A year ago, in southern Ukraine, the staff of Snihurivka's regional hospital rallied to treat the constant stream of wounded civilians and combatants—what these medical professionals didn’t realize was who they would be forced to coexist with.
Russian troops closed in on Snihurivka, in southern Ukraine, the staff at the town’s large regional hospital rallied to treat the constant stream of wounded civilians and combatants. What these medical professionals didn’t realize, however, was that for the next nine months they would be forced to coexist with the hospital’s new overseers: the invading commanders and soldiers themselves.
Snihurivka hospital is located in Mykolaiv, a region on the Black Sea, some 80 miles from Odessa. When Russia began its full-scale invasion of Ukraine on February 24, 2022, towns along Ukraine’s southern flank, north and east of annexed Crimea, were early targets of the advancing troops. By March 19, Snihurivka fell under Russian occupation.
A little over a year ago, Dvoretska had retired from her work at Snihurivka and joined a private laboratory. But when the first explosions hit, in March, she knew the wounded would soon be arriving in droves, putting a strain on the hospital staff. And she felt useless sitting at home. Just a few days into the war, she reached out to the most senior doctor at Snihurivka. “If my hands are needed,” she texted. “I am ready.
First encounters like this frightened her and the other nurses, who said they experienced similar treatment whenever armed Russian troops came into the hospital. Soon, the soldiers were showing up at the institution almost every day. But one man stepped up to fill the gap—on the very first day of the war. Valentyn Shmyhelsky, a 61-year-old neuropathologist, volunteered to run the operation. He also took it on himself to deal with the Russians directly.
As one of the attending doctors explained, there were many elderly men among those who had been mobilized to serve in the Russian army. Frequently, according to the physician, these conscripts had heart disease or kidney issues and would seek aid for chronic problems. Others would come in when they were injured by friendly fire or after suffering a mishap during a night of drinking—a binge they wanted to keep hidden from their superiors.
Then and there, the acting chief of the hospital decided he had to immediately seek refuge in Mykolaiv. As he would later assert—echoing many other medical personnel who found themselves in similar situations—“I didn’t accept” the idea of leaving; instead, he insisted, “I wasBefore his departure, on April 30, Shmyhelsky appointed a younger, trusted doctor—a urologist named Volodymyr Todosenko—as his replacement.
For the medical staff, it was painful to recognize their former patients among the civilian casualties. “I will never forget one young girl, born 1986, who came in with some gynecological issues,” remembered chief surgery nurse Natalia Libedenko. A while later, “her body was brought into the hospital after yet another bombing.”
Destroyed cars, along the roads leading to non-occupied territories. The “Z” insignia was routinely emblazoned on vehicles used by Russian troops or Russia-aligned militias.The Russian occupying forces targeted women too. Libedenko relayed a story of a woman who had been previously treated for a shrapnel wound in her cheek, which she had endured during a shelling that had also killed a man and a young girl.
In many cases in Snihurivka—as seen time and again across Ukraine—arrests of citizens by occupying forces happened without evidence, and the Russians often did not explain the reason for a particular detention. Instead, they often accused their victims of cooperating with the Ukrainian army, of being politically active before the war, or of having a Ukrainian flag at home.
Tkachuk’s situation was particularly dangerous. As a dentist—part of a separate unit from the rest of the facility—she usually worked with a single assistant nurse in an empty, four-story building. Because many of the dentists had left at the start of the war, she was on her own, sometimes tending to five or six patients a day.
Tkachuk, who trained at medical school in Kyiv, resisted pleas from her daughter, also a doctor, who begged her to return home to Ukraine’s capital. “Our generation was brought up this way,” she said. “In my apartment block, all the people are old. They all asked, ‘Who would they ask for a pill? What if a tooth needs attention?’ So we stayed together.
The longer the occupation lasted, the more difficult it was for the staff to deal with the Russians’ demands. For most of the year, the doctors’ salaries were still being deposited by the Ukrainian state directly into their accounts in Ukrainian banks. But with no working ATMs in the city, staffers could not access the funds. Even so, they found ways to pay for things online or to transfer money.
Todosenko gathered the hospital staff to explain his decision. He said that his wife, a nurse, instrumental to the functioning of the hospital, needed to go with him as well. “We came to say goodbye and explain our actions,” he told the assembled teams. “We couldn’t just flee. But there was no choice left to us.” He promised to return as soon as he could.weeks to make it safely into government-controlled territory, including the time they spent in a processing center in the Zaporizhzhya region.
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