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A doctor in Ukraine shares her experience caring for war refugees

AYESHA RASCOE, HOST:

As Russian forces retreat from Kyiv, fighting is intensifying in eastern Ukraine. In the city of Dnipro, the mayor urged women, children and the elderly to evacuate. Dnipro connects the eastern and western regions of Ukraine and has served as a hub for humanitarian aid. Dr. Joanne Liu with Doctors Without Borders is currently stationed in Dnipro. She's been helping evacuate patients as they come in. She joins us now from Dnipro. Dr. Liu, thank you so much for being with us.

JOANNE LIU: Good morning.

RASCOE: What are you seeing in patients as they come to you and your team?

LIU: So actually, the patients are transfer from hospital to our evacuation train. And the patients that we are boarding have been either injured, or they are other patient, as well, who had some medical disease that are stable but need to be transferred because they're not mobile. I would say the basic idea is to take patient who comes from closer to where there have been military operation and where the hospital have been a bit overcapacitated by the influx of patients who were injured. And we bring those patients. We ensure they have continued - we say - high level of care, and we bring them to a place where they are going to continue to be cared but in a safer place.

RASCOE: And so, like, with patients who are coming in with such severe injuries, are you able to stabilize them to be able to move? Are there some patients who are in such severe condition that you can't move them?

LIU: So we have patients that, most of the time, have been injured a few days ago, and they are stable. And we are making sure that, during the transfer, which lasts up to 20 hours, they can sustain such a long transfer. But we are going to have an intensive care unit medical train, which - we're going to be able to welcome patients who are in need of greater care in terms of maybe ventilation, oxygen and a patient who are a bit unstable in terms of their blood pressure, we do hope, in the next few weeks.

RASCOE: How do you talk to the families of patients or to patients who are not stable enough to be transferred? Like, how do those conversations go? Like, do people understand? Do people get upset, especially if it's, like, a child that's not stable enough to be moved?

LIU: Actually, had the exactly situation where there was a child in the intensive care unit of a children hospital who was unstable with oxygen requirement and was not stable in terms of his blood pressure and was a bit of a fever - a child who sustained injury to the abdomen after a blast injury. And so we discuss with the medical team, and we discuss with the mother. And all of us were a bit nervous about transferring the patient. And the mother - you know, at the start, she just said, I think my child is too sick to be transferred. I don't think he's going to sustain that transfer of 20 hours. And honestly, when a mother tells you something like this, you've got to stop. You've got to focus. And you've got to make sure that you're bringing value to what you are trying to do. And so we decided that we will postpone the transfer. And, next time around, we will transfer the patient.

RASCOE: Yeah, well - and has that child been able to be moved or...

LIU: The case is still ongoing, yes.

RASCOE: Ongoing, yeah. I mean, obviously, there are physical injuries, but what we are talking about here is horrific for people to go through. Like, what is the mental health of your patients, and how are they sustaining?

LIU: It's a - it's difficult to say to a certain extent. But what really struck me is how stoic people are, you know, for some reason. And just one anecdote of another child, the child who had - having open fracture to the four limbs. The mother looked at me, and she said, I want my child to keep his legs. And then I turned to the teenager, and he just said, transfer me. I want to walk again. And then the medical team turned to me and just said, you have to transfer this child because he fled Mariupol, and he survived. He needs to survive his injuries. And so we went back and forth, and we just said, let's do it. And the child was actually safely transferred, was stable throughout the 20 hours of the transfer. And then once they arrived to the hospital in the west, he was afterwards transferred to Germany for reconstructive surgery and for rehabilitation. So sometimes, you know, there are some stories who are better than others.

RASCOE: Yes. Yes. Well, thank goodness for that child and for the care that you're providing. You know, you are working also with Ukrainian doctors who are serving and caring for their own people during this time of war. You talked about how people have been stoic. What has it been like working with Ukrainians who are trying to take care of their own - people who are from their own country?

LIU: They honestly - they are rock in the hospital. And they are so strong and so resilient. And the reality in, like, many, many other crises is more than 95% of the response is done by people from the country. Ukrainian doctors, Ukrainian medical staff are the one on the front line caring for the injured. They're stabilizing the patient. They're doing an amazing, amazing job.

RASCOE: Dr. Joanne Liu is with Doctors Without Borders in Dnipro. Thank you so much for being with us. And please, please stay safe.

LIU: Thank you very much. Transcript provided by NPR, Copyright NPR.

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Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.