World

In Rural Ukraine, Medicine and Hope Roll In on a Truck

Young mothers gather with baby carriages in the morning chill and exchange village gossip while waiting to visit a health clinic on a truck. The vehicle’s arrival is a big event.

For eight months, the village of Levkivka in eastern Ukraine was under occupation by Russian troops, who cut off roughly 300 residents from the outside world. There was no running water or power, and Russian soldiers would often snatch their cellphones and stomp on them, fearful that locals would betray their locations, residents said. The only medical care was provided by two village nurses, who braved the constant shelling to make house calls with limited supplies and medicine.

Though Ukrainian forces recaptured Levkivka in September, reconnecting the village to basic services has come slowly. Power and water are back, but medical care is still hard to come by. The medical truck, provided by the United Nations Population Fund and staffed with doctors from the city of Kharkiv, 75 miles to the north, travels around the region, part of a continuing Ukrainian government effort to bring a semblance of normalcy to once occupied villages in the east.

With Russian troops dug in just 50 miles away and the occasional rumble of artillery in the distance, there is a palpable sense of urgency. Ukraine’s military may have cleared the immediate area of Russian forces, but fully controlling territory means more than planting a flag. And in the villages of eastern Ukraine, where many locals speak a blend of Ukrainian and Russian called surzhik, loyalty to Kyiv is not guaranteed.

Ukrainian mothers and their babies waiting for checkups in Levkivka, Ukraine, from a team that provides services to villagers who have largely not had access to doctors since Russia’s full-scale invasion began nearly a year ago.

A couple hugging while waiting to see a doctor in the mobile medical truck in the Kharkiv region. While the war is not far from people’s minds, most villagers are preoccupied with more quotidian concerns.Credit…Lynsey Addario for The New York Times

Viktor Putyetin, 62, who came to the mobile clinic for a checkup, said in a whisper that there was significant support for the Russian troops in Levkivka, though he strongly opposed the Kremlin’s designs on Ukraine. He said that under occupation he approached a 22-year-old Russian soldier operating an air-defense battery, who was wearing an arm patch with the Soviet hammer and sickle.

The State of the War

  • A New Offensive: As the war intensifies in Eastern Ukraine, doctors struggle to handle an influx of injuries and soldiers fret over the prospect of new waves of conscripts arriving from Russia.
  • Russia’s Economy: Shunned by the West, Russia was for a time able to redirect its oil exports to Asia and adopt sanction evasion schemes. But there are signs that Western controls are beginning to have a deep impact on the country’s energy earnings.
  • Leadership Shake-Up: President Volodymyr Zelensky’s political party will replace Ukraine’s defense minister, Oleksii Reznikov. The expected move comes amid a widening corruption scandal, although Mr. Reznikov was not implicated in wrongdoing.
  • Nuclear Fears Abate: U.S. policymakers and intelligence analysts are less worried about Russia using nuclear weapons in the war. But the threat could re-emerge, they say.

“I asked him, ‘Sonny, have you ever seen the Soviet Union?’” Mr. Putyetin said. “‘In the Soviet Union, you had to wipe your butt with newspaper because there was no toilet paper. Ask your dad about that.’”

While the war is not far from people’s minds, most in the village are preoccupied with more quotidian concerns like renewing drug prescriptions and dealing with their hypertension and diabetes. Many who arrived for medical checkups were women: either older adults or young mothers with babies.

Halina Romashenko, 26, gave birth to a son, Sasha, just as Ukrainian forces were pushing Russian troops out of the area. For seven months, she received no prenatal care and said she had to hide in her potato cellar as rockets crashed into the fields around her home. She said her family had no money to move and nowhere else to go.

“So we had to stay here,” Ms. Romashenko said.

A mother and her son during a checkup in Levkivka, which was formerly occupied by Russian forces.
Halina Cherednichenko, who is almost 80, said she gets free pills at the medical center. “A lot of people like me died a long time ago,” she said, “but I’m still moving.”

