How One Besieged Hospital in Ukraine Treated Wounded Citizens, Soldiers, and Invading Russian Troops

At one point, the doctors overheard that the occupying authorities, appointed by the Russians in consultation with Ukrainian collaborators, had become unhappy with the arrangement of payments. So these authorities started pressuring Volodymyr Todosenko, the acting chief of the hospital, to reregister the facility, placing it under Russian jurisdiction. Todosenko’s saving grace: There was no coherent procedure for such a transfer, according to Ukrainian experts on the region, since the Russians, who had enough trouble running the war, had not set up a clear system for governing the area. To some of the members of Snihurivka’s medical team, this bureaucratic conundrum seemed like a bad joke reminiscent of a scene in a novel by Gogol.

Still, as hospital insiders recalled, the Russians persisted in trying to take over the monetary reins of the hospital and its employees. In the middle of August, these sources said, representatives of the occupying authorities came to Todosenko with a Russian FSB officer. The men went into Todosenko’s office while two men with rifles were positioned outside. 

The Russian officer—according to Todosenko, whose account was later corroborated by others—said that after the weekend, the chief doctor or one of his designees was to go to Kherson and finally reregister the hospital as a Russian facility. “Otherwise,” the officer declared, “it will become an execution pit.” 

Todosenko, chastened, considered his options. Only two other doctors remained in Snihurivka. And he could not imagine that Dvoretska, being a nurse, would be allowed to sign documents, given the hidebound traditions of Russian bureaucracy. Todosenko, sizing up the situation and realizing he had no easy choices left open to him, asked if he could resign and leave. He was informed that if that was his plan, he would first have to report to the so-called mayor of the occupying authorities. Todosenko said that this was indeed his plan. And, taking his leave of the Russian officer, he knew that in deciding to resign he would be risking detention, interrogation, and far worse. Even so, in the back of his mind he suspected that, given the institutionalized chaos of Russian governance, it would take weeks or months for Snihurivka to be reregistered.  

Todosenko gathered the hospital staff to explain his decision. He said that his wife, a nurse, instrumental to the functioning of the hospital, needed to go with him as well. “We came to say goodbye and explain our actions,” he told the assembled teams. “We couldn’t just flee. But there was no choice left to us.” He promised to return as soon as he could.

It took the Todosenko family weeks to make it safely into government-controlled territory, including the time they spent in a processing center in the Zaporizhzhya region. And as he had hoped, the procedure for reregistering the hospital stalled, dragging on and on. 

The passage of time proved to be a blessing for the Todosenkos—and the hospital. By November, a campaign by Ukrainian forces—coupled with a retreat by Russian troops, who refocused their efforts on the fighting to the east—put Snihurivka back in Ukrainian hands. And after nine devastating, grueling months, the town and hospital were liberated.

Shortly thereafter, the Todosenkos returned to their posts, even though the town still had no electricity or running water, and despite the fact that the region had been heavily mined and was not fully opened for civilians. They were among the exceptions. Of the prewar staff of 215 employees at Snihurivka hospital, only a small number came back. The rest had settled elsewhere, realizing that much of their town had been decimated and knowing the tragic consequences of life in a war zone.

Upon his return, Volodymyr Todosenko learned what had transpired in his absence. For the final three months of the occupation, Natalia Dvoretska, the chief nurse, took charge, even as tensions with the occupying forces remained high. “They hated us and this hospital so much,” recounted Natalia Libedenko, the head surgical nurse. “When there were signs they were leaving, me and Natalia Anatoliivna [Dvoretska] thought that they had left us for the end. Once, when they were walking around, searching, they told us they didn’t like how we behaved and said that the next time our staff didn’t smile at them, they’d undress us and chase us around the city naked.”