Armageddon in Kharkiv Perinatal Center: A Daily Fight For Life

This is a story about how, in the current conditions, despite all the forces of evil, our heroic babies are bravely born. As well as about those who help them do it.

article by Marko Baianov,

Frontman, songwriter in TRUBA & D.Kolo

“Man, what are you looking for? This is a maternity hospital,” says the woman on duty in the reception department.

Reception of Obstetric department. A few minutes to noon. The half-forgotten taste of a medical mask. This season, covid is back in trend again.

“I’m visiting Iryna Yuriivna. We’ve had an appointment.”

Iryna Yuriivna Kondratova is head of the Kharkiv Regional Perinatal Center as part of the Regional Clinical Hospital. This is such a special maternity hospital for pregnant women and mothers with various chronic diseases, pathologies that occurred during pregnancy, or problems that may arise with the child’s health. Since the beginning of the war, a special regime has been in place in the center. Enemy shells were exploding within a radius of about 200 meters from the building, the electricity and the water supply went out. However, the center was working all this time. To make this work known to the world, in spring, football player and UNICEF goodwill ambassador David Beckham gave Iryna Kondratova his Instagram page for a day. This story got wide media coverage.

It was not easy to choose a relatively quiet day for the meeting.

“We have our own Armageddon here every day,” admitted Ms. Kondratova.

“I wanted to tell our readers more about the course of this battle – about the enemy, allies, weapons, maneuvers, reconnaissance, and personnel. About the help the state and society can provide, as well as about what is being provided.

“You are going to have such an opportunity. Come along with me, I’ll show you everything.”

Here is the room where childbirth took place during the intense shelling and bombing of the city – it’s a semi-basement, dark, with light-masking observed and lots of equipment.

“There was a postnatal ward nearby, explains Iryna Yuriivna. There are four exits to the street from this place. It was not possible to give birth in the basement since there were pipes with boiling water above the head and people, probably 600 staff, patients, and relatives from the whole hospital. That’s why such a place was chosen. Not that it is the safest one, but from here you can easily evacuate if need be. For a kind of protection from shards, if the glass suddenly flies out, there are large cardboard boxes with diapers and other things. This is where we all gave birth under bombings and shelling.”

Let's go further to the delivery facility.

“There are delivery rooms and operating rooms. At least, they used to serve like ones in peacetime. This is a special delivery room for extremely preterm babies weighing from 500 to 1500 grams at birth, we call them rushers. There is a lot of special equipment that allows you to open the lungs of these babies immediately after birth and continue to breathe for them until they are transferred to the intensive care unit. Here’s a new transportable incubator with a self-contained fan, courtesy of David Beckham and UNICEF. The Japanese one is considered the best of those available today for our small patients. Now we have three of them – the necessary minimum for a super-tense situation. The appearance of such equipment is a chance to save the most defenseless infants.”

“That is, there was a material effect from the so-called spring Beckhamiad?”

“Of course. There was a great effect. Thanks to all the donations, UNICEF bought what we needed and created special medical kits for childbirth, sets for babies with clothes and care items, distributed them to all maternity institutions in Ukraine. It was a “planned action,”and I understood WHAT exactly the country had to gain from this whole beautiful media viral story. Several hospitals were equipped with ambulances. And, of course, moral support was extremely important at that time.”

The next department is neonatal resuscitation. There are babies in incubators who cannot breathe on their own. Various tubes extend from the babies to the devices.

“This is Platon. He’s one kilogram and thirty grams. Tiny Platon has been living with us since September 9. And this is Petryk, his rescue required the mobilization of our entire collective mind, and we were literally on the verge of a foul. I did not leave this place for three days. He was born full-term, but he has severe infectious lung damage. These children live thanks to equipment, some of which have no analogues in the world. Look at how many things around them that are plugged in are blinking and beeping and signaling us about their condition every single second.”

“What is all this powered by when there is no electricity?”

“We have powerful diesel generators for all hospital buildings. The problem is that the generator depends on the person. One needs to check it. In order for the equipment to continue to work, uninterruptible power supply equipment is required, which automatically switches to the autonomous power supply of the intensive care unit. During the next emergency power outage, the uninterruptible power supplies failed. Only our people are, so to say, made of reinforced concrete – but equipment breaks in extreme conditions. The staff manually ventilated the babies until the generators were turned on. Thanks to our charming Kharkiv Santa, businessman and volunteer Yuriy Sapronov, who ten hours after my Facebook post was made public bought and himself brought us batteries for the uninterruptible power supply, now these problems are gone.”

“What do babies eat? Where are their mothers?”

