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(800) LA TIMESFounded Dec. 4, 1881
Vol. CXXXVIII No. 358
LOS ANGELES TIMES (ISSN 0458-3035)
is published by the Los Angeles Times,
2300 E. Imperial Highway, El Segundo,
CA 90245. Periodicals postage is paid at
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Pricing for all subscriptions includes the
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All subscriptions may include up to five
Premium issues per year. For each
Premium issue, your account balance
will be charged an additional fee up to
$4.49, in the billing period when the
section publishes. This will result in
shortening the length of your billing
period.Printed with soy-based ink on recycled newsprint from wood byproducts.U.S. ambassador:In the
Nov. 24 Section A, an article
about newly released State
Department documents
that shed light on attorney
Rudolph W. Giuliani’s activ-
ities in Ukraine misspelled
the last name of Gordon
Sondland, U.S. ambassador
to the European Union, as
Sonderland.FOR THE
RECORD
pressure Ukraine to investi-
gate Democrats.
Often lost in the debate
about that effort, the heart
of the impeachment inquiry
roiling Washington, is the re-
ality on the ground in
Ukraine. The United Na-
tions says the war has
claimed about 13,000 lives,
and the Ukrainian military
says it has lost 4,150 of its sol-
diers, including more than
80 this year. “What do Ameri-
cans know about Ukraine?”
Lagoda said. “Do they know
we have a war going on
here?”
Behind her, across a
courtyard, stood a five-story
ruin that was once the hospi-
tal’s main building, before
tank fire, mortar shells and
heavy artillery ripped
through the roof, slammed
into the emergency room
and shattered every window.
The field next to it is laced
with land mines.
In all, the campus has
taken 20 direct hits, destroy-
ing four of the seven build-
ings.
Dr. Tatiana Teplyakova,
the chief of the lab, pointed
to shrapnel marks on the
walls and ceiling of her quar-
ters on the first floor of the
former maternity ward, now
the main building of the hos-
pital.
“This is all happening
here in Europe, in the 21st
century,” she said.
Seeing their country
used as a pawn in U.S. do-
mestic politics has left
Teplyakova and many other
Ukrainians wondering
whether they now stand
alone in their fight against
Russian aggression.
“We’ve just come to
understand that we must dothings on our own,” she said.
Before the war, Avdiivka
was a sleepy suburb of 35,
people whose lives largely re-
volved around a massive So-
viet-era coal processing
plant that hovers over the
edge of town and anchors
the regional economy.
It employed 4,000 work-
ers, who toiled turning coal
into coke used to fuel
Ukraine’s biggest metallur-
gic factories.
Natural gas from the
plant heats Avdiivka’s rows
of housing blocks and other
buildings, including the hos-
pital.
Then in 2014, a street rev-
olution in the capital, Kyiv,
ousted then-President Vik-
tor Yanukovich, who favored
closer ties with Russia. That
paved the way for the elec-
tion of a Western-oriented
government, but also
prompted Russia to annex
Ukraine’s Crimean penin-
sula.
That April, separatist mi-
litias backed by Russia took
over several eastern Ukrain-
ian cities, including Avdi-
ivka, and declared them
part of the so-called
Donetsk People’s Republic.
Avdiivka stood on the
geopolitical fault line be-
tween a resurgent Russia
and the West, with the
United States promising to
back Ukraine.
The actual battle line fell
not far from the Avdiivka
City Hospital on the road to
Donetsk, a cosmopolitan
city that became a rebelstronghold. The war came to
the hospital grounds that
May as Lagoda was con-
ducting a staff meeting in
her office.
“It looked like mush-
rooms popping out of the
ground as the shells ex-
ploded,” she said.
The staff rushed the 200
patients into the basement
bomb shelter.
Before the conflict, the
community hospital was a
place to deliver a baby or
have an appendix removed.
But as the closest medical
facility to the front line, it
soon became a makeshift
military hospital.
Doctors with little train-
ing in combat wounds were
soon treating more soldiers
than civilians. The Ukrain-
ian military sent in special-
ists to work side by side with
the hospital staff.
“We picked up a lot of on-
the-job training,” said Dr.
Anatoly Arkatov, a general
surgeon who has worked at
the hospital for 40 years.
