MSF doctor Lisa Searle recounts her experience caring for displaced people in Kharkiv metro stations
Since the start of the war in Ukraine, Kharkiv, the country’s second city, has been hard hit by the Russian offensive. While many of the 1.8 million people who lived in Kharkiv before the war broke out have fled, some 350,000 people who were unwilling or unable to leave remain in the city, according to local authorities.
Many took refuge in underground metro stations to escape the incessant bombardments. Trapped underground, they are cut off from essential services, including health care. From children who are too afraid to fall asleep, to people who feel like they can’t breathe, to patients with high blood pressure at risk of stroke, the mobile clinics of Médecins Sans Frontières/Médecins Sans Frontières (MSF) working in multiple stations across three of Kharkiv’s metro lines addresses a wide range of health issues, both pre-existing and conflict-related or exacerbated.
Here, Lisa Searle, an MSF doctor, describes her experiences caring for refugee patients under the city.
The public transport system has completely collapsed here and the network of underground metro stations has become a haven for people whose homes have been destroyed by airstrikes and bombings, or who are too afraid to stay at home. above the surface. Being on the surface now seems so strange, eerie. A few people rushing through the streets by one or two holding bags of groceries. Trying to get to safety before the next air raid alarm sounds, which often happens at least four or five times a day. And after only a few days here, the sound of incoming and outgoing shelling has become background noise. It’s just too exhausting to spend too much time thinking about what it means every time we hear that sound. Another building destroyed, more lives lost and houses destroyed. Today, during one of my too brief visits to the surface, I could see smoke rising from a building that had just been hit, in a part of the city already destroyed and undergoing every day more damage. Blows from above force the contents of buildings to vomit into the streets. Books, clothes, shredded insulation, bricks, curtains and pots dragging out of the buildings to the ground, like intestines dangling from a disembowelled body.
The whole country is in a state of emergency. The few remaining inhabitants of this city are crammed underground, crammed into subways or in makeshift basement shelters. Try to survive. Most of the people who could afford it left, leaving behind the elderly, the disabled, the chronically mentally ill. The most vulnerable. During the day, some people venture outside, squinting at the bright lights and shuffling through the streets, terrified and waiting for the next impact. Some people are too scared to surface and have been underground for weeks.
We work underground, run mobile clinics for the displaced population, and sleep in underground metro stations with whatever we can find. With the sudden influx of displaced people from Ukraine, over 6 million now across the country, there is no camping gear anywhere. The nights are cold, so people wrap themselves in coats and blankets, trying to stay warm. As we finished our clinic tonight and packed our bags, making our way through the crowded platform, a woman I had treated called me “Doctor!”, and handed me a shiny red apple. with a smile. I took it gratefully, holding her hand for a second, touched that she wanted to share what little she had with me. She looked me in the eyes, thanking me profusely for being there. She lost her home in the bombings and has nowhere to go. She suffers from panic attacks and insomnia, and does not have access to her usual medication for high blood pressure.
Tonight I spoke to an elderly woman whose home was hit and destroyed yesterday. She and her husband were at home, she inside the apartment and he on the stairs. They heard the first explosion and had no time to react before their block was hit. They were pulled from the rubble by the emergency services and, miraculously, the only injury between them was a ruptured eardrum. She was upset. She has nowhere to go, so she joined the thousands like her who now live an underground life, with no privacy or sanitation facilities. Stories like this are everywhere. As many patients as we see come to us for a problem that seems simple enough at first glance, such as additional medication for high blood pressure, or a checkup for a sore throat. But once we start talking to them, they often break down, words welling up from them about the horrors they’ve endured.
I treated an 11 year old boy two nights ago whose father brought him to see me. Initially he was complaining of breathing difficulties, and when I asked a few more questions it became clear that this only happens when he has to come to the surface. Panic attacks are common among people living here underground. They are terrified of surfacing and many of them suffer severe panic attacks at the mere prospect of ascending.
Amidst all this suffering, something inspiring and positive is the emergence of local networks of volunteers across the city: people who organize and work together to help those most in need. Residents who have decided to stay here are taking requests from those stuck at home and coordinating donations of food, hygiene items and medicine. Local drivers move around the city, taking huge risks to get these much-needed items to the most vulnerable. Every day I meet people whose compassion and determination to help the most vulnerable bring tears to my eyes and force me to see the hope that lives on in this devastated place.