“The mothers of these children have been discharged from the hospital. They come to their infants every day, express milk, feed them, take care of them, read poems for them, and tell the babies how much they are loved. After all, our tiny rushers can hear and understand everything. Until babies can breathe, they eat through a tube. The priority is mother's milk. One of the mothers is sick with covid, so she will not come yet so as not to infect the little one. For this case, there are special medical mixtures for prematurely born children. And here is Oleksandr Mykolayovych, the head of intensive care. Talk to him.”

“Oleksandr Mykolayovych, did the number of patients decrease during the war?”

“It doesn’t matter, whether it is wartime or peacetime. There are no fewer sick children. Let’s say that last year, according to the report, there were 92 children in six months, and this year - 86. That is, the department is constantly full.

Many institutions that aid such children have closed. The infants in need of help were delivered to us by emergency vehicles from all districts of the Kharkiv region.”

“Has the staff been seriously cut?”

“On February 25, Iryna Yuriivna, Iryna Ihorivna and I were the only the doctors here. A big thank you also goes to our girls, who work as nurses. In general, there should be many nurses, one for every two newborns. But there were only two or three of them. At first, someone miraculously got to work, then we just stayed at the hospital. We, doctors and nurses, lived here, my family with a seven-year-old child and me. We ate and slept here for three months — first on the floor on mattresses, then on beds. We established an everyday life here, children studied with teachers.”

“Were you scared?”

“We were more worried about the children. Imagine hearing an air raid siren and seeing everyone in the hospital run to the basement. But where do we take the kids? They won’t survive without the equipment. Here you have a baby. It needs liquid oxygen and air at a pressure of four atmospheres; you also need to keep it warm and looked after. It is impossible to move all of this to the basement. So, we decided that during air attacks we should stay at the department with our patients and continued working. When the siren goes off, we go to a relatively safe spot and pray there is no power outage. No electricity means no life. Iryna Ihorivna, was it scary when planes were flying here and dropped bombs?”

“No,” Iryna Ihorivna replies. “We were constantly busy… giving nose drops…”

“To whom?”

“Some frightened people came, just to get nose drops for their child. The simplest task you can imagine.”

“Is it easier now, Oleksandr Mykolaiovych?”

“Yes, doctors are gradually returning. It makes it a wee bit easier. But there is no time to get bored. Endless incidents happen, not to mention everything else. An explosion wave during the latest missile strike in the city center caused a part of the ceiling to crumble. A pipe burst, the department was flooded. There is not a single boring day here at all. At first, our hospital served as a sort of a central hub for all the humanitarian aid, which was then distributed across the region. Male members of the stuff set up a group in Viber. Alarm! Urgently, everyone to the checkpoint, the truck has arrived. We unload ten tons per hour. Three or four such trucks could come a day. On top of that, ambulances from all regions brought newborns.

“Iryna Yuriivna, how many patients came in during wartime?”

“About 600 in seven months. However, we accepted children from other institutions at the peak. There were probably 500 births. Accurately three times less patients statistically than usual.”

“What general trends can be noticed?”

“In the first months, the number of premature births increased, because stress makes everything worse. Since the end of March, there have been significantly less premature births than before the war. The thing is, women with early pregnancy periods left, thank God, Kharkiv and the region. A different trend began to be observed after two or three months, when patients with a complicated course of chronic diseases, against the background of which women decided to keep the pregnancy, and with obstetric complications, began to arrive. This is due to the deterioration of access to qualified medical care, a change in priorities, and inattention to one’s health. Now we are seeing a new surge of the same problems because patients are arriving from de-occupied territories, where there was no adequate monitoring of pregnancy. There have been many staphylococcal infections in newborns. Like in the last century, when there was no modern infection control and no access to effective antibiotics. Long-term living in basements, in unsanitary conditions, without medical care and prevention has led to the fact that we are dealing with a real pemphigus of newborns, which my young doctors only saw in textbooks. Emphasis have shifted, people, being constantly in extreme conditions, stopped paying attention to their health. A pregnant woman was brought to us, after having been at home for several days with confusion, convulsions, and high blood pressure.”

“Why does it come to this point?”

“This is a polyetiological problem. Undoubtedly, the war is the one to blame for this. The woman did not know about high blood pressure, her family did not pay attention to changes in her well-being, there were no medical personnel nearby who could competently assess the first symptoms and their progression in order to urgently refer her to hospital. As it turned out, the child’s condition was also critical, we made medical decisions without alternatives very quickly. We saved the mother, but, unfortunately, we could not save the child.”

“Has communication with patients become more difficult or easier today?”

“We never had any communication problems with the patients or their partners during the first three months when we all lived here together. Suddenly it turned out that in life there are main and unimportant things. It only became essential whether we survive after the arrival of the Russian plane or not. During some baby deliveries, the pregnant woman calmed us down. They are bombing us endlessly. We put headphones on them, in operating rooms and even in delivery rooms they listened to whatever music they wanted. However, we had no headphones. They sometimes calmed us down, helped us mentally. Our partners brought us water, food, washing powder, and looked after the neighbors.

