“There are no borders”: treating sick and injured Ukrainians abroad through the medical evacuation and repatriation programme
Vitali travelled from Ukraine to Austria through the medevac programme
“After the attack, I was afraid that my wife would leave me because my leg had been amputated and I could not work anymore,” Vitali shyly admits.
His wife Iryna rolls her eyes and laughs, reaching for her husband’s good hand. She sits near him in the apartment in Vienna where the family is being accommodated while he receives treatment for his extensive injuries. Contrary to her husband’s fears, she has not left his side during his long recovery, nor throughout his medical evacuation (medevac) from Ukraine to Austria.
Vitali is one of over 70 sick or severely injured Ukrainian patients brought to Austria to receive specialist medical treatment through a dedicated medevac and repatriation programme.
As of 30 April, 4069 patients had been evacuated for specialist trauma treatment and oncological, rehabilitation or prosthetic care in hospitals and rehabilitation centres across the WHO European Region and further afield. The programme, co-funded by the European Union and run with technical and operational support from WHO, is helping to relieve some of the pressure on Ukrainian health services caused by the war.
Vitali has been supported at each stage of his complex journey towards better health. He has already received intensive treatment to help him regain use of his arm and now has a prosthetic leg that, with time and physical rehabilitation, will enable him to walk unaided.
Treating complex injuries
Back in March 2023, Vitali was working as a locomotive driver in the Dnipro Region of Ukraine. One day, he and his colleagues were called out to repair damage to an important railway line. “There were a lot of missile attacks in the area where we were living,” he says. “We’d got used to them, and I thought I’d never be injured.”
When a Russian drone spotted them, they scrambled into a hole to hide, but it was too late. Artillery hit their hiding place. He remembers a loud whistle and an explosion.
“I lost consciousness for a while. I couldn’t see anything; I lost my sight. Then I woke up. I saw my injuries – my arm and leg were hanging by a thread. My ears were ringing, and for some time I couldn’t hear anything. Later I heard everybody screaming, and I realized that I was, too. I did not think I would survive.”
Two of his colleagues were killed outright and others were horribly wounded. Due to the danger of further attacks, Vitali waited in agony for 4 hours until help reached him. He was then rushed to a local hospital, but such was the extent of the damage to his leg, arm and lungs that he was quickly transferred to the main health facility in Dnipro, where it became clear that his leg could not be saved.
“I was very glad that I survived. I was in the emergency room. They helped everyone very well,” he recalls.
Vitali's injuries were severe
His right arm in particular had suffered extensive damage, and Vitali was soon suggested as a medevac candidate. The Ukrainian Ministry of Health’s Medevac Coordination Unit set the wheels in motion.
Three weeks after sustaining his injuries, Vitali was transferred with Iryna to a train specially equipped with an intensive care unit which took them to one of the 3 health-care facilities in Lviv that are part of the medevac and repatriation pathway.
Vitali’s medical needs, including pain relief and heart monitoring, were met during the journey. Next, he and Iryna were handed on to an ambulance team who took them to the Medevac Hub in Jasionka, where the couple recuperated overnight. The next morning, the Austrian medevac team took Vitali by ambulance to the AUVA Trauma Centre in Vienna.
“We received such good treatment. The doctors tried hard to understand our every wish,” says Iryna. “There are no borders for the medevac programme.”
Facilitating the evacuation of severely injured patients
Diana Tembikovska and Diana Dobriy are the formidable focal points of the small Ministry of the Interior team tasked with coordinating the medical care of patients arriving through the medevac and repatriation programme.
Both Ukrainians and long-term Vienna residents, they juggle multiple logistics: they receive patients’ medical notes and locate specialist doctors and facilities that may be able to work with them, then translate for and liaise between patients and their accompanying family members and medical staff.
“Sometimes when we see the photos and videos of the incoming patients’ wounds, we think it is impossible they’ll survive. Then, after a few months of treatment, their improvement is often such that we try to forget we ever saw those images,” says Diana Dobriy.
Of the 65 patients they have supported, 12 were children. Twenty of the patients have now been repatriated back to Ukraine. Diana Dobriy shares a video on her phone of one of them – a young gymnast who lost a leg performing on a Ukrainian talent show. When Vitali was feeling low, frustrated with his progress with his new prosthetic, she showed him the video as inspiration.
“It’s more than a full-time job,” she admits, “For the first few weeks after arrival, we aim to always be on the end of the phone when it rings. That’s the most intense time, when patients need us most. But when they stand up, when they’re smiling or sending us videos when they walk for the first time, it’s the best feeling.”
Her colleague Diana Tembikovska adds, “We are helping them through this hard period in their lives. When somebody is well enough to return back home, if they want to go back to Ukraine, for me, it’s like freedom. I feel freedom that our job is done.”
Iryna
The long road home
In the hospital in Austria, Vitali has been receiving specialist vacuum and electrical treatment on his arm that has helped to restore its circulation.
“When doctors ask me how I’m doing, I have learned to say in German, alles ist gut: everything is good. I’m very happy to be treated here. Now I just need to wait for an operation on my arm. I’m looking forward to receiving the treatment.”
He is also making progress with walking. “When I first stood up on my prosthetic leg, it was so frightening and exciting that I rang Diana Dobriy to tell her,” he says. “I have been doing laps up and down the corridor to practise and get stronger.”
Vitali has been in Vienna for over a year and is longing for the day when the medevac and repatriation programme will deliver him home. He hopes to spend more time with his family, swimming, fishing and relaxing in their garden.
“There are 2 lives for us – the life before and the life after Vitali’s injuries,” says Iryna. “Now I’m calmer and I have hope for the future. I’m so grateful for all that we have.”
About the programme
The medevac and repatriation programme relies on an extensive network of partners. It is co-funded by the Foreign Policy Instrument of the European Union and coordinated by the Medevac Coordination Unit of the Ministry of Health of Ukraine, with technical support from WHO.
The majority of patients are referred to European Member States and European Economic Area countries through the medevac pathway financed by the European Union Civil Protection Mechanism (DG ECHO). Eligible patients are selected in Ukraine based on defined criteria, and treatment is provided via the mechanism of temporary protection or similar programmes in the receiving countries.