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Ukraine’s drug runners risk it all to deliver medicines to the front line – POLITICO

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Until recently Oleksandr Diryavko managed a company that installed security systems in homes and businesses.  

Russia’s invasion of Ukraine on February 24 brought an abrupt career change. Now the 35-year-old resident of Boryspil, near Kyiv, spends his days far from his office desk, behind the wheel of a van delivering medicines to some of the most dangerous parts of the country. 

“I’m a manager. I know that every cog needs to play its part so that things can work,” said Diryavko about his decision to go to “hot zones” — areas contested between Ukrainian and Russian forces where shooting and shelling are commonplace. 

The fighting has caused a sharp increase in the demand for painkillers, antibiotics and tourniquets — essentials for wounded soldiers. In Kyiv, media have reported long lines in front of pharmacies. Disruption to regular medicines deliveries has also caused fears of insulin shortages, as well as shortages of medicines to treat the infectious diseases that are prevalent in Ukraine, like antiretrovirals for HIV or drugs to treat tuberculosis.

Diryavko said that he didn’t waste any time after his country was attacked to set up the informal delivery service. He started out paying costs out of his own pocket, though he has started receiving donations. He relies on volunteers, as well as on vehicle owners to loan him their wheels.

“I called my buddies and asked if they wanted to help. No one has said no,” explained Diryavko. 

The former manager is just one link in an informal network of private citizens that criss-crosses the country — stretching across the border to western neighbors like Poland and beyond.

Organized over WhatsApp and Facebook, they connect with hospitals and clinics looking for painkillers, antibiotics, insulin or any of the other hundreds of drugs that are needed as the war rages on. Others volunteer in warehouses, helping to package medical supplies donated from abroad, while translating instruction leaflets into Ukrainian. Others still work the phones to match demand and supply. The end result is a society-wide effort to keep Ukraine stocked with medicine, as well as essentials ranging from food and water to baby formula and diapers.

Kyiv to Chernihiv 

Diryavko’s ground-level operation is more like an improvised charity drive than an organized humanitarian mission: Cars are filled with food and medicines collected from friends and acquaintances, and unloaded in towns and villages near the front lines — sometimes on people’s doorsteps or in their garages.

It can be a risky undertaking. Married and with two children, Diryavko said he’s been both shot at and shelled while helping to evacuate civilians from Chernihiv, a city to the northeast of Kyiv near the Belarusian border, which was until recently besieged by Russian forces. 

So far, Diryavko hasn’t lost any drivers. But one van was destroyed in a Russian attack, and its occupants injured by shrapnel.

The former manager didn’t escape Chernihiv unscathed. Speaking to POLITICO over Zoom on a break during a recent delivery run, he waved a bandaged hand as he described how his life had changed over the past month.

“We loaded an epileptic person during the evacuation and he had a fit in the car,” said Diryavko. “We didn’t have anything to put in his mouth so to stop him choking on his tongue, so I put my finger in.” Doctors have told him they might have to amputate his finger.

Diryavko said that his team now checks in with the Ukrainian army to avoid areas where there is active fighting.

Lviv to Kyiv

The Russian aggression poses a constant threat to humanitarian workers. The World Health Organization has verified 91 attacks on health care staff during the war in Ukraine, resulting in 73 deaths. In response to attacks on civilians — in violation of international conventions — Ukrainian officials have repeatedly had to close humanitarian corridors that they sought to establish to evacuate civilians.

The safety of his drivers is a major concern for Pavlo Skala, policy director for Ukraine’s biggest health-focused NGO, the Alliance for Public Health. Skala, a former police officer and U.N. peacekeeper, has seen his role change since the invasion. Now he manages APH’s drug distribution operations, overseeing two-dozen drivers and 16 vehicles.

APH vans bring medicines from safe zones like Lviv, near Ukraine’s western border with Poland, to cities like Kyiv and Lutsk. The vans were formerly mobile HIV and tuberculosis labs that have been converted to transport aid. Traveling in convoys of eight to 10 vehicles, each can carry a cargo of 2 metric tons. Supplies are dropped off at a hospital or city center, where local drivers pick them up and bring them closer to the front line. Skala said that deliveries included insulin for diabetics, cancer drugs and HIV medicines — as well as common drugs like paracetamol and ibuprofen. Medicines for people with chronic diseases, who could get sick or die without them, are a priority.

APH drivers with a loaded van | Photo by Pavlo Skala

Before the war, APH led a successful campaign to provide opioid substitution therapy and clean needles to drug addicts to reduce the spread of infectious disease. Harm reduction continues to be its guiding principle, Skala explained. “Hot zones” are avoided and APH drivers are given flak jackets. He tracks the vans through GPS on the drivers’ phones.

Ultimately, though, there are no guarantees: “Everybody knows the security conditions,” said Skala, whose 20-year-old son is a volunteer driver.  

