No ambulance near the front line: emergency substation being liquidated in Donetsk region

The doctors insist that such a decision is unfair and emphasise that they constantly risk their lives for patients. At the same time, the management notes that the National Health Service of Ukraine (NHSU) has refused to fund the institution, so there is no possibility of working. The employees have been warned that they will be dismissed in two months. More details about the situation writes Socportal.

"Ambulance" moves behind the front

We worked first in Pokrovsk. From Pokrovsk we were transferred to Udachne, then to Dobropillya. And from there to Novodonetskoye. And all the time the front was 15-20 kilometres away from us, says paramedic Albert, who has worked in the ambulance for more than 40 years.

Despite this proximity, the community remains relatively quiet - it is not on the list of areas where mandatory evacuation of families with children has been announced. Medics say they have a lot of work to do - they regularly remove civilians and military personnel, take them to local hospitals or, in severe cases, evacuate them to the nearest regional centres.

There are still a lot of residents we serve. Now we go to Kramatorsk, to Dnipro, to Poltava. There are a lot of sick people. There are not less people. People stay and children stay. How many heart attacks, strokes we carry. It is absolutely unclear what this reduction is connected with," says Lina, Albert's colleague, a paramedic.

This work is dangerous. As of 2025, 58 ambulance medics have been killed by Russian shelling, according to the Ministry of Health. At least one more fatality occurred in January 2026 in Kyiv, where a paramedic treating victims was killed by repeated shelling. However, Albert notes that medics are ready to continue doing their job.

The people who work for us are from Avdeevka, Selidov, Pokrovsk, Mirnograd. People have no homes left, only work left, Albert says.

According to medical technician Valerii, who is originally from Avdiivka, he has long known what it is like to work in war conditions.

We have been taking out the wounded since 2014. The old part of Avdeevka was shelled, we felt it all the time. And when the "full-scale" began, I began to "move" with the front, - says Valery.

Over the years, his brigade has been in the hottest and most dangerous places.

We left when the Gorbaty bridge in Pokrovsk was bombed. In Selidovo we took out the wounded when the hospital was shelled. We were the first ones on the spot together with rescuers when there were dozens of wounded after shelling. It is impossible to count all such cases. No one refuses to work. What kind of vehicles? On these [outdated]. But we are working. We are doing our job. And this is what they did to us, says Valery.

Oksana, a paramedic, has also been working at the ambulance since the beginning of the Russian aggression in Donbas.

In 2014 and early 2015, we drove our guys who were wounded. The first ones, shot at Karlovka, we took out. Then from the airport. Now we are more prepared, we have at least some training, turnstiles, blood-stopper. Back then we were not ready, we had old tourniquets, bandages and that's all, Oksana says.

During the full-scale invasion, her brigade was also practically on the front line.

It's not rockets or shahedas, it's already artillery, it's grenade launchers, it's tanks. We hear the exit, and we hear a bang, and it's already coming, it's already clay flying at us and everything else. But people need help, says the paramedic.

For her work, she received the National Security and Defence Council of Ukraine's (NSDCU) second-degree award. However, the award does not provide for additional payments for her work.

And even the fact that Oksana is now pregnant did not prevent her from being warned about redundancy.

I can't legally be made redundant. The HR department said they don't have to know everything about everyone. I complained to the government hotline. They passed it on to Derzhprazi. They are all shocked there, says Oksana.

According to Svetlana Ryazantseva, head of the Regional Centre for Emergency Medical Care and Disaster Medicine, the situation of the employee was not known.

Although before that, information about everyone was collected by the human resources department, the manager assures.

The trade union was supposed to report on the protected and vulnerable categories, as well as participate in the process of determining the employees who have the priority right to stay at work during the reduction in force. However, it was not involved. Now the medics believe the process was non-transparent and plan to appeal.

"The bottoms are not the bosses." What motivates the reduction of medics

When the staff of the substation received a message about the impending reduction, they demanded an explanation from the management. Since the administration is in another city, a videoconference was to be held. The medics asked their station manager to hold it in the morning, when most of the staff would be present.

And when this was voiced by us, he said the rumour that the grassroots cannot tell the top when to schedule the meeting place. People heard that and were outraged. What is it with the grassroots and the uppers? It is as if we are slaves who should only work in silence, Albert pointed out.

Humiliation on the part of the head pushed, as often happens in such cases, the collective to resistance. Therefore, the medics demanded documents related to the downsizing process. The station manager responded with intimidation.

