There were few certainties in the life of Ukrainian Oksana Fomeniuk since Russia invaded her country. But one thing she was sure of: the hospital where she was caring for her daughter Solomiya would be safe from bombs. And they had been there for almost three years. “You protected yourself with that thought,” explains the 35-year-old mother. On July 8, that faith vanished as quickly as a missile hit the same building where mother and daughter were: the toxicology ward of the Okhmatdit hospital, the largest pediatric specialist center in Ukraine. The attack left two dead – a doctor and a visitor – 18 injured, countless damages and 94 minors evacuated to other hospitals. Among them, Solomiya and the other seven young residents of the collapsed ward, whose images wandering around the building, bloodied and disoriented, went around the world.
A month and a half later, the news is worrying the parents of these patients, all suffering from terminal kidney disease. No agreement has been reached to rebuild the hospital, there are rumours that the nephrology service in the destroyed ward will not be re-established, and the Minister of Health has just suspended the director of the centre.
These eight children suffer from a type of chronic insufficiency that can only be solved with a transplant. They all benefited from a unique service in Ukraine: a children’s haemodialysis unit where they could live and were monitored 24 hours a day, with all the specialists and health services at their disposal. “While they are waiting for the transplant, they have to receive haemodialysis three times a week and they could do it there; in addition, their immune system is very low, so they often have other secondary diseases,” explains Fomeniuk.
The attack on the Okhmedit hospital has highlighted the consequences of the deterioration of the Ukrainian health system due to Russian attacks. Since 24 February 2022, the World Health Organization (WHO) has verified 1,921 attacks on medical facilities, laboratories, ambulances, staff and patients. According to Jarno Habicht, WHO representative in Ukraine, healthcare infrastructure is the most affected, in addition to damage to energy facilities. “They impact the capacity of healthcare facilities due to the lack of electricity, water and heating,” he illustrates.
Maria Ionova, a member of parliament and a member of the board of trustees of Okhmatdit, points out that around 25,000 children were treated each year and more than 200,000 consultations and around 12,000 surgeries were performed, which increased with the outbreak of the invasion. “Okhmatdit is the largest children’s hospital in Ukraine, with unique equipment and experienced doctors. It can accommodate up to 700 children,” she told Morning Express.
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Solomiya is 16 years old and has been on haemodialysis for almost three years. “She was receiving comprehensive, high-quality treatment there, but we have missed a unique opportunity,” laments Fomeniuk, who acts as a spokesperson for the other parents. “The most difficult patients have always come there, because the doctors have vast experience in treating the most complex pathologies,” Ionova agrees.
Fomeniuk’s harrowing account, sitting on a wooden bench in the shade with Solomiya beside her, contrasts with the idyllic surroundings of the gardens of Kiev’s No. 1 hospital, where the children have been taken in for now. While mother and daughter recount their experience, the other children play pin-the-tail-on-the-donkey, getting wet in the sprinklers that water the grass… They do not look like sick people or survivors of a bombing.
“It was a real miracle,” Fomeniuk says. The morning of the attack, the children were receiving haemodialysis and when the alarms went off they had to stay in their beds. “The dirty blood comes out through one of the tubes, goes through the machine that cleans it and comes back in through another cannula. This means that at the time of the bombings, the children had a good part of their blood outside their bodies. You can’t just disconnect them, it takes about 15 minutes,” sums up this mother.
Doctors were rushing to begin extinguishing the missile when the first missile hit. Solomiya, bedridden — she was born with spina bifida and other complications that force her to get around in a wheelchair — remembers doctors lying on the floor. Seven seconds later, the second missile hit.
When Fomeniuk managed to get out of the shelter where she had taken refuge, her heart sank. In the window next to her daughter’s bed, she saw a lifeless body, only an arm among the rubble. It turned out to be Svitlana Lukianchuk, one of the two specialists in paediatric nephrology. But she did not know if Solomiya was still alive, she recalls anxiously. Fortunately, all the children were evacuated alive and without serious injuries.
In the new hospital, the children are not receiving the same care, Fomeniuk admits, because the only two specialists for these children can no longer care for them. In addition to Lukianchuk’s death, the head of the department was seriously injured and remains in intensive care. The lack of medical care is widespread throughout the country. According to the WHO, 5% of the population does not have access to a family doctor. “Given the size of the country, this could apply to more than 1.5 million people,” estimates Habicht. Another issue is that almost all households (81%) have problems obtaining the necessary medicines because of the rising prices, says the WHO representative. Fomeniuk admits that they are having problems with the supply of medicines and that more than once they have been financed by voluntary donations.
Problems around the hospital
Meanwhile, the rehabilitation of the facilities and the restoration of the buildings of the Okhmatdit are becoming more complicated. “Currently, the hospital is operating at 60-70% of its capacity,” says Ionova. The MP estimates that the cost of the repair will be around 20 million euros. The amount of funds raised for the restoration has exceeded 40 million, according to the Ministry of Health, so the price should not be a problem.
However, the renovation remains on hold due to problems with the tender for the works. Of the 14 bidders, the board of the Okhmedit charity foundation chose the third most expensive bidder without giving any reasons. This decision sparked suspicions to the point that the Minister of Health, Viktor Liashko, ordered the procedure to be cancelled, called for an investigation by the Ukrainian police which is already underway and formed a council to oversee the restoration of the hospital. On 16 August, the ministry suspended the director of the hospital, Volodymyr Zhovnir, from his duties until the police inspections are completed.
Fomeniuk, meanwhile, insists that none of the parents have received clear information about what will happen to them, but on July 26 they met at the Ojmadit with the Deputy Minister of Health, Serhi Dubrov, who informed them that the toxicology area will not be reopened, but that a daytime outpatient service will be established.
Just a couple of days before his dismissal, Zhovnir explained during an interview with Morning Express that the plans for the destroyed pavilion did involve converting it into a daytime outpatient service, and hinted that a charitable foundation was considering creating a small residence near the hospital for these children, although not within it. The Ministry of Health initially agreed to grant an interview with the minister, but has not specified a date or responded to the questions sent.
For the parents, a daytime outpatient service is not a solution. In Solomiya’s case, the family happens to be from Rivne, a city 350 kilometres from kyiv. If the toxicology ward is not restored to its pre-bombardment state, the teenager will have nowhere to stay: renting a flat in the capital is not possible for this family, as only the father works – Fomeniuk is always looking after his dependent daughter.
And it is not just her case. “There are children here who come from conflict regions and neighbouring areas, they cannot go home and receive treatment there because they cannot return or there is no such treatment,” warns Fomeniuk. Habicht, from the WHO, explains that a significant number of health workers have fled the country or are internally displaced.
Regardless of whether the problem at the medical centre is solved or not, Fomeniuk admits that their lives will never be the same again. “Every day we are better, but now we know that there is no safe place. No hospital, no basement…” he sighs.
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