Turf Wars, Disaster Robbers and Tourists: Life in a Canadian Field Clinic on the Polish-Ukrainian Border

Galina Bunesky sat quietly in a chair while Canadian doctor Daniel Kollek listened to her heart. Her daughter and two grandchildren watched anxiously nearby.

“She felt sick and dizzy,” Bunesky’s daughter Marina Petrova said.

The family had traveled 770 kilometers from Kropyvnytskyi in central Ukraine to the Korczowa-Krakovets border crossing between western Ukraine and Poland. It’s an 11-hour bus trip on a good day—and it wasn’t a good day.

They waited inside a large white tent on the Ukrainian side of the border, crowded with hundreds of people fleeing the war by bus or car.

Inside was a field clinic staffed by volunteers from Canadian Medical Assistance Teams (CMAT), a disaster relief organization established in 2005 following the deadly Indian Ocean earthquake and tsunami that devastated parts of Indonesia, Thailand, Sri Lanka and India.

“She is very tired after such a long journey and all these difficulties, and she has very high blood pressure,” said Ukrainian-Canadian translator Natalya Halych. “That’s why they had to ask for help.”

Bunesky left the clinic soon after with blood pressure medication and advice to see a doctor once she arrived in Poland.

“Thank you very much, it was a very nice surprise. I am touched by the care I received,” she said in Ukrainian as she left with her family.

“They are all cold, hungry, tired”

CMAT has a roster of 1,000 doctors, nurses, paramedics, and psychologists who volunteer their time and pay their own way to help in disaster areas around the world.

This is Kollek’s first deployment, but the ER doctor, who is Jewish, says it’s personal for him.

“My family fled Europe during World War II, and those who got out, came out — and those who didn’t come out, nobody came to help,” said Kollek, who is usually based in Burlington, in Ontario, west of Toronto. .

He is part of a 15-person CMAT team deployed to help refugees trying to escape the war in Ukraine. Last Saturday, he worked with paramedic Scott Haig of Vancouver and registered nurse Teresa Berdusco of Edmonton. CBC News spent five days with the group as they got the clinic up and running.

Kollek, who is usually based in Burlington, Ont., consults with Teresa Berdusco, a registered nurse from Edmonton, while Scott Haig, a paramedic from Vancouver, is away working on his laptop at Krakovets Clinic. They are part of a 15-person CMAT team in Ukraine. (Margo McDiarmid/CBC)

During the first full day, the team saw a steady stream of people seeking help.

“They’re all exhausted. They’re all cold, hungry, tired,” Berdusco said. “Their blood pressure is high. My blood pressure would go up if I lost my house and had to move to a new country.”‘

Haig, who has been on nearly a dozen humanitarian deployments, said he had never seen anything like it.

“The volume of people passing by is just incredible,” he said. “It’s hard to imagine the number of people who actually cross…maybe a thousand a day at this border post.”

Refugees fleeing the war in Ukraine rest and have a meal inside the tent at the Korczowa-Krakovets border crossing before heading to Poland. (Margo McDiarmid/CBC)

The mobile clinic is not designed to treat traumatic injuries, such as severe bleeding or broken bones. These patients are sent to nearby hospitals.

Instead, the clinic is there to diagnose problems that, if left untreated, could get worse, such as high blood pressure, diabetes, coughs, and stomach problems. Most can be handled with medication and reassurance.

“These are things that might be seen in a family doctor’s office if that office was there,” Kollek said.

Fluid situation on the pitch

Since 2005, the CMAT has carried out nearly ten deployments in disaster zones, but this is the first in a conflict zone.

Team members found out the hard way that offering aid in a war is more complicated – a minefield of organizational turf wars, ever-changing needs, thieves and disaster tourists. .

“It’s a fluid, fluid situation. Every day we have 10 plans in place, and 11 get canceled, and then 20 more appear,” said CMAT executive director and co-founder Valerie Rzepka, who is a nurse practitioner in primary health care. .

People, mostly women and children, arrive at Przemyśl station in Poland on Tuesday on a train from Ukraine. Poland has taken in more than two million refugees since Russia invaded Ukraine on February 24. (Jeff J. Mitchell/Getty Images)

The situation is also very personal for Rzepka, who is Canadian of Polish origin.

“This border… is only 150 kilometers from where my family is,” she said. “If that boundary shifts, my family could be affected.”

Poland has taken in more than two million refugees since Russia invaded Ukraine on February 24. Local volunteers, businesses and municipalities stepped in to help, turning school gymnasiums into dormitories and offering food, clothing and support. A new Polish law allows refugees to work and receive health care and social benefits.