Valentina Kalashnikova, 66, her grandmother, accompanied her to the clinic, putting on sparkly pink lipstick for the occasion. The stress of the occupation had aggravated her high blood pressure. A shell destroyed her kitchen, and two of her cows were killed. She made an effort to smile brightly, but at times she could not keep the tears at bay.

“I’m scared, of course, mostly for them,” she said, pointing to her grandchild and great-grandchild. “I’m a war granny.”

Levkivka, a village of tidy homes along the Siversky Donets River, is in a region mangled by vicious fighting. The carcasses of tanks and armored vehicles, their metal hides perforated by rockets, litter the rolling farm fields. Whole villages have been simply wiped out, with piles of brick and charred wood where houses once stood.

Russian troops did not subject residents of Levkivka to the kinds of horrors endured in places like the Kyiv suburbs of Bucha or Irpin, where hundreds of civilians were killed. But their presence was still traumatic, locals said. Tatyana Budyanska, one of the two nurses in town, said she was on her way to a house call, her 3-year-old grandson in tow, when Russian troops stopped her and accused her of passing information to Ukrainian forces. They put an automatic rifle to the boy’s head, she said, but ultimately let them go.

Compared with many neighboring villages, Levkivka appears relatively unscathed, a bit of good fortune that locals attribute to the Russian military’s decision to retreat before the arrival of Ukrainian troops. One morning, residents woke up and the Russian forces were just gone.

Halina Romashenko, right, watching as Sasha, her son, was checked by a pediatrician in Levkivka. For seven months, she said she received no prenatal care and had to hide in her potato cellar amid fighting.
A doctor from Kharkiv during a prenatal exam in a village in the region.

This has made Levkivka a refuge for people whose homes fared far worse. Halina Cherednichenko, who is almost 80 and walks with a pronounced hunch, recalled rushing for water when her daughter’s house caught fire in an attack on her nearby village. She now lives in Levkivka, where volunteers provide her with groceries as well as with seeds for a small garden. At the medical center, she said, she gets free pills.

“I’m an old granny,” she said. “A lot of people like me died a long time ago, but I’m still moving.”

Alina Okunyeva, an ultrasound specialist with the mobile medical unit, said she had made an expansive survey of the villages once under occupation in Ukraine’s northeast. Some villages still do not have power or water she said, and telephone communications are spotty. Residents are isolated and suffering from the effects of stress. Hypertension is a major problem, she said, but, in general, people have held up well.

“I thought things would be much worse,” said Ms. Okunyeva, 27. “They’ll never beat our people.”

Villagers waiting for checkups from the medical team in Levkivka. Residents are often isolated and suffering from the effects of stress.
Getting an electrocardiogram in Levkivka.

For many, it is still difficult to suppress fears that the war will return to their village. Fighting has intensified nearby, and it appears as though Russian forces are preparing for a new offensive aimed at taking back some of the territory recaptured last year. Mines scattered in the farm fields periodically explode, straining the nerves.

“We’re alive, but still, we live in fear,” said Nina Kachenko, 72. “The war is still not over.”

While the mothers received checkups for their infants in the medical truck, a cardiologist with the group took over an office in the town’s clinic nearby, seeing mostly older patients. Outside the office, locals got into a spirited debate over whether Russians might rise up one day to overthrow their president, Vladimir V. Putin, just as Ukrainians once expelled their Kremlin-backed president in a popular uprising in 2014.

Halina Kapran, 66, who was dressed in a gray fur hat, said she believed that support for Mr. Putin was low among Russians and that one day they would liberate themselves. Mr. Putyetin dismissed the notion, arguing that propaganda had turned Russians into obedient farm animals.

“Halina, if I told you every day that you were a cow, you’d believe it,” he said.

Inside the medical office, the doctor was busy checking electrocardiograms and blood pressure. He also was dispensing prescriptions for anti-anxiety medicine.

Destruction in the city of Izium on the road to Levkivka, in a formerly occupied area of the Kharkiv region. Compared with many neighboring villages, Levkivka appeared relatively unscathed.

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