During the discharge, they would bring us coffee, tea, and some goodies saying, you live here, this is for you.

This is not the way our hospital works. The pure atavism of the last century, that plastic bag with presents, is back, but now filled with food that was really important back then.

All the personal connections formed in the first three months of the war are worth a lot. Now it has become a little different. Last weekend, a humanitarian cargo arrived, it was quite heavy. I accept and control everything myself, so I arrived and asked those partners living in the wards with mothers to help unload. There were three men in the department at that time. No one helped, everyone found a reason not to do so. Then I approached each of them and carefully found out whether they were in Kharkiv in the period from February to April. They weren’t. These are people who left then and now have returned. There are people to whom we have again started to owe something, and this is obvious in communication. For three months, we have been one team with our patients and understood that none of us knows whether we will wake up tomorrow, and all this staff should definitely not be the case in a relationship. Apparently, this is the story of any society. However, this is a traumatic story for us, as we already are somehow on a different wave.”

“How much does it cost patients to stay here today?”

“All the mothers lying here do not buy medicines and consumables and never pay for anything. On the contrary, during discharge, we give them things for children, food, bottles, sometimes medicine. We still have this opportunity thanks to UNICEF and our friends – volunteers.”

“What is the most needed at the moment?”

“Open resuscitation systems and closed incubators are the things that help keep infants warm since the delivery room. This is a unique technology of monitoring the child’s body temperature every second and automatically adjusting it when it deviates from the set temperature by 0.2 degrees. We prefer Japanese-made equipment. Our need is ten such systems. Thanks to Americans of Ukrainian origin from the Ukrainian association of Washington State, funds were collected on the Ukrainian fundraising platform, and the Ministry of Health and SE Medical Procurement purchased for us exactly what our doctors ordered.

However, we need much more, and we also always need disposable consumables that make all this equipment work, namely circuits, filters, sensors, cuffs. It would seem like small things, but this is a serious amount of expenses. Now let’s go to another department, we have heroes there too.”

Maternity unit with operating rooms. A patient from this department will now undergo surgery. She has severe scoliosis, so she cannot give birth on her own. She is worried.

“How are you?”

“Everything is fine, the area is just...”

“An area of what? It’s nothing...” Iryna Yuriivna hugs the woman. “Ok, calm down. The person inside you can feel everything. Now we will turn on the music for you. Yaroslav Anatoliyovych! Prepare the music, please. Oh, look at her.”

“Gotcha!” Yaroslav Anatoliyovych responds. “Which do you prefer? Maybe Rammstein? Let’s go, everything will be fine.”

Yaroslav Anatoliyovych is our anesthesiologist. He and his family has lived with us for three months in the hospital, with a child and a pregnant wife who gave us a “daughter of the regiment.” They are from Luhansk, and experienced 2014 there. Yaroslav had tactical medicine training and other courses there. They left for Kharkiv, just settled life here, bought an apartment – and the “russian world” has come again. As experienced guys, they taught us how to behave in extreme situations. The decision not to go down to the basement was made, in particular, thanks to them. Please chat with our girl’s partner while she is being prepared for surgery.

“Do they give you anesthesia?”

“They don’t,” smiles the man.

“Even for bravery?”

“No, I don’t need that. We are Donetsk citizens. We arrived to Kharkiv five years ago. After the start of the war, we lived in Vinnytsia for two months and decided to return. It’s somehow easier to breathe here.”

“First time?”

“The third time...”

“So, the mood is cheerful?”

“What kind of mood can we, the people of Donetsk, have? Only cheerful...”

“Well done. You are the rock.”

“Well done, of course. Look at his hand shaking...” notes Iryna Yuriivna. “This is our department, where we transfer rushers from the intensive care unit after they have been trained to breathe. Here they are with their mothers around the clock. At the peak of the shelling, we transferred them from here to a deep basement in a separate building built in the beginning of the last century. They lived there for 70 days. Our parrot lived there, responsible for peace and beauty, and doctors lived there with their children. In April, when it warmed up, I began to push them outside to breathe fresh air, because they began to look like “children of the underground.” This is Viktoriya Oleksandrivna, head of the department for post-intensive care and nursing of preterm infants. Do we have any talkative mommy? Let the reporter ask her a few questions.”

Our “talkative mommy” is also called Viktoriya, which is quite symbolic.

“What are you complaining about?”

“Nothing to complain about, it’s fine. I am very grateful to the doctors. And personal. They literally saved us. Everything here is at the highest level, there are no complaints. Absolutely.

“Do you have a boy, your first child?”

“Yes, this is our son. Dmytro. One kilogram and 480 grams. We had the girl first. She is already a young lady, ten years old.