So far APH has avoided casualties. But one of the vans they donated to a partner organization was destroyed in a Russian strike on a mission to evacuate civilians from Chernihiv. Both drivers in the van were killed.

Warsaw to Lviv 

Ukraine’s western neighbor Poland has — in addition to taking in the largest number of refugees fleeing the war — quickly become the main hub for getting humanitarian aid into Ukraine. The Polish Strategic Reserve Agency — established to maintain stockpiles of food and medicines — is playing a key role in keeping the lifeline open. 

The Strategic Reserve has transported 5,000 pallets of medicines by rail in temperature-controlled wagons to cities in Ukraine. Supplies include bandages, disinfectants, painkillers, antibiotics and blood products — as well as nearly 80 ambulances.

Poland is also a staging ground for other countries donating goods, the Reserve’s president, Michał Kuczmierowski, told POLITICO. So far, 42 countries have sent help by air, rail and road. Kuczmierowski didn’t disclose the routes by which medicines were being sent, but he said they were constantly changing to try to pre-empt possible Russian attacks.

“We have to be two steps ahead,” said Kuczmierowski.

Beyond humanitarian assistance, Poland has also become a conduit for donations of arms and military equipment, with friendly nations trying to level the playing field for Ukraine’s outgunned armed forces. According to reports, weapons and life-saving medicines sometimes arrive in the same shipment. The chaos of war and porous borders also create ideal conditions for black marketeers to flourish — and for corrupt officials to try to take their cut.

“If you bring the medicine in small amounts, there aren’t many problems,” said Oleksandr Ruzhytskyi, a partner at the Kyiv-based legal firm Everlegal, speaking about checks on the Polish-Ukrainian border.

The lawyer said that, when the war broke out, he decided to start delivering medicines together with the other partners using donated vans, bringing them from Warsaw to Lviv.

The exact legality of this improvised medical supply operation is shaky, said Ruzhytskyi — but so far he has always managed to get his cargo across. “My help is small. But it is effective and very fast” he added.

Ruzhytskyi, who is exempt from Ukraine’s ban on men under the age of 60 leaving the country because of his aid work, said he will usually drop his delivery at a warehouse near Lviv for unloading and sorting. A web of volunteer-run logistics hubs has sprung up to handle these tasks.

Further to the south, Julia Hrytsku-Andriesh runs a logistics operation that straddles the border between Romania and Ukraine. Before the war, she worked in the nonprofit sector helping to empower women. With a former business partner she co-founded Help Ukraine Romania. It has two warehouse locations, one on the Romanian side of the border in Siret, and another in Chernivtsi in Ukraine.

Hrytsku-Andriesh has been working non-stop with other volunteers since the war broke out, loading and unloading cargo, translating the leaflets in medicines packages into Ukrainian, and coordinating between donors in third countries and recipients. Having partners in the U.S. means she’s fielding calls at all hours but, she explained, she can’t bear the thought of an aid request going unanswered.

“We managed to deliver oranges from Valencia … to children who hadn’t seen fresh fruit for a month,” she said.

Residents in Chernihiv receiving supplies | Photo by Oleksandr Diryavko

On a wing and a prayer 

Poland is just one link in a larger humanitarian supply chain that stretches across the Atlantic. The U.S. government has announced $1 billion in aid to those affected by the war, including money for medical teams and for the delivery of emergency health supplies and medicine. The country’s NGO sector is also ramping up operations, including California-based Direct Relief, which has already provided disaster relief to conflict zones in Syria, Afghanistan, Myanmar and Venezuela.

But with Ukraine, “the combination of speed and scale of the disruption … make it quite exceptional,” said Andrew Schroeder, vice president for research and analysis at Direct Relief.

Since February, Direct Relief has delivered nearly 200 metric tons of medical equipment, including refrigerated insulin to address a “critical” supply shortage in Ukraine — as well as a 50-bed field hospital donated by the State of California.

By the time the supplies are unloaded, pallets are taken apart, and the medicines have been loaded into the vans to cities in conflict zones like Kharkiv or Chernihiv, drivers will likely have no idea where they came from. But all say they are grateful for the help given.

Chernihiv in ruins | Photo by Oleksandr Diryavko

On the long drives through their country-turned-war zone, drivers like Oleksandr Diryavko take in the scenes of destruction wrought by the Russian invasion. “I drive, and I think, how long will I need to work to bring the nation off its knees,” he said.

As Russian forces withdraw from the north of Ukraine to redeploy in the east, aid is finally reaching residents who had been cut off by the Russian front line. But for some in places like Bucha, the suburb of Kyiv that was the scene of indiscriminate killing by Russian forces, it will be too late.

A few days after his interview Diryavko reached out again to POLITICO. He sent pictures from Chernihiv after the Russian siege was lifted, showing homes reduced to rubble and masonry spilling into the road.

“I didn’t take really scary [pictures], but the city is destroyed,” he wrote.

Zoya Sheftalovich contributed reporting.

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