Ukrainian children with cancer evacuated through elaborate network

Hidden in the basement of her parents’ village hall, where she and her daughter fled, Besidovska continued to text the oncologist across enemy lines, begging for guidance. They never mentioned the Russian shells that rained on Kharkov and other nearby towns.

“I didn’t want her to stop helping us,” Besidovska said.

The doctor concluded that Yevheniia needed specialized radiation therapy and advised the family to come to Moscow. But Besidovska had no intention of entering Russia – “they are trying to kill us” – and nearby Ukrainian hospitals were under fire or were running out of supplies.

“She needed treatment and everything stopped,” Besidovska later said. “I knew we had to find it somewhere. We packed our bags to the sound of sirens.”

Over the next 19 days and more than 1,900 miles, Besidovska and Yevheniia found themselves on a grimly specialized path within the mass flow of Ukrainian refugees fleeing for safety: childhood cancer patients, some of the most vulnerable cases known to medicine.

Even brief interruptions to the young victims’ precisely calibrated chemo and radiation protocols can be disastrous, oncologists say, meaning their transport is fast, reliable and controlled, even in the quietest of times.

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During this war, a kind of underground railway was created for some of Ukraine’s sickest children. Doctors, nurses and specialist volunteers from dozens of countries have concocted a pipeline of stopover clinics, buses, ambulances and a hospital train to transport cancer patients and their families out of the country to a “Unicorn Clinic” in central Poland, and from there to children’s centers across the country. worldwide.

Those who make it — more than 700 children to date — become some of the most celebrated refugees. A flight to Paris was met by the French first lady. Jill Biden last week visited patients who had been airlifted to St. Jude’s headquarters in Memphis.

Besidovska, a 31-year-old manicurist from Sumy, Ukraine, knew nothing about this when she left with Yevheniia on March 12. She was just on her way from the doctor who once saved her daughter’s life to find someone who could help her now.

Her husband, Oleksandr, also 31, was left behind, banned by law from leaving the country. The couple and other family members participated in a group chat in the Viber app every morning and evening. “If he answers, I’ll know he’s still alive,” she said.

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With two gray duffel bags between them, Besidovska, her daughter and her 20-year-old sister, Marina, took a bus to Lviv, a large city near the Polish border that has been a gateway to security since the beginning of the war.

Before the war, the city’s West Ukrainian Specialized Pediatric Medical Center treated about 20 to 30 oncology patients at a time. In the past month, those numbers have doubled and then tripled.

The first spikes came from pediatric centers in the firing line. As fighting approached Kiev’s main children’s hospital and entire wards were forced into basement bomb shelters, hospital and government officials took busses of cancer patients to an obscure railway line, where they could board trains far from the chaotic main station.

“People were fighting to get on the train,” said Yuliya Nogovitsyna, program director at the Tabletochki Charity Foundation, which has been working full-time on pediatric cancer evacuation since the beginning of the war.

In Cherniv, the transport of young cancer patients had to be cut short for two days in a row after local militias sent the buses back to the hospital, Nogovitsyna said. Finally, all patients reached the facility in Lviv.

“We had families sleeping in the conference rooms,” she said.

Besidovska and her daughter arrived on March 28 – a day after a Russian missile blew up a fuel depot near the city. It felt like the war was overtaking them, she said.

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But by that time, Ukrainian medical workers and volunteers had received help. The Polish Society of Pediatric Oncology and Hematology sent doctors. The Polish government opened a side corridor for cancer convoys to bypass border delays that exceeded 20 hours on some days. Hundreds of young cancer patients were guided through a triage clinic that St. Jude’s International Branch had set up in a former hotel near Kielce, Poland.

“They told me I had to go to the ‘Unicorn Clinic’ and that they could help us,” Besidovska said. “Anywhere is better than Ukraine if they can heal my daughter.”

Two days later, she dressed Yevheniia in a Daisy Duck sweatshirt, zipped up their tired duffel bags, and boarded the red bus that would take them out of the war.

Two buses and eight ambulances followed a police escort to the border – where the convoy promptly came to a halt in a bureaucratic snag for nearly four hours. A nurse told Besidovska that border guards had opposed the Ukrainian-registered bus and a Polish driver. “They needed orders from Kiev,” she said.

