Translated from the Spanish original written by María Senovilla for Público.

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Alexander Ogorodnik is 29 years old, with a bright and inviting air that makes you want to talk to him. He also has a brain tumor that hasn't been treated since the war in Ukraine began. He was getting radiotherapy, and the treatment simply stopped.

He was living in Saltivka, in the north of Kharkiv, when the Russian Army began bombing Ukraine on February 24th. 95% of Saltivka's residence fled during those first weeks, Alexander and his family included. They went to a country house in the southwest, almost three hours away from Alexander's oncology center and his doctors, but Russia's continued bombardment of the city has left them with no choice.

"Before,I worked as a salesman in a warehouse and also as a security guard. I've worked everywhere," Alexander explains, sitting on his bed, where he spends most of his time. He speaks slowly. "Now I think more slowly. I need more time,"he says. "But I'm grateful that I didn't die, first from the cancer and then from the war… Even though I can't even change a lightbulb anymore."

Four years ago, when he was 25, he was operated on for his first tumor. "It wasNovember 23rd. I remember the date. I had to relearn how to do everything:walk, talk, shake hands, eat…" His mother and brother listen attentively as he speaks, leaning against the door frame. Their tired faces reflect the strain of caring for Alexander 24 hours a day, but they look on him with infinite tenderness.

"I'm left-handed now! Before the operation, I was right-handed," he adds, amused, but the scrapes on his hands and knees reveal the challenges of his situation. "I fell the other night, when I tried to go to the bathroom alone." Alexander suffers spontaneous blackouts due to a new tumor that appeared after the first one was treated. It is between his eyes, and they cannot treat it in Kharkiv right now.

Sourcing medicines 1500 kilometers away

"I thought I was in bad shape even before the war. I've been fighting cancer for four years by then, but the worst was yet to come: there is no medicine now, many doctors have fled, and we had to leave the city… We've lost our home, our jobs, everything." he says, recounting the four months since the invasion began. 

On April 23rd, after two months without treatment, Alexander's condition worsened dramatically. An ambulance was called, but the wait seemed endless. He was finally able to see a doctor at the Grigoriev Radiological Institute inKharkiv. "But the medications Alexander was prescribed only stopped his condition from worsening," his mother Natalia says. "There was no possibility of advanced treatment in the middle of the war."

 Alexander's radiologist meets with Público at the Radiological Institute, one of the oncology centers in eastern Ukraine. "We don't know if the second tumor isa metastasis or a side effect of radiotherapy," explains Dr. Sergii Artiukh. "We first need to run a series of diagnostics to see how we can treat it, but they can't be done here right now, and the only chance he has is to evacuate to another country."

This is why Dr. Artiukh contacted Mission Kharkiv, an NGO specializing in medical supply and evacuation founded by Rostislav Filippenko. Filippenko, a Ukrainian native who grew up in Spain, was preparing his doctoral thesis in Kharkiv when the invasion began. Despite having a Spanish passport and able to evacuate, he decided to stay and organize the supply of medical aid to the Kharkiv region.

Kharkiv isone of the cities furthest from the Polish border, where almost all humanitarian aid enters Ukraine. The near 1,500 kilometers that separate themmake supply chains—especially medical supply chains—complicated. "More than 3,000 people now depend on Mission Kharkiv," explains Filippenko."We supply medications to eight hospitals, and we are focusing all of our efforts on helping cancer patients and other chronically-ill people who are dying indirectly from this war."

Chemotherapy costs five times the average salary

Unlike in the Spanish healthcare system, in Ukraine the drugs used to treat cancer are paid for by the patient. Hospitals prescribe the treatments, administer them, and do follow-ups, but the patient must purchase medication in pharmacies and bring it to the treatment center themselves.

"A single chemo injection costs between 4,000 and 10,000 hryvnias (€120-300, or$95-240), depending on the active ingredient, and you need 3 to 6 injections per treatment," explains Dr. Artiukh. This means that a normal course of chemotherapy can cost up to €1,800 ($2,000) in a country where the minimum wage is €370 ($410) a month." 

The war has made this problem worse. The supply of medications has slowed, and the money to buy them is running out. In Kharkiv, Ukraine's second-largest city, 35% of citizens have lost their jobs. Many others, while retaining their jobs, are now left at home with no benefits, waiting for everything to end. Not only are people desperate from not being able to afford treatment, but they are also unable to find it even if they do have funds because the pharmacies are out of stock.

Medical evacuation as the only chance

Dr. Artiukh explains to Público that 10% of his cancer patients—who, before the war, would have made a full recovery—have already died due to disruptions in their treatment. He warns that there is worse to come: “People haven’t been able to get diagnosed these past months. When they do finally get seen, it’ll be with stage four tumors, and then it’ll be too late.”

The war has reduced the life expectancy of Ukrainians by 10 to 15 years, and cancer and other chronic patients are the worst affected. “The conditions of a considerable number of patients have worsened, and because we cannot treat them now, they’ll only receive drugs—when those are available—to alleviate their symptoms,”continues the radiologist from the Grigoriev Institute.

“In Kharkiv alone, 20 to 30 cancer patients need to be urgently evacuated to other countries to have a chance at recovery—Alexander is one of them—but the evacuation process is very long and complicated,” stresses Dr. Artiukh. Since the war began, he has practically lived in his hospital. He has even worked as an ambulance assistance in the worst moments, when there was no other staff.

The gravity of Alexander’s case, and the urgency with which he needs treatment, has prompted Mission Kharkiv to intervene and organize him a medical evacuation to a hospital in Bologna, Italy. After surviving four months of war and hardship, he is finally reaching long-awaited care as this article is being written.

But there are more patients in Kharkiv. Many of them have cancers like leukemia, which are virtually untreatable in Ukraine right now. Others who can be treated at home desperately need medicines valued by Mission Kharkiv at almost five million euro. This is the odyssey of surviving cancer and bombardment all at once.

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