Hospital transportation, in a war.
I'm sitting behind a man who has been hit by either a drone or an airstrike. I don't know which. The conversations around me are in Ukrainian and no one has clarified the details. Every part of his body is mummified in bandages. He is blind. He has lost his hearing. The doctor describes him as a critical case. “Not a good scenario,” he tells me. The man does not move. He is heavily sedated. There is a real chance he will not survive. Our ambulance is parked outside a military hospital in the east. I've been asked not to film, and to keep the camera in my bag. It smells like summer outside. The carpark is full of soldiers smoking cigarettes. Bandages around heads, arms, torsos. Most of them are silent. They stand or sit and look into the distance while they smoke. No one speaks. The atmosphere is heavy and static. I become aware of my own breathing. The hospital building itself is damaged. Parts of the facade are missing. Emergency rooms in this region have been hit repeatedly. Some operate without intact walls. They continue anyway. Airspace is closed. Hospitals are overwhelmed. Four years into the full-scale invasion. Our task is to move this patient across the country to another emergency department that might be able to save what remains of his life. There are three men with me: a medic, a doctor, and a driver. They have been working since early morning. This is the third patient of their 24-hour shift. We have been collecting wounded all day and transferring them to emergency departments and medical trains. This case is different. There is no small talk with the patient, no questions about cigarettes, no attempts at humour. The work becomes quieter. More fragile. Less margin for error. In most countries, a patient like this would be airlifted. The purpose of a medical transfer team is normally speed: stabilise, move fast, deliver to definitive care. Here, speed is constrained by geography, damaged infrastructure, and risk. Every hour on the road increases the stakes. Artesans ResQ operates as a specialist medevac unit. The vehicle is not just an ambulance. It functions as a mobile intensive care unit, designed for journeys that can last many hours across an active warzone. One of the teams returned to base this morning after a 28-hour transfer to Germany. Artesans-ResQ (ARQ) is an NGO established in 2022 after the full-scale Russian invasion of Ukraine. Their two medical transport units operate 24 hours a day. They move critically injured patients: civilians, soldiers, children, and newborns. They were among the teams transporting children after the bombing of the Okhmatdyt hospital in Kyiv, relocating patients across borders when local care was no longer possible. They show me photos of past patients, mostly children. With adult patients, there seems to be a necessary emotional distance. With children, that distance collapses. Every doctor I've spoken to talks about those transfers with a quiet pride. We arrive at the emergency ward. The patient stabilises and the tension in the vehicle lifts slightly. I've spent the last two hours silently observing. I get the nod to take a few photographs. Just before midnight, I return to base with the team. A battered red hatchback pulls into the driveway. Illia and Maxim step out, the founders and directors of Artesans ResQ. They look more exhausted than we are. They've spent the day coordinating the movement of Amelia, a three-month-old, across the country for urgent airway surgery. She has congenital heart disease, ongoing seizures, and relies on oxygen delivered through nasal cannulas. I pour a coffee with an Estonian volunteer and ask why she is here. “We know we are next,” she says. “This is WW3.” This belief, that Ukraine is the beginning of wider conflict, is one of the reasons Artesans has partnered with the WHO and government agencies to train other medical units in medevac transfers. The goal is to build capability that can outlast this war and be replicated elsewhere. Their time off is filled with training classes and precise study. Later that night, back on the road. Another patient, another silence. The siren recedes into the background. I focus on the doctor's fingers clicking against a can of Red Bull as we drive east. This is not an exceptional day. This is normal.