“Is Kharkiv your hometown?”

“We’re from the suburbs. Solonytsivka.”

“Why did you not leave the region?”

“To be honest, somehow, we decided to stay as it is. My pregnancy was not very good from the beginning. Leaving was even scarier. All my relatives are here, they have not left anywhere.”

“Is the baby gaining weight normally?”

“Yes. We have been here for 15 days already. Maybe in another two weeks, I will be able to hope for the discharge.

“All the best to you and Dmytryk.”

At the same department.

“Here is another phenomenon,” says Iryna Yuriivna. “Neonatologist Valeriya Eduardivna. On February 24, the woman was in his native Poltava City, on vacation. On March 1, when everything was destroyed here, I saw her silhouette in the corridor of the department. I asked her what she was doing here. “Well, my vacation is over, and I came to work, you need help,” she replied. It was the first time since the beginning of the war that I cried.

We send her periodically to Poltava, but she still returns to us. If I ever get to see Lera’s mom and dad, I will bow to them to the ground for her. Pediatricians are the most resistant ones. Especially the doctors of these miniscule folks.”

“Dear heroic person, why didn’t you stay at home in Poltava?”

“I am not a heroic person at all. It’s scary – well, it is. However, you just go and work.”

“Iryna Yuriivna, is there any scientific explanation for this?”

“We are currently attending group classes with a military psychologist. We have failed to find any adequate literary explanation. I sometimes listen to what they say. None of us talk about ourselves when we explain why we stayed. Everyone talks about a sense of duty. Everyone understood that if they had left, no one would have stayed with these children. I knew that no one could do this job better than me. And I could not leave them. Neither the children, nor the staff.”

“Likewise, we couldn’t leave you. Each of us was thinking about what you would say then,” adds Viktoriya Oleksandrivna. “We are used to being close. We are like a big family, I guess.”

“At that time, 30 per cent of the staff remained. After everyone started leaving, sometimes without even sending a text message or calling, the doctors and nurses who remained were afraid that I would abandon them. I realized that I would survive if I felt their support. I knew, even when I was completely exhausted, that I had to go out in the morning and say something encouraging. And if not wearing makeup, then at least smiling.”

“Iryna Yuriivna, what questions are the most difficult to answer?”

“Apparently, the question “Where do you get your strength?” You always have to make up something.”

“May I ask about that too?”

“I do not know what to respond to you! When my son was little, he would ask me “Mom, why do you go to work at night?” Because the child there is very sick, I would say. “When you come back, come in and kiss me.” But I will wake you up, I answered. “Come in anyway and kiss me.” I would come back and kiss him. He’d open his eyes and ask whether the child survived. I’d tell him the baby survived. He asked me whether the infant would have died if I had not come. I would tell him that the child would die then. “Okay then,” he used to say while turning and falling asleep again.

Now my son is studying in another country. From the very beginning, we have a strict agreement that he calls me in the morning and in the evening. For sure, at the age of 19, you don’t always want to talk so much with your mother. But he calls me saying “Mom, talk to me.” And I asked him “Son, you are my only consolation. Tell me anything you want about how you are there in your Arizona.” I talk to him for thirty minutes – and I have strength again. Thanks to him.

When wounded children were brought here, our adult surgeons operated them, and Oleksandr Mykolayovych and I were responsible for anesthesia – since there was no one else. I did all this; I don't remember how I got to my office. You work all your life in intensive care. You take in children after a road accident. Mushroom poisoning of whole families and all kinds of other horrors. But the injured children... A one-and-a-half-year-old girl whose eyes only aren’t injured. The rest are in shrapnel wounds. Well, they are shallow. But you understand that this is a wounded child with simply not a whole spot on her face. I am not even mentioning anything else. I went into the office, locked it with a key and started really howling.

However, there are close people in different cities and countries whom I could call at any time, and this saved me. I am a very verbal person. I guess having someone to put in a good word is where I derive my strength from. I don’t know of any other source. And then there are people who are truly heroes. I’ve had a brother on the front lines since day one. I am embarrassed by the fact that I can relax here somewhere, and he and his brothers are there protecting our lives.

When volunteers call me now and ask what is needed, I often answer – donate to the Armed Forces of Ukraine. The military is our protection, and children are under this protection. This is our future. There is a well-known phrase that when children are born, they themselves choose their parents. And they themselves choose the day and hour when they will be born. In my opinion, all those children who survive today will be the strongest people. They will build our Ukraine after us.”

 

P.S. A few days after my visit to the center, on October 10, Russia launched massive missile strikes across the territory of Ukraine. Kharkiv was left without electricity and the Internet. I called Iryna Kondratova to ask how the center was doing. “There is no electricity, but generators are working. After everything we’ve been through, we’ll make it,” she answered.