He said: "You have to think about the future. Who will write your characteristics? It's us." They started to intimidate that there would be no bonuses for you, says Oksana.

In turn, the head of the regional centre of "emergency" Svetlana Ryazantseva, notes that the main reason for the reduction of the substation is the refusal of the NHSU to finance the centre. According to her, the institution had savings from previous years, which allowed it to pay increased salaries and bonuses to medics. Even though the NHIS had already stopped funding last year. This year, however, the centre has been rejected again, and the savings have dried up.

There is enough money to last until May. I was at the ministry a fortnight ago, talking about our situation. And this is what I got. I am, of course, "delighted", - says the head of the centre.

In response to a request from Socialportal, the NSZU confirmed that the funding of the centre for last year and this year was 12 UAH - 1 UAH per month, and noted that the calculation was made "based on the provisions of paragraphs 6-7 of paragraph 32 of the Order". This refers to the Cabinet of Ministers' Resolution No. 1808 of 31 December 2025, which states:

The NHSI shall conclude contracts for the provision of emergency medical care with a planned cost of 1 hryvnia per month with health care institutions in which the balance of funds on current and other (depositary (deposit), etc.) accounts as of 1 December 2025, according to information on payment and expenses for the provision of medical care under the programme of the contract in force in 2025, exceeds the total amount of the average accrued wages and accrued unified social contribution for six months of 2025, according to information on payment and expenses for the provision of medical care under the programme of the contract in force in 2025, exceeds the total amount of the average accrued wages and accrued unified social contribution for six months of 2025, according to information on payment and expenses for the provision of medical care under the programme of the contract in force in 2025.

As a result, the state suspends payments if the facility has a "safety cushion" that would be sufficient to cover six months of salaries and the ERU. That is, the NHIS does not send new money until the balances are utilised. According to OpenDataBot, the net profit of the company as of 2025 was negative and amounted to -287 million UAH. The assets of UAH 534m are also displayed, but here we are talking about the entire property of the centre.

"We are for ourselves and for the people". What will happen to the residents of the community without an ambulance?

In turn, Svetlana Ryazantseva connects the refusal of the NHRI to finance with the reduction of the population in the community. The previous norms assumed that one brigade should serve 10 thousand people. Now there are 4-5 brigades at the substation, and only about 15 thousand people live in Novodonetsk and the surrounding villages. It is assumed that now brigades from neighbouring communities will come here. In addition, according to the head of the centre, some of the calls, especially those of elderly people, are not related to emergency care.

The primary health care centre should serve such patients. In this regard, the contracts with the NHSU stipulate that we should not serve non-emergency calls, otherwise they will check and fine us. But in a war situation, we don't exclude anyone. If there are calls that are not "ours" at all, we redirect and notify the primary, which should go to them. They have a car, says Sitlana Ryazantseva.

However, according to medics, the capacity of other substations and the nearest medical centres is small. And primary care mostly conducts appointments online.

We have a man with oncology, he has a constantly clogging catheter. We take him practically every shift to Kramatorsk. Or a woman with a mixed type of asthma. Grandparents who have no help. Many chronic diseases that are already neglected, because family medicine here only works online. And what is online medicine? says paramedic Marina.

In her opinion, after the reduction of ambulances, patients will have to decide for themselves how to get to the nearest medical aid station. Her colleague Oksana also stresses that the community is constantly receiving displaced people from neighbouring war-torn territories. These are mostly people without significant income and without their own transport. At the same time, in the frontline regions, there are many more risks and almost no public transport.

If they close our substation, who will serve them? We are left with a small number of people who love their work very much. That's 44 people working around the clock for the good of the community and the people. We still receive wounded people from Dobropillya. Some of them have low sugar, some of them have high sugar, some of them have something else. There are a lot of villages here, a lot of people migrating, moving little by little, because they do not want to go far away. If we are cut down, who will cater for these people? People will be left on their own, they will have no right to medical care. It's nonsense! The nearest hospital is Kramatorsk. There are a few therapeutic beds in Aleksandrovka. But if in an "emergency", a child falls ill or is wounded, God forbid, no one will take him there, says Oksana.

Therefore, according to her, they will fight for the preservation of the ambulance substation, "for themselves and for the people".

If we have already started, we will not stop. We have called the hotline of the Ministry of Health, the hotline of Derzhpratsi. We will send collective letters to the president, said paramedic Maryna.

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