Adam Hay-Nicholls

In war-torn Ukraine, professional medical staff and well-equipped ambulances are essential for treating injured soldiers. After driving an ambulance a thousand miles to where it’s needed, Adam Hay-Nicholls meets the medics saving lives behind the front line.

An air raid siren wails. No one reacts. It’s the fourth in two hours. Nothing happened during the first three. Then, suddenly, there is an enormous bang, like the last firework on Guy Fawkes night. I’ve been enjoying a barbeque with half a dozen Ukrainian medics; suddenly everyone ups and sprints to the basement. Sitting on rickety old hospital beds, staring at the peeling beige walls, we wait underground for the all-clear.

I’d entered Ukraine a day and a half earlier. My mission: to deliver a new ambulance from the Polish border to the front-line of the Russo-Ukrainian war in the east, a 1,000-mile journey, on behalf of a humanitarian organisation called MOAS. I’d then take the sleeper train back. My journey began with a Ryanair flight out of Stansted; a suitable purgatory ahead of the horrors of war, I felt. You can’t fly to Ukraine anymore. I flew to Rzeszow, the closest airport on the Polish side, arrived late, and spent the night in the town’s superbly named Hotel Ambasadorski. I can hear other guests snoring through the walls. The curtains glow red from the lights of the go-go bar next door. My fitful sleep is stirred again by the buzz of a text, via the encrypted app Signal.

‘All good?’

It’s Sergii. I haven’t met Sergii before. I message back to say everything’s good. We’re on. Shortly after sunrise, I’m in a taxi making the trip to Medyka, the closest pedestrian border crossing. The cab driver, Robert, points at where I need to go. I give him his 500 zloty, grab my backpack, and trudge past portacabins selling SIM cards towards the Polish border control and on through the overgrown no man’s land towards Ukraine. I’ve been warned, at this point, to switch off my phone’s roaming and location services. Russian intelligence might be tracking foreign numbers, and as well as attacking hospitals, Vladimir Putin’s army has dropped bombs on ambulances. Both of those things are war crimes, by the way. I’m not taking any chances.

On the other side of the fence, hundreds – mostly women and children – are queued making the journey the other way. I’m the first person to walk into Ukraine this morning. “Why are you here?” asks the Ukrainian border control lady. “I’m an ambulance driver” I reply. Passport stamped, I spot a recruiting post for foreign fighters, a handful of taxi drivers touting for business, and a huge wall of a man. He’s tattooed, wearing sand-coloured tactical gear bearing the red cross of a medic and a skull badge with the words ‘memento mori’. This is Sergii. He’s smoking a vape. He calls it his “android dick.”

The ambulance is similarly brawny: a Toyota Landcruiser with a treatment bay that’s almost tall enough to stand up in, massive chunky tyres, bull-bars, winch, raised ride height and uprated shock absorbers. Its off-road ability is unmatched: if the Ghostbusters entered the Dakar Rally, this is what Ecto-1 might look like. Inside, it has a sturdy manual stretcher, monitor defibrillator, ventilator, syringe pumps, suction unit, and enough plasters and bandages to go to war. It’s a brand-new vehicle; a 4.5 V8 J70-model designed in the 1980s and long-since discontinued in the European Union, but still built largely for the African market where its mighty diesel emissions are acceptable. With all the medical kit included, it cost MOAS’ private donors £90,000. They’ve bought 15, bringing their total number of ambulances to 50.

I take the wheel. The Ukrainian highways are smooth, while the byways are strewn with potholes. The landscape is a blur of corn, potato and sunflower fields. Every hour or so we’ll come to an intersection with a checkpoint, all sandbags, camo netting and hedgehogs – those big metal Xs designed to stop invading tanks in their tracks. Each time, we smile at the Kalashnikov-wielding gatekeeper and he waves us through. We’re making good time, aiming to get to Kyiv for tea. After espousing the joys of Clarkson’s Farm, Sergii takes an anxious call, then tells me his house has just been hit by a Russian drone.

