Vitalii and Dmytro Averchuk, father-and-son heart surgeons in Lviv, western Ukraine, are doing their utmost to prevent war destroying the orderly calm of their department.
Beyond their hospital's thick 18th-century walls, Lviv is still functioning, but normality is long gone: 1.5 million people have fled across the nearby border into Poland since Russia poured troops into Ukraine last month, and the city's peacetime population of 700,000 has swelled by about a third.
The old town’s statues are now swathed in protective padding and plastic, its church windows are boarded up, while wounded soldiers are arriving at Lviv’s military hospital and in its Lychakiv cemetery fresh flowers crown the graves of their fallen comrades.
Russian forces are pushing into Ukraine in a huge arc from the east, north and south, devastating cities such as Kharkiv and Mariupol and bombarding the capital, Kyiv, and other major centres such as Odesa, Dnipro, Kherson and Zhytomyr.
The war rattled Lviv in the early hours of Sunday with a deadly rocket attack on a nearby military base, but it remains the biggest city in Ukraine that has not yet been targeted by Russia, making it a safe haven and turning its regional clinical hospital into a lifeline for thousands of Ukrainians who need urgent treatment.
“Patients are arriving from Kyiv region, Kharkiv, Odesa, Vinnytsia and other cities. They are finding out about us on the web and coming here themselves, so now we are helping people not just from all over western Ukraine but also refugees too,” says Vitalii Averchuk, head of the hospital’s cardiac surgery department.
He says the inflow of patients has already “doubled or tripled”, at a time when it is getting harder to source key supplies from war-torn cities in Ukraine and one of his team is now a military surgeon near the frontline.
“We don’t have issues with staff, but supplies are already a problem. From the east they have stopped almost completely. Disposables like needles, syringes, sutures, we can get from western countries, but some important drugs and other things that we got from eastern Ukraine are already becoming scarcer,” says Averchuk (66).
Fundraising efforts and donated foreign equipment help the cardiac unit provide a “European level” of care for all patients, says surgeon Dmytro Averchuk.
“But some of our machines are 20-30 years old. Every day we are in contact with potential partners from abroad,” to discuss ways they can help, says Dmytro, who studied in Britain.
Devastation
One recent morning, the Averchuks and their colleagues were looking after 26 cardiac patients on their wards, 11 more were in intensive care, and two open-heart procedures were planned for that day.
As Russian forces appeared poised for a major assault on Kyiv, Vitalii admits it is “quite possible” that his department could soon face an influx of heart patients from the capital, as well as of wounded civilians and soldiers: “We are getting ready,” he says.
What they cannot prepare for is the type of devastation seen in cities such as Kharkiv and Mariupol, where civilian infrastructure has been levelled in an invasion that Ukraine says has killed thousands of people.
“We understand the Russians may hit any object, they will not stop,” says Dmytro (39) “They will hit hospitals, kindergartens, children – it is horrible but it’s true.”
For centuries Lviv has been a bastion of Ukrainian culture, language and national identity, and as diplomatic missions and international agencies relocate here from Kyiv, there is talk of it becoming the de facto capital of a free Ukraine if Russia occupies Kyiv.
“The war has really unified and mobilised our society. Everyone is doing not only their normal work, but also volunteer work too, helping refugees, sending help to the frontline,” says Vitalii.
“This is a kind of test for us, to see if Ukraine deserves to remain a country and a nation. Our motherland, our territory is very dear to us Ukrainians. Russia doesn’t understand this. It thinks this territory is theirs, because they are bigger and stronger – they think it is some sort of ‘misunderstanding’ that we exist.”
Whatever happens, Dmytro says, “no one will be sent away from here without help”.
“This building is 250 years old, so we have thick walls, including in our operating theatres,” his father explains.
“They will give us some protection, and we cannot just move everything underground,” he adds. “If the war comes to Lviv, I think we’ll just sleep here in the hospital. And we’ll be ready to work all the time.”
