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Dr. Ilona Butova almost looks out of place in her neatly pressed lavender scrubs as she walks through a door frame that hangs from a crumbled wall into what used to be an administrative office of her hospital in Zolochiv.
Not one building in the facility in the northeastern Ukrainian town near the Russian border has escaped getting hit by artillery shells.
Since Russia’s invasion on Feb. 24, space to treat patients at the hospital has shrunk constantly because of damage. Her staff has dwindled to 47 from 120. And the number of people seeking treatment in the small town 18 kilometers (11 miles) from the border is often higher now than before the fighting began.
Ukraine’s health care system struggled for years because of corruption, mismanagement and the COVID-19 pandemic. But the war has only made things worse, with facilities damaged or destroyed, medical staff relocating to safer places and many drugs unavailable or in short supply. Care is being provided in the hardest-hit areas by doctors who have refused to evacuate or have rushed in as volunteers, putting themselves at great risk.
It’s very hard, but people need us. We have to stay and help, said Butova, a neurologist who also is the administrator of the hospital in the town near Kharkiv, Ukraine’s second-largest city. She added that she has had to do more with fewer resources.
The World Health Organisation declared its highest level of emergency in Ukraine the day after the invasion, coordinating a major relief effort there and in neighboring countries whose medical systems also are under strain.
