She takes a sip from her Martini Rosso, flips her hair and looks me straight in the eye. “I want Ukrainians to have a voice,” says Anna Smolova, a 33 year-old radiation therapist from Sumy, Ukraine.
Smolova is one of the eight million Ukrainian refugees who have been registered across Europe since the Russian invasion of Ukraine last year. She arrived in Spain in February 2022 and started working at the Bizkotxalde Clinic near Bilbao in March 2023, after a long administrative process. “It was complicated,” she remembers. “They kept asking: why can’t you bring your documentation? And I answered: because it’s in a bunker!’’
Smolova had already managed to get her diploma homologated before the war, prompted by a desire to work abroad. “To be honest, I never thought that this diploma would be useful,” she sighs. “But here you go.” As she waited to have her paper work approved, she volunteered to help other migrants and give them visibility in the public space. “It’s actually my second interview here,” she says in her
mellifluous Spanish. “I want to raise awareness of migrants and explain why they had to leave their home.”
Getting out
Her own escape in the early days of the war was not free of danger. Sumy, a city in northeastern Ukraine, is located only 30 kilometers away from Russia.
“The Russian troops were crossing our region and destroying houses, and at the beginning, they were waiting for people to come and collaborate,” she recalls with emotion. “We had been planning our escape for at least ten days, but we were not sure if we were really going to leave or when. It was very risky.”
One morning, she received confirmation that the soldiers had left the streets. “Groups of neighbors were always watching outside, and communicated with each other using WhatsApp,” she says. “We heard that the Russians were having breakfast, so we took the opportunity and left.”
Smolova left with her then five-year-old son and her parents. “I wasn’t working when the war broke out. I wanted to go back to the hospital but there was a lot of chaos after the invasion, so I decided to leave. My dad came back the same day to Ukraine. My husband chose to stay. Both also work at a hospital.”
Compared with other areas of Ukraine, Sumy, although geographically close to Russia, has barely been touched by bombs. “The Russians tried to bomb our critical infrastructure but missed the marks. They have destroyed a lot of the south and east of the country though. We’ve been lucky we had so many people who wanted to fight back,” she says proudly.
Smolova comes from a family of physicians. Her father is an oncology surgeon and her mother worked as a radiologist for many years. Smolova’s husband is a pediatrician, rescuer and sonographer. “Even my parents-in-law are physicians,” she says laughing.
Smolova trained in Kharkiv and Kyiv, and received her medical degree from Sumy State University, and her degree in radiation therapy from Kharkiv Medical Academy of Postgraduate Education. She worked at the Sumy Regional Oncology Center between 2012 and 2017, with a five-year interruption as part of her maternity leave.
Impact of the war on healthcare in Ukraine
One of the key characteristics of Russia’s strategy has been to try to destroy the Ukrainian healthcare system. A recent article in The Lancet stated that there had been more than 1,000 attacks on Ukraine’s health centers and staff by the end of 2022, resulting in a decline in the quality of healthcare and service delivery. 1
“During the first three months of the invasion, Russian forces also used other techniques to reduce patient access to medical care,” Smolova explains. “Some people were kidnapped and couldn’t recieve their treatments. I remember the case of a patient with cancer who was trying to explain to her captors that she had to go to the hospital to receive her chemotherapy. They detained her and her husband for weeks.”
Over a year after the war started, things are not back to normal. Many facilities are running without water or electricity, and some hospitals and clinics are beyond the point of repair. Medical teams tend to patients the best they can in dreadful conditions, without schedule.
“Waiting lists, for a while, didn’t exist anymore,” she says. “Now everything gets done as soon as possible, like before the war.” The Russian invasion has also caused important migratory movements inside the country and at least six million Ukrainians have been internally displaced.
The number of patients who need medical care has therefore doubled, or even tripled in some areas, Smolova reports. “My father is overwhelmed,” she says. “He tends to 60 patients a day, instead of 20 before the war. There is no limit to the number of patients to tend to per day.”
The contrast with the Spanish healthcare system is stunning, but not in a way that one would expect, she explains. “I went back to Ukraine last January for my son to receive tonsillectomy because every patient there is treated right away. In Spain, there are huge waiting lists and he would have had to wait for months. Delays here are unbelievable and I’m surprised people are not more indignated.”
Another big difference she notices between the two countries is that physicians in Spain can only chose one specialization. “In Ukraine, you can specialize in whatever you want – pediatrics, ultrasound, oncology, etc. In Spain the training is stricter, but they lack doctors across the country.”
She is however glad to live in Spain, a country she had visited many times and whose language she had learned long before the war. “Living here is a challenge, but I feel like I’m progressing every day. My son is happy at school, I’m happy. Security gives you a lot of things. We can’t plan anything as long as the war is raging. So for now, we will continue here in Bilbao, but we hope to be reunited as a family as soon as possible. It doesn’t really matter where.”
In the future, Smolova, who also has a degree in international management and teaching, plans to complete a PhD in microbiology. “There is nothing unattainable,” she says gracefully.
Her grit resonates with what other Ukrainians have achieved so far, back home.
REFERENCES
1 DOI: https://doi.org/10.1016/S0140-6736(23)00387-2