“Unfortunately, one of the children has deteriorated,” said Pavel Kukiz-Szczucinki, a Polish oncologist who traveled with the group, in between cell phone calls to arrange for an immediate medical helicopter.

Six other critically ill patients were driven directly to Austria as planned. The rest drove on a dirt road near the border station and found a converted passenger train waiting at a freight station.

Yevheniia leaned against her mother for a moment as they walked along the track, more bored than tired. “That took sooo long,” the girl said of waiting hours to cross. “I just looked out the window.”

Besidovska gave her a squeeze, but they had to keep going.

There was no stage. Paramedics helped patients push and carry on a bench they propped up as a ramp. On board were nurses, an anesthesiologist, a psychologist. One car was a complete Intensive Care Unit.

The Besidovska family took a seat in a car with low cots for the five-hour drive. A clown twisted Yevheniia into a pink-and-green balloon flower. Back east, her father was concerned about the slow progress.

“I’m so worried about Zhenia,” he texted.

“Everything is fine,” replied Besidovska. She sent a photo with the balloon.

“I know you’re next to her. It makes me feel calmer,” he says.

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It was dark and raining when the train pulled into Kielce station, greeted by scores of uniformed police, Red Cross volunteers and medics with bright headlights. Some families looked shocked as they were all put on a different bus and driven to the outskirts of the city.

It was nearly midnight when Besidovska and Yevheniia finally sat down at one of the three tables in the noisy lobby of the Unicorn Clinic. A triage team of five people crowded around. A nurse checked Yevheniia’s heart rate and temperature. They flooded her medical records, which had already been translated into English by a network of Ukrainian- and Russian-speaking doctors in the United States.

Katarzyna Kononczuk, a volunteer doctor from Bialystok, Poland, asked about the girl’s first tumor, the remission, the MRI scan that showed a recurrence.

“How does she feel now?”

“Same. But her eyesight is deteriorating,” Besidovska said.

Clinic officials say the flow of patients has slowed in recent days, and so many have already made it. But these latest entrants are some of the most challenging, because they haven’t received treatment for so long or because they’ve been re-diagnosed. An ambulance is waiting outside just in case.

“Now we see children who are sicker and more likely to get sick,” said Marta Salek, a pediatric oncology fellow at St. Jude’s in Memphis, who happened to be visiting her ailing grandfather in northern Poland when the war ended. broke out. She has been running this clinic ever since.

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The Besidovskas were given a room and plates of spaghetti. They were out of the war zone. But the question of Yevheniia’s treatment was still uncertain.

The Unicorn Clinic is set up as a temporary resting place. For each group of arriving refugees, a clinic team processes all medical information and goes through a list of facilities that patients can take in for treatment. They hold nightly conferences with doctors in Lviv, Warsaw and around the world, matching cases to hospitals.

The process used to take a day, sometimes two, but it has become more efficient. Shortly after dinner, the Besidovskas were told that the psychologist was ready to see them.

“I don’t care where it is, as long as there’s no shelling,” Yevheniia said as they waited.

The psychologist, Inna Alanbousi, turned out to be Ukrainian and asked about Besidovska’s family and their village. Besidovska told her how it was surrounded by Russian troops, how she told Yevheniia that the explosions were thunder until she couldn’t lie anymore, how their only hope was to get away from the war, away from the Russian doctor who could no longer help , to get somewhere else.

It would be Rome. You are going to Rome, said Alanbousi, to the famous children’s hospital Bambino Gesù. The bus to Warsaw airport was supposed to leave at 7am

Besidovska nodded. Rome was fine.

And because war is both tragic and absurd, there was more. Alanbousi told them that their trip to Rome – the family’s first flight – would be on the plane of Polish President Andrzej Duda, who would visit Italy. They were to meet Pope Francis.

Besidovska nodded again, more tired than excited. She did not follow politics and was more Orthodox than Catholic. But any sign that God was watching Yevheniia was welcome.

“It’s like God heard our prayers,” she said. “We may have traveled under his blessing.”

Oksana Parafeniuk in Kielce contributed to this report.

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