WATCH | Resources in Warsaw are stretched as Ukrainian refugees flood the city:

Ukrainian refugees flood Warsaw, straining resources

Warsaw is struggling to deal with an influx of Ukrainian refugees, with the city’s mayor asking countries like Canada for help. 2:33

Two weeks ago, Rzepka and Brandon Duncan, a registered nurse, visited border crossings between Poland and Ukraine to see where the CMAT clinic would be most needed.

They settled in Hrebenne, a small border point about 350 kilometers southeast of Warsaw. It was staffed with a doctor who needed help dealing with a growing stream of refugees.

But two weeks later, when the CMAT team arrived, the place had become a small village.

“Now there are thousands of people there and tents everywhere and NGOs serving hot meals,” Rzepka said. “It’s interesting how in two weeks things have absolutely exploded.”

Territory wars, aspiring doctors

This raised the question of whether there was still a need for the Canadian clinic. Rzepka and his team tried to make it work, but ran into bureaucratic hurdles and local turf wars that made it difficult to get a few tents.

“It’s a shame that you’re kind of fighting people when you should be working together — and ideally you’d work together, but egos get in the way,” she said.

Then five boxes of CMAT medical supplies disappeared from a storage shed at the border.

Ukrainian refugees cross the border in Hrebenne, Poland. (Margo McDiarmid/CBC)

“Things are still working out,” said Duncan, who is on his fourth international deployment.

“I’ve had things work in every mission I’ve been on, and I had a feeling that was going to happen. Everyone wants what you have to look good and get what they want from people. assignments.”

At the same time, there were people walking around the Hrebenne border camp in camouflage clothing claiming to have medical experience. Kollek calls them disaster tourists. A man showed up with a gym bag full of medical supplies.

“A weird hodgepodge of stuff in shoeboxes and so on, and then [he] threw it on the table [and said] ‘Can I volunteer? I’m a tactical medic,” Kollek said. “We’ve had a lot of people claiming to be tactical medics. One of them told me… he has good knife skills. It becomes a big problem when they get in the way.”

Refugees wait at the Krakovets border post. They are held until another group of refugees enters Poland, then they will be allowed to move towards the border. (Margo McDiarmid/CBC)

“We go where there is need”

It became clear that the team had to look for a new location.

“We go where the need is. So if we don’t see the need on the Polish side and there is a very strong need on the Ukrainian side, that’s what we need to address,” Rzepka said. .

CMAT contacted the Polish Medical Mission, a humanitarian organization operating a clinic in Krakovets, Ukraine. Six people had died of heart attacks at the border post recently, and the group desperately needed reinforcements.

A mother holds her child as Kollek, left, provides teething medicine at the Krakovets clinic. The CMAT team traveled to the clinic after contacting the Polish medical mission and learning that they were in desperate need of help. (Margo McDiarmid/CBC)

Registered Nurse Berdusco said it was the right decision to try to help those passing through the transit point.

“It keeps them from getting sicker because they still have travel days ahead of them,” she said. “So if we can… treat their exposure injuries or whatever they have now, they don’t have to stop until they get to where they want to go.”

On the first full day the clinic was open, staff saw a steady stream of sick children and exhausted adults. Late in the afternoon, a man rushed into the tent in search of a doctor. Her mother was unconscious in a wheelchair in the line of refugees waiting to cross the border.

The team rushed to the elderly woman, who was dehydrated and slipping in and out of consciousness. They gave her intravenous fluids and called an ambulance, which took her across the border to a hospital in Poland.

Kollek, center, helps a fainting woman into an ambulance in Krakovets. She received intravenous fluids and was taken to a hospital in Poland. (Margo McDiarmid)

“Today I really felt that we did a meaningful job,” Kollek said. “The lady we evacuated by ambulance to a Polish hospital did well, we learned from the ambulance team.”

CMAT plans to operate the field clinic for at least 90 days and will extend it if the need arises.

The organization has not completely abandoned the location of the original clinic in Poland. He plans to establish a small presence there when more volunteers arrive this week from Canada. Four hundred new volunteers have registered to join the CMAT roster since the start of the war, he added.

This trip to Ukraine is Kollek’s first volunteer deployment with CMAT. The Burlington, Ont.-based emergency physician is Jewish and said this project was very personal to him. (Margo McDiarmid/CBC)

For Kollek, the trip is already a success.

“The number of people who thanked us from everywhere … it is extremely important because it is a bad feeling to be alone,” he said.

“They see that we are there; they come to us [and ask], ‘Are you Canadians?’ I think it’s something huge.”