The gray building recedes into the forest background in eastern Ukraine, its windows boarded to prevent giving away activity within. Owls hoot from the pines, their calls punctuated by the screech of incoming missiles.
Inside, medics await the arrival of casualties from the front. Some manage to ignore the ground-shaking explosions and steal a wink of sleep. Others drink tea and stroke pets.
For Valeriia Malyk, sleep is fleeting. Her usual shift starts at 5 a.m., but tonight she springs into action soon after midnight. A call reporting three or more wounded means all hands on deck.
Why We Wrote This
Front-line medics work grueling hours to help Ukrainian soldiers defending their country. Many come from other professional backgrounds. Behind them stands a scaffolding of support to help maintain their mental well-being.
“Whenever I feel frustrated or despairing, I remind myself my conditions are good compared with what the infantry endure,” says Ms. Malyk, who is now serving as a paramedic with the Da Vinci Wolves battalion. “We must maintain our spirits – if we fall into despair, it weakens the whole war effort.”
Wartime medics like Ms. Malyk reflect a whole-of-society effort by Ukrainians to defend their country from an invader who would deny its identity and basis for existence.
Many front-line medics come from civilian professions and were thrust into the war effort with little preparation. Ms. Malyk is a veterinarian by training. Her words capture the challenge of caring for wounded people without becoming overwhelmed by physical toil, burnout, or despair.
“They are really very close to the combat zone, to the battlefield. They are saving lives, but they are really exhausted,” says Maryna Sadykova, co-founder of Repower, a Ukrainian charity that supports battlefield medics.
“There is life outside of war”
An October 2024 survey by the International Rescue Committee pointed to a deepening mental health crisis among Ukraine’s medical workers. One in 5 showed stress symptoms; 30% struggle to manage emotions in a healthy way “without harming themselves or others.”
Ms. Sadykova’s organization, Repower, tries to catch medics before that exhaustion overwhelms them. It runs short but intensive recovery retreats abroad, where front-line medics share burdens in group sessions, learn stress-management skills, and reconnect to life beyond war.
“The main part of our program is the psychological part,” she says. “Group sessions, learning classes – we try to give them knowledge of how they can cope with stressful situations.”
Since 2022, Repower has guided nearly 900 medics through such retreats. The stays last just 12 days – limited by the need to rotate medics back to the front. “Even 12 days gives them strength to continue,” she says.
For Pavlov, an ambulance driver at Repower’s Kyiv office, that strength was badly needed. Pavlov, who goes by the nickname Pasha, declined to give his full name for privacy reasons.
Formerly a motorsport racer from the Zaporizhzhia region, Pasha joined the volunteer Hospitallers Medical Battalion in 2022, drawing on his professional skills to ferry wounded people while under fire. By his tally, he completed 318 evacuations, a number he had tattooed on his finger as a badge of service.
His habit of tracking and tallying, he says, gives him a sense of control.
His team, for example, endured 83 airstrikes within 400 meters (437 yards) over three days. At Avdiivka in 2024, he operated just 207 meters from Russian positions, sleeping only when someone kept watch.
Pasha arrived at Repower exhausted. He participated in a retreat in Sweden and continues to benefit from the nongovernmental organization’s services and community. But he openly acknowledges that the mental toll exacted by his front-line experience still unsettles his daily life.
“There is life outside of war,” he says, stroking his dog, Phoebe, whom he keeps constantly by his side, providing both the grounding of companionship and the subtle therapy of routine. “Maybe we will be able to live the same way or even better than before.”
“It’s good to be here”
Back at the building in the forest, a volunteer medic steadies himself – through clarity of purpose.
Ben Asak, an American paramedic with roots in Kyiv, aspired to this kind of work from boyhood. By age 18, he was an EMT; within a year, he advanced to paramedic school. Four years on U.S. ambulances equipped him to keep his cool in high-stress situations such as those he encounters in Ukraine now.
But Ukraine’s front lines push everyone to the limit. What keeps him going?
A mix of natural adrenaline and the ability to keep things in perspective. “I like bringing order to the chaos,” he says.
Since 2022, Mr. Asak has rotated through front-line medical sites where wounded people are stabilized before being moved to hospitals. He has trained combat medics in days to perform battlefield interventions. But he worries about the long-term damage that many soldiers’ injuries will do to them, “how someone’s going to live the rest of their life.”
Like Ms. Malyk, he is quick to draw distinctions between his work and the fighting that soldiers do. “My job is kind of easy, compared to the warriors that are brought to us,” he says. “I have running water, a shower, regular food, internet. They’ve been in position for weeks without replenishments or rotation.”
One night, a Russian guided bomb fell just short of Mr. Asak’s position. The memory gives him perspective and a sense of gratitude – both essential to steadying the course. “It’s good to live,” he says simply. “If it had been a little closer, I wouldn’t be here. It’s good to be here.”
Oleksandr Naselenko supported reporting for this article.
