Okhmatdyt shows how hospital works almost three months after Russian attack

The team of the toxicology building, which was destroyed by a direct missile hit, and the entire surgical building, which was declared emergency after an inspection, moved to the new building.

According to Chernyshuk, due to the missile attack, the hospital cannot use about a fifth of the premises. It was fortunate that only a third of the damaged rooms were patient rooms.

Most of the damage was done to the staff rooms, so this allowed Okhmatdyt to ‘more or less resume its work in a normal way.’

Chernyshuk leads the way down the corridors and shows that for the most part, the wards were either combined - two into one - or left in place if one wing of the ward was damaged and the other survived.

For example, the urology department was moved to the thoracic surgery department because the other one had damaged its wards. Each has its own wing in the department, although they also share common areas. For example, nursing and sanitary rooms. 

There are some departments in Okhmatdyt that were left in the old configuration. For example, neurosurgery. According to Chernyshuk, this is a specific department where there are both cancer patients and children with nervous system injuries: ‘Neurosurgery - both tumours and serious injuries - is a large percentage of emergency patients. They cannot wait long. It is dangerous to reduce their bed capacity. Whereas in urology or thoracic surgery, most patients are scheduled. If they wait a week or two, it's not critical.’

The orthopaedics and traumatology departments were also not touched, as the Okhmatdyt is a centre for children's polytrauma: ‘That is, all road accidents, falls from a height, all serious injuries that occur in Kyiv and the region are brought to us, and we cannot reduce the capacity of the department,’ explains the medical director.

The Intensive and Efferent Therapy Department for Acute Intoxication, which was left without its own premises after a direct hit to the toxicology building, was also moved to the new building. This is a unit for serious patients. Its core is intensive care. Children are admitted here as a result of infection, acute kidney and liver disorders, acute poisoning, suicide attempts with medications, drinking household chemicals, etc.

Thanks to the fact that the new building was equipped with a small intensive care unit that could be used for the needs of this department, it resumed its work. The capacity here is less than it was before the missile strike, but there are opportunities to work and save children. Although some devices are still missing.

The isolation units in the intensive care unit are not working now because of damage. They are needed here for children who need intensive care and isolation from everyone else. For example, cancer patients. Or patients after organ transplants. This is necessary to minimise the risk of infectious complications. 

The damage here is moderate - there are no windows, the ceiling has collapsed, equipment has been hit. But it is impossible to treat an intensive care patient in these conditions. Okhmatdyt has found a temporary solution: the intensive care unit has several large rooms, not isolation rooms. They are designed for two or three patients, but if necessary, they can be used for one patient who needs to be isolated.  In general, the intensive care unit and the operating theatre survived. According to Chernyshuk, they are the centre of the building, and if any of them were fatally damaged, it would be a ‘catastrophe’. Because then they would not be able to provide the basic services that are provided in the new building.

He adds that some of the equipment showed signs of mechanical damage after the strike, while others looked intact: ‘I was surprised that high-tech equipment also has a term for contusion. The blast wave passed, some visually invisible contacts in the chips were damaged, and there seems to be no mechanical damage, but there are always some failures, reboots, and so on.’

In general, the ward was mostly damaged in the staff quarters. As long as it's warm, says the medical director, nodding at the doctors inside, it's still possible to work here. But when it gets cold, it won't be possible. So they are waiting for a tender for reconstruction.

The bone marrow transplantation unit has to ‘live’ between two rooms. Special sterile boxes are important for cancer patients who need a bone marrow transplant. After all, transplantation requires actually killing their immune system so that the body can accept donor cells. Therefore, any infection can be critical for them.

That is why they are placed in single old boxes. And some of these boxes were damaged by the blast wave on 8 July. ‘To the eye, nothing terrible happened to the premises - the windows were damaged in some places, the ceiling was slightly lowered. But this is a visual deception.

If the box is not airtight, it will not be suitable for specific cancer patients. That is why the ‘boxed’ patients are now at the Kyiv City Centre for Nephrology and Dialysis. And those who are outpatients - semi-outpatients who do not require special conditions - remain in the Okhmatdyt because their ‘wing’ has survived. The doctors are shuttling between the two buildings.