Across the border and in the heart of Ukraine, the refugee situation is no better. School gymnasiums and classrooms, monasteries, fitness studios, and other storefronts have all been re-appropriated to house the ever-growing number of refugees fleeing eastern Ukraine for the relative safety of western Ukraine. Tanya Bucierka, DO, an emergency physician from Oregon with deep Ukrainian roots, has made the perilous journey across the border by bus twice already, with plans for a third trip this fall.

Ukrainian refugees are examined by physician volunteers in Poland.

“It’s a lot of primary care, but more than headache cures or blood pressure medications, many of the patients just want someone to hear their stories,” Dr. Bucierka said. “They may be resilient, but they’re still traumatized.”

She remembers meeting Petro, a Russian-speaking refugee who lived in Luhansk in eastern Ukraine. A hacking, wet cough interrupted him whenever he tried to speak—after spending a month underground in a bomb shelter, hardly ever venturing above ground, his untreated respiratory symptoms sounded suspiciously like pneumonia. When Petro and his wife Anna finally fled Luhansk, they had to dig their car out of the debris, finding that everything was covered in ashes. Anna, who had similar symptoms, minimized it as a simple chest cold and at first refused the medication offered.

“The soldiers on the frontlines need it more than us. Send it to them,” she said, apologizing for speaking in Russian. She and Petro are Ukrainian but don’t speak the language—it never seemed important before, but now they are taking a free class, trying desperately to learn. The war forced them from eastern to western Ukraine, but no matter how much the fighting intensifies, they are determined to flee no further. “This is our home.”

When Dr. Bucierka is not braving the road in a car heaped full of donated medical supplies to make rounds among the refugees, she can be found in the local medical university’s simulation lab, where she teaches point of care ultrasound to a group of Ukrainian doctors while in another classroom her surgical colleague demonstrates trauma surgery techniques on pig cadavers. Before the war, many civilian physicians had limited experience with trauma medicine. The Ukrainian emergency physicians learn eFAST, cardiac, ocular, and musculoskeletal ultrasound exams, cramming years of knowledge into a few short days so that they can return to the frontlines, bringing the new techniques—and the new donated ultrasound machines—with them.