I’m a medic with a team helping Ukrainian refugees who are fleeing their country. Tonight, we hope we’ve given one young man a chance to survive.
The author (bottom left) and colleagues from the Canadian Medical Assistant Team at the Krakovets border crossing between Ukraine and Poland
I am a Canadian emergency physician on the Ukraine-Poland border providing medical treatment for Ukrainian refugees fleeing the invasion of their country. I’m here as a volunteer for Toronto-based charity Canadian Medical Assistance Teams (CMAT). Tonight is my team’s third 12-hour night shift at our clinic in Krakovets, a Ukrainian checkpoint by the Polish border.
We work on the Ukraine side, as that’s where the need is. While Ukrainian refugees who have made it to Poland encounter a robust network of support and services immediately upon entry, the Ukraine side has long border lineups without much support. Just two weeks ago, six Ukrainians at Budomierz, a nearby crossing, died of hypothermia and heart-related conditions while waiting in line to enter Poland.
It’s 1 a.m. and all is quiet at our clinic. We’ve spent most of the night hand-tightening screws on metal shelves, which will add much-needed storage space to our pharmacy. In the past three days, the clinic has grown from an empty corner of a white welcome tent into a reasonably well-stocked urgent-care clinic.
During the lull, Jordan Lenz, a pediatric nurse from Canada, buys the team hot dogs — our undisputed favourite snack — from the gas station down the road.
A dozen Ukrainian refugees stand inside a tent.
Before we can get two bites in, a middle-aged woman in a black head scarf enters the tent, sobbing in distress. “My son is having a seizure in our tent. We need your help,” she says frantically in Ukrainian.
Katia Trusova, a Ukrainian interpreter from the United States; Brandon Duncan, a pediatric emergency nurse from Canada, and I make our way across the street to the woman’s much smaller tent — just one of many dotting the landscape of NGOs and other groups camping at Krakovets.
Brandon, Katia and I squeeze through the small tent’s tiny entrance and I am immediately struck by how packed it is inside. Around us are rugs and piles of clothing with brightly coloured patterns. There are maybe a dozen people standing in the tent, their eyes all fixed on a man seated on a box, which is covered with blankets.
Oleksiy, whose name has been changed for confidentiality, is a 27-year-old man from Kharkiv, nearly 1,100 kilometres away. He’s thin and missing half of his teeth, and he has bandaged wounds on his massively swollen lower legs. His body is tense as his head jerks repeatedly to the right, eyes flickering back. He doesn’t respond to my voice.
“This is definitely a seizure,” says Brandon, who rushes to Oleksiy’s side and guides him gently into recovery position. Oleksiy, whose full-body twitches slowly abate, is confused and keeps trying to sit up on his own. We make a plan for Brandon to retrieve a wheelchair from the clinic so we can move Oleksiy to a safer place.
Nobody here can work in a vacuum.
Meanwhile, I explain to his family, with Katia’s help, what needs to be done. Surrounded by the dozen people in the tent, all of them speaking at once, I raise my hand and my voice as calmly as possible: “Quiet in the tent, please!” I then focus my attention on Oleksiy’s mother, the woman who had asked us to come.
She says Oleksiy has never had a seizure before but that he does have a history of IV street drug use. This does not bode well for him. The cause of his seizure could be anything from an overdose to a stroke — even meningitis.
“He’s very sick. If we don’t get him to a hospital tonight, he could die.” I speak slowly, using as few words as possible, afraid that something may otherwise get lost in translation. “May we move him?” After a brief discussion among his family members, they agree.
Brandon and I help Oleksiy into the wheelchair and we bring him to our clinic, where we examine him head to toe and take his vital signs. His neck is supple and his lungs sound clear. His blood sugar is normal. His fingers are so dusky and cold, I can’t get an oxygen saturation reading from them. He finally regains consciousness and is able to recognize his mother.
Unfortunately, Oleksiy does not carry sufficient documents to get into Poland — one of the reasons he and his family have camped next to the border rather than just crossing it. He’ll need to go to a Ukrainian hospital. We ask one of the community volunteers in the tent to dial 1-0-3 for an ambulance.
As we wait, suddenly there is a commotion as Oleksiy clenches his teeth in another seizure. With the resources we have, we won’t be able to stop it here. There is frantic chatter among his family, who motion that they are worried he will choke on his own tongue — a common myth with seizures.
The ambulance arrives within a few minutes, and a young paramedic injects Oleksiy with a drug to stop the seizure temporarily. Then he’s whisked away to a hospital, the nearest one more than 70 kilometres away in Lviv.
It’s 2 a.m. now and the tent is empty once again. As we reflect on the experience, I’m reminded that no matter how effective one person may be, nobody here can work in a vacuum. Paramedics, interpreters, nurses and doctors each play their role. Tonight, we hope, we’ve given Oleksiy a chance at recovery.
Three questions to consider:
- Why is the author working on the Ukrainian side of the border?
- How many Ukrainians have fled their country, and how many to Poland?
- What does the author mean when he writes, “nobody here can work in a vacuum”?
Anthony Fong is a journalist and emergency medicine faculty member at the University of British Columbia. He practised family medicine in Nunavut from 2011 to 2015. In 2020, he provided medical aid on a disaster-relief mission to Honduras, and again in Ukraine in 2022. He is currently based in Vancouver.