The patients, everything that has been done to help them to live their life longer is being destroyed in seconds or minutes. And it's such a pain in your heart and hopelessness in your soul.

DANIEL: This is what Tatiana Lebedieva had come to document - the latest in a string of attacks on health infrastructure, verification of possible war crimes. This was the city's sixth hospital damage report.

LEBEDIEVA: (Non-English language spoken).

UNIDENTIFIED PERSON: (Interpreting) We need to have the evidence that this happened. This is a breach of all military conventions.

DANIEL: The hospital staff repaired the buildings the best they could. It took four days to cover the windows with plywood and tarps. The hospital contracted to the ground floor, transforming into an emergency triage center.

Director Vladislav Khuhar.

KHUHAR: (Through interpreter) There was no alternative. We were there to help under any circumstances. That's what we did. That's what we had to do. Fate has made this choice for us.

DANIEL: More than half of Chernihiv's population has fled, but numerous medical personnel have stayed behind to help at City Hospital No. 2, like Alexander Rashenko (ph). In the before times, he was a pediatric surgeon elsewhere in Chernihiv. One person told me he has hands that are capable of big miracles. But once the war broke out, Rashenko became a full-time volunteer trauma surgeon. As we're speaking, explosions start going off in the background.

ALEXANDER RASHENKO: (Through interpreter) Right now, above my head, is some artillery bombing - the sound, you could hear.

(SOUNDBITE OF MUFFLED EXPLOSIONS)

DANIEL: Rashenko tends the wounds caused by explosions like these. Often, he's extracting shrapnel and bullets from the bodies of his patients. His days have followed a cycle, pinned to the sounds of fresh bombs. He says when the explosions pause, staff holed up in the basement stream out of the hospital with gurneys and tourniquets, ferrying new patients back inside, where the triage begins anew.

RASHENKO: (Through interpreter) You need to understand whom you should help first, whom you should help second turn and whom there is no sense to help anymore. And that's part of this new reality.

DANIEL: Rashenko and the other surgeons do the best they can, running their operating equipment on generators. But fuel is scarce.

RASHENKO: (Through interpreter) In the night, the temperature was minus, so you could imagine what are the conditions in the hospital without windows.

DANIEL: Within Chernihiv's city limits, all seven municipal hospitals are damaged, and only three remain partially open. And while other parts of Ukraine have been spared, Chernihiv isn't alone. Health infrastructure in the regions of Kyiv, Luhansk, Kharkiv, Mariupol and elsewhere have all been hit hard. As for Vladislav Khuhar, the director of City Hospital No. 2, he actually says he's filled with gratitude for those who helped repair the hospital and for his colleagues who've stayed to help others heal.

KHUHAR: (Through interpreter) It demands more effort these days. But the patients get better. They leave the hospital, and they get their health back. And it brings us joy. It brings us pride. And it's the greatest honor in this situation.

DANIEL: At this point in our interview, Khuhar politely tells me he must get going; he has patients who need him.

Ari Daniel, NPR News. Transcript provided by NPR, Copyright NPR.

Ari Daniel is a reporter for NPR's Science desk where he covers global health and development.