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Nancy Wespetal, MD, a family physician and the international director for Hope in Action, a humanitarian aid organization in Ukraine, left Kyiv less than a week before the Russian assault began, and traveled to Poland a week later to help care for Ukrainian refugees.

Just before Wespetal left Ukraine, Hope in Action, which is made up of 300 members who provide medical care and ministry in rural parts of the country, sponsored an American group who helped train medics to respond to mass casualties.

In simulated drills, medics moved "patients" from one room said to be "under fire" to another designated as a "safe space." There, they practiced triaging and stabilizing patients with mock injuries -- everything from gunshot wounds and gaping chest wounds to partial amputations.

While the intent of the trainings was to prepare for what looked to the world like an imminent conflict, people were calm, Wespetal recalled. "Nobody [there] believed this could happen," she said.

Today, those very same medics are still in Ukraine, providing care on the front lines. Most of Hope in Action's physicians are continuing to work in hospitals in Western Ukraine, but the physicians in Kyiv, which has been heavily bombarded by Russian forces, are harder to track, with some likely working in military hospitals. The organization is also working to help bring medical supplies and food into Ukraine, while trying to help ferry people out.

"It just feels like we're all just blown to the wind," she said.

In Poland, Wespetal is helping care for refugees in a "transition center" in Przemyśl, across the border from Lviv. The center, which is run by the Polish Red Cross and housed in a large school gymnasium about a mile from the city's train station, processes hundreds of refugees each day. Wespetal helps by providing arriving refugees with medical care and acting as a medical interpreter.

When she first arrived, she was struck by the sheer number of people at the site, "just a mass of people," she explained.

Wespetal moved to Ukraine in 2001 upon completing her medical residency in the U.S., where she grew up. While she has helped refugees in Eastern Ukraine, Russia, and other areas affected by conflict, it is especially heartbreaking to see families fleeing a country she's considered home for decades, she said.

She said that in the past she has never been "under fire" or feared for her physical safety, but the work has always been emotionally draining. "I know there have been refugee crises for years, it's just never been on my turf," she added.

At the transition center, a dining area has been set up at the back of the gym. Registration is at the front. People sit along bleachers on one side, and there are endless stacks of clothing, toys, and diapers, along with hundreds of cots for sleeping for those who can withstand the noise. Announcements blare overhead, calling out buses ready to depart for different cities all across Europe -- places like Estonia, Germany, and Italy.

"All of the European Union is open to them," Wespetal said. Long-distance trains are free for refugees, and Poland is providing free medical care, as well as opportunities to stay and work.

Wespetal works alongside medical students, EMTs, and one other doctor in a tent at the back of the center -- greeting refugees, treating their ailments, and talking to them about their problems. In all, there are somewhere between 50 and 100 volunteers. While she works from 9 a.m. to 9 p.m., the paramedics are available 24/7, rotating in 4-hour shifts during the day and 2-hour shifts at night.

New arrivals stay at the transition center anywhere from hours to days, she explained. Complaints include high blood pressure and high blood sugar, headaches, insomnia, and swollen feet. Wespetal said that it takes time to talk to patients even if they don't have serious health issues. Sometimes, she offers to pray with them, believing that the body, soul, and spirit "need to be treated in order for the person to be whole."

Nearly every day the medical team sends at least one person to the hospital, for reasons ranging from appendicitis to myocardial infarction.

Wespetal recalled one patient, an elderly man with suspected myocardial infarction, who told her that he and his wife were waiting in a line of cars close to the border when they were offered one bus seat. They decided to separate, with the man being told it was only 20 kilometers to the border. After walking for 80 kilometers, he arrived at the border and could not find his wife.

"She's missing. No one has been able to find her so far," Wespetal said.

Asked what clinicians and healthcare workers in the U.S. can do to help, Wespetal said the trainings for medics are a "wonderful thing." A lot of groups are also working to get medical equipment into Ukraine, she added.

She explained that while it is currently a challenge for foreign doctors to come to Ukraine to lend their support, the country's Ministry of Health has created an with the goal of helping qualified foreign workers volunteer their services. It's complicated but "it's not impossible," she said. "It's very hard to see what's going on and not want to help."

While the medical needs are there, the humanitarian needs are even more severe, Wespetal noted. "You're moving a country with more than 30 million people ... by ones and twos and tens and twenties. So there's great humanitarian need."

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