In fact, it was debris from a drone, shot out of the sky by Ukrainian air defence. There’s no serious damage, but his wife is, understandably, shaken. She’s Alena Vinnitskaya, a famous Ukrainian singer and TV presenter. Sergii Bolshoy was born 48 years ago in Moscow. His dad was Ukrainian and in the military, and the family moved to Kyiv in 1986 so Sergii Senior could help clean up Chernobyl. These ‘liquidators’ were heroes. He died of cancer, as most did. ‘Bolshoy’ means ‘big’, and it’s not Sergii’s real name. It’s a stage name. He’s a multi-instrumentalist musician and plays the bass in three different rock bands (check out Mozes Dick), or at least he did before the war. We bond quickly over music. We share a love of The Clash, Led Zeppelin and, quite niche, the Fun Lovin’ Criminals. Who knew Huey Morgan had a following in Ukraine? I put on U2’s War album, which seems apt for this road trip, but Sergii’s not keen on the chorus to the song Surrender. “No! No surrender! Ukraine will never surrender. Fuck Russia.”

We arrive on the outskirts of Kyiv, where I have a room booked at a curious Egyptian-themed hotel. Imagine Abu Simbel meets Fawlty Towers. It’s actually a floatel, sitting on the Dnieper River, looking for all the world like the Nile. It’s a side-hustle: the owner’s principal business is selling caviar. Nearby, the monumental Motherland statue, which has stood there since 1981 to honour the Soviets, is having its hammer and sickle removed, replaced by the Ukraine trident. Derussification is happening nationwide.

Joining me for dinner is Sergii’s MOAS colleague and occasional band mate Igor Sereda. Igor is reputedly the best drummer in Ukraine and has epic ‘90s pics to prove it (check out Green Grey). He certainly has the best beard. An office building a block away from his apartment recently met with a missile. “Kyiv is not so dangerous now, but who knows about tomorrow.” We spend the evening indulging in soup. Hearty borscht, with thinly cut beetroot and sour cream, followed by solyanka; all sorts of smoked meats, tomatoes, onions, lemon and parsley, it’s goulash on steroids. That, a shot of vodka, and I’m out. The next morning, Sergii arrives with another Landcruiser ambulance and we drive in a 100mph convoy east; they’re ambulances, we won’t get a ticket. We have another 500 miles to cover, fuelled by petrol station hotdogs (the Wog Dog, named after a petro-company, is something of a culinary tradition on the road, convinces Sergii). These services also sell camo caps and Zelensky-style khaki t-shirts and jackets. You find stuff like this is some US gas stations too, but that’s for adolescent-minded cosplay. This is for the real thing.

As we get closer to our destination, the tarmac becomes badly rutted; the result of heavy equipment making its way to the battlefield. We’re staying the night at a civilian hospital that’s been partly taken over by the military and MOAS’ medics. I’m withholding the name of the town for security reasons. The houses are cute, with well-kept lawns, flower gardens and picket fences, but it’s become like a garrison town. Most people are in fatigues, and most of the cars have been re-sprayed green. There are many freshly-dug graves in the cemetery. The night before my arrival, a school here was destroyed by a missile. So, when there’s another bang that evening, thoughts turn to the worst. MOAS team leader Alina Bilous later investigates and confirms it was another missile, launched from a Russian S-300, but this one was successfully intercepted. Alina trained as a paramedic when war was declared. How does she feel about her role 18 months in? “I’m happy because I can help, but I’m angry because we have a war in our country. It kills me, the idea they want to kill everyone; civilians, children, the elderly. Many people have died. It’s not okay.”

I see the implications of this conflict up close the next day, visiting one of the country’s top hospitals in the city of Dnipro. This hospital only treats the most serious casualties – ‘red’ casualties – and since the war started 21,000 victims have passed through its doors. I’m told 90% of the injuries are caused by shrapnel. Dr Sergii Ryshenko, the head doctor, tells me they’ve managed to save 96%. He credits MOAS’ professionalism in assisting with that – stabilizing the patients 10-20 miles behind the front-line, undertaking temporary surgery, and then transporting them to a proper hospital like this one. Sometimes that drive can take up to four hours. Helicopters aren’t an option, due to risk and restrictions. MOAS have been tasked with 80% of Ukraine’s front-line ‘red’ casualties. Astonishingly, they haven’t lost a patient yet on their watch. Not one.

Patients remain in ICU for up to three weeks before being transferred to another hospital further to the west to convalesce. Dr Oleksandr Tolubaiev, Ryshenko’s deputy, takes me around a ward. One young soldier, who was brought in a week ago, is hooked up to a dialysis machine to “help with a leg injury.” Is his leg going to be alright, I ask? Dr Oleksandr lifts the bedsheet to reveal the man’s left leg has been amputated, sawn off five or six inches above the knee, the stump wrapped in what looks like red gaffer tape.

