Appearing inside Ukraine's "kill zone": ARA visits Sumi's maternity ward

Sumi (Ukraine)The Sumi Maternity Hospital is an oasis of peace amidst the war. This city of some 250,000 inhabitants in northeastern Ukraine lies about 20 kilometers from the front line, near the Russian border, and suffers constant attacks, which have intensified in recent weeks. Alerting the population with sirens or through the Air Alert mobile app, designed by the Ukrainian authorities, is of little use: here, a missile takes between 5 and 8 seconds to hit the city center, and in the case of drones, there are less than two minutes to find shelter. But in the Maternity Hospital, which will celebrate its 100th anniversary on March 8th of next year, there is only calm and silence. This is what the mothers and babies need in a place where, despite the horror, life finds a way.

Anya, a 24-year-old teacher, tries to soothe Odelle, her first daughter, who is two days old and weighs only 1.3 kilos. The little one twitches in her crib, barely visible beneath the blanket that swaddles her. When we ask her why she decided to become a mother under these circumstances, the young woman smiles: "Why not? War can't take our lives. It can't rob us of being mothers. And what's the point of waiting? We don't even know when all this will end." Like the vast majority of women who seem to be in Ukraine today, she must face pregnancy and raising her child alone. She eagerly awaits the arrival of the baby's father from the Zaporizhzhia region, where he is fighting, to meet Odelle and spend the few days of leave he will have with her.

Beside her, Victoria, a lawyer with whom she shares the room, seems more at ease caring for Yeva, who was also born weighing just over a kilo. She's not a young mother: she has a 13-year-old son, with whom she fled to the UK at the beginning of the war. But she decided to return: "It's better to be at home," she says. Although her house, in a border village in northern Sumi, was destroyed by Russian artillery, drones, and missiles that constantly bombard these towns, where only a few elderly people remain, reluctant to leave. Yeva and her brother will live in a small apartment in the city where their mother has taken refuge. She will also have to raise her alone, because her husband is always on her case. When we ask her how she sees her children's future, she answers the same thing any mother anywhere, under any circumstances, would say: "I hope they are happy."

Giving birth underground

In these almost four years of Russian occupation, the maternity ward has had to adapt to the war. The operating rooms, delivery and labor wards, and the neonatal intensive care unit have all been moved to the basement levels. They're making the most of every corner: in the corridors, doctors and nurses are typing away on computers, and they've even placed beds against the walls. In case of attack, patients and staff from the first floor can also go down to the basement. The hospital is equipped with generators to operate autonomously for up to 24 hours. To make the labyrinthine corridors more welcoming, they've hung photographs of pregnant women radiantly showing off their bellies in formal attire and pictures of babies with bows in their hair. The temperature outside is -6 degrees Celsius, but inside the hospital, it's perfectly comfortable in short sleeves. Since February 2022, nearly 5,500 babies have been born at Sumi Maternity Hospital, but the war is also impacting the birth rate: last year births at the center fell by half compared to 2024.

of helping women. “Here underground, we all feel safer, and the patients too, because the enemy is very close,” explains Olga, a pediatrician at the center. For security reasons, the ARA has agreed not to give details about the hospital’s location or its staff. Almost the entire team working at the hospital is female: gynecologists, anesthesiologists, pediatricians, intensivists… The men are on the front lines. But, in reality, the mothers and babies are too, because the front line in Ukraine has vanished: within the so-called “kill zone,” the 20-kilometer strip along the front line, no one is safe. Two anesthesiologists and a gynecologist from the center were sent to the front, a pediatrician from the hospital was seriously injured in a missile attack in the city center a year ago, and last October a Russian Shahed drone of Iranian manufacture crashed into the building next door and caused damage to the center.

The main impact of the war on pregnant women is stress, they explain. Maternity ward professionals. "They are distressed by the bombings and the constant danger. We are seeing more miscarriages, more premature births, many low birth weight babies. Sometimes the women cannot get adequate nutrition and don't take enough vitamins because not everyone here can afford a proper diet, or they also suffer from psychological problems that result in being overweight or having diabetes. But she assures us that the women are strong: "They are true heroines who take on the responsibility of having a child alone in the midst of war. The desire to be mothers is stronger than anything else."

At the Sumi Maternity Hospital, everyone tries their best to leave the war at the door, but it's an impossible mission. Iulia, the hospital's medical director, recalls that one of the most difficult moments she has experienced was having to explain to a midwife that her husband had died in combat: "The news devastated her, and she didn't want to hold her baby. We provided her with psychological support until she was able to cope." At the hospital, all the staff are very clear about the importance of promoting breastfeeding, for the health of both mothers and babies. All of this is an obstacle course they must overcome every day. War, they say in Ukraine, is not a sprint, it's a marathon.

The maternity hospital is funded by the central and regional governments, and care is completely free. Tetiana, the director, says they have the basic equipment, but they lack some specialized devices, such as audiometers to check newborns' hearing and blood infusion pumps. For everything else, they manage with what they have.

The center also goes out of its way to continue helping mothers after they go home with their babies. They've even set up an underground "Mama Café," with a large counter stocked with macaroni, breaded meat, soups, sausages, fish, and vegetables. There, they can spend time with their children when they have to go to a medical appointment and also buy food for the whole family before heading home. The power and heating cuts caused by Russian attacks on energy infrastructure this harsh winter are making life impossible for Ukrainians, and even more so for women with young children.

Julia, head of the neonatal ICU, has brought babies who weighed barely half a kilo to life, as well as others who suffered from serious heart or respiratory problems. She doesn't boast, but the center's medical director doesn't want to miss the opportunity to emphasize it: "She has the gift of gold and works tirelessly." Julia has a 20-year-old son studying in Germany, but she has decided not to leave her job: "I want my job. My life is helping babies: it's who I am, and they need me here." She says she doesn't think about the future that awaits the children she cares for when they are born: "My job is to make sure that mother and child go home with a smile on their faces, and that's what we do here every day."