By September 2014, half
the hospital’s buildings had
been destroyed by shelling.
Thousands of Avdiivka resi-
dents fled, along with about
a third of the hospital staff.
Other doctors andnurses sent their families to
live in safer parts of Ukraine,
then moved into the hospi-
tal, sleeping in offices or the
hallways for weeks at a time.
For five months in that
first year of war, the hospital
had no heat or electricity.
There was no water for 11
months, and hospital staff
brought in buckets of water
from streams and ponds
nearby for boiling. Doctors
performed surgery by
candlelight in the basement
of the maternity ward.
Two weeks after Trump
was sworn in as president in
January 2017, Avdiivka be-
came the center of the war
again in the worst fighting in
several years. Heavy shelling
lasted for a month, cut off
the heat and electricity to
the city and nearly shut
down the coal processing
plant.
The hospital lost heat as
February temperatures
plunged below zero. Doctors
walked around with drip
medicine pouches tucked
inside their coats to keep
them at body temperature
before administering them
to their patients. The hospi-
tal stayed open even as most
of the city was evacuated.
“People ask me why Istayed this whole time and
why I didn’t just leave when I
could,” said Dr. Oleksandr
Poltoradnya, the head of an-
esthesiology. “I don’t know
what to say. I just look at
them and say, ‘I must be
crazy.’ ”
The hospital has seen
about 300 soldiers and 200
civilians a year over the
course of the war.
The fighting continues in
ebbs and flows. The hospital
staff lives in fear of a new
uptick in combat.
On Nov. 7, a mortar shell
fired from the pro-Russia
militia side hit a Ukrainian
army truck not far from
Avdiivka. One soldier was
killed instantly. Two were
wounded.
A fourth was brought to
the hospital in critical condi-
tion. Surgeons and military
doctors worked for hours
but failed to save him.
On the day of the attack,
acting U.S. Ambassador
William B. Taylor Jr. was
visiting the front lines with
Ukrainian President
Volodymyr Zelensky’s team
to examine Ukrainian troop
withdrawals as part of nego-
tiations with Russia to end
the conflict.
A week later, Taylor testi-
fied to Congress in the im-
peachment trial.
“Part of the strength,
part of the ability of the
Ukrainians to negotiate with
the Russians for an end to
the war ... depends on the
United States and other in-
ternational support,” he tes-
tified. “If we withdraw or
suspend or threaten to with-
draw our security assist-
ance, that’s a message to the
Ukrainians.”
Zelensky and Russian
President Vladimir Putin
are scheduled to meet in
Paris on Dec. 9 for peace
talks headed by the leaders
of France and Germany.
The Avdiivka City Hosp-
tial has taken advantage of
quieter periods of the war to
make improvements. The
children’s clinic has been re-
paired and converted into an
infections ward with tile in
bright yellow and blue, the
colors of the Ukrainian flag.
Shrapnel damage on the
second floor of the former
maternity ward is being
fixed to create new warmly
lighted patient rooms.
There is still no elevator,
so when patients need X-
rays, doctors and nurses
carry them on stretchers up
and down three flights of
stairs.
Dr. Vitaliy Sytnyk, the
deputy chief of the hospital,
said the hardest part of his
job these days is reassuring
his staff members when they
ask when the war will end.
“You can tell them that it
will end soon, but the truth is
that you know very little
about what will happen in
the future,” he said.
In the meantime, the
soundtrack of war plays in
the distance.
“Don’t listen to anyone
who tells you that you get
used to the sound of
shelling,” Sytnyk said. “You
never do.”Ayres is a special
correspondent.OLEKSANDR POLTORADNYA,head of anesthesiology, speaks with a patient. The Avdiivka hospital stayed open even as most of the Ukrainian city was evacuated.
Photographs by Brendan HoffmanFor The TimesUkraine’s war comes to local hospital
UKRAINIANmilitary medics eat breakfast at the Avdiivka City Hospital. As the closest medical facility to
the front line, the community hospital became a makeshift military hospital soon after the fighting started.A BUILDING in Avdiivka bears shell damage. The
hospital is another war casualty, having taken 20
direct hits, destroying four of the seven buildings.[Ukraine,from A1]