I sit down with MOAS’ founder, the garrulous Christopher Catrambone. He’s a 42-year-old maverick American millionaire turned humanitarian disrupter. Nine years ago, he was fishing migrants out of the Med (MOAS stands for Migrant Offshore Aid Station). Now he’s saving lives in Ukraine. He’s put £790,000 of his own money into this effort, and he’s raised an additional £15 million from private donors. It’s costing £865,000 a month to run this operation, which employs 150 medics – all professionals, no volunteers. They are all Ukrainian, patriotic and committed. Chris didn’t want adrenalin-junkie war tourists. He pays top dollar to get the best, and it’s working.

Since the war started, Chris has only been out of Ukraine for four weeks. “You exhaust every effort you can, both in the field and raising money. If you fail, people die. A lot of these humanitarian organizations try to do what they know, replicating it in different places without modifying the process, and it becomes ineffective and a waste of money. For me, it’s very simple: Where’s the problem? Let’s go to it and start making the impact. And that, crazily, is disruptive.” Most aid outfits are afraid to pick a side in a war, he explains. “At the beginning, people were like: We can’t help a soldier. Well, they’re the ones dying. You’ve got to care for human lives, regardless of whether or not they’re wearing a uniform. By the time we see them, they’re not carrying a gun.”

Catrambone made his money insuring US military contractors and providing emergency medical assistance in hostile places. He’s used to war zones. But this war is different. “The injuries are unlike anything we’ve seen before,” he says. “This is a major war featuring two sides with modern weaponry. In Iraq and Afghanistan, people were being injured by mortar attacks, IED blasts, suicide bombers. They were quite targeted. Here, it’s a different enemy. They’re throwing everything they have at each other, and they have similar weaponry and similar mindsets in terms of how they fight.”

Sergii Bolshoy drives us to another MOAS stabilization point to the south, very close to the front-line and ‘hot’. I’m instructed to wear body armour. There’s a ‘red’ casualty incoming and we’re racing to meet him. Sergii practically forces a cop car off the road. “Correct, policeman,” he mutters. A stooped lady in a headscarf goes to cross the road, then thinks better of it. “Correct, old woman.”

MOAS’ stabilization point at this location is a requisitioned farmhouse, and the army has just dropped off the soldier. His abdomen has been torn open; a hellish casserole of intestines. Seven big fragments of mine are removed and he’s patched up and put in the Landcruiser. We blue light it to Zaporizhzia, swerving in and out of traffic. Once we get to the hospital and the patient is transferred to theatre, MOAS anaesthetist Dr Inna Demiter signs the paperwork and hands over responsibility. “He’ll live,” she tells me on the way out. “He may even return to the battlefield in a few months.”

That’s the tenacious spirit that Vladimir Putin’s forces are up against. Putin wants to crush Ukraine’s western liberal values, and the curious thing is an hour behind the front-line the Ukrainians are just getting on with it. Everything is open. People are drinking on terraces, sunbathing, they’re even bungee jumping off bridges that are rigged with explosives. The supermarkets stock everything, and the one I visit invites me to wipe my boots on a t-shirt laid at the entrance bearing the Russian president’s face. That night, in Dnipro, I enjoy a sensational eel tartare, tender veal filet mignon, and a fine skin-contact Ukrainian chardonnay. We could be in Notting Hill.

Between sleeper trains on my way back to Poland, I explore downtown Kyiv. It is a living war museum. On streets and in squares, you’ll find captured or destroyed Russian military hardware, usually with a laminated guide affixed to it explaining what it is and where it was when the Ukrainian army took it off the chess board. A large collection of enemy tanks and surface-to-air missile launchers is rusting away in Mykhailvska Square, a stone’s throw from where there is an ever-growing wall of pictures of the tens of thousands who have been killed since 2014 trying to defend Ukraine from Russian aggression. It started with Crimea and it hasn’t stopped. It was only with the February 2022 invasion that western governments took notice and decided to help. MOAS was ahead of them on that. MOAS pre-empted the war and got its logistics lined up a month in advance. But they, and Ukraine, need more support. Countries like the US, UK and Germany are providing weapons, but nowhere near enough aid. Chris Catrambone and his 150 medics are carrying the can. That Landcruiser I drove over is already saving lives, lots of them, before I even get out of the country. I understand where the indomitable will of its people now comes from – Ukraine is a beautiful country and it must remain free. Sergii’s right: there will be no surrender.

To learn more about the work that MOAS is doing in Ukraine to save the lives of people impacted by the conflict, and to donate, visit moas.eu