The bunker of hope: Revolutionizing cancer care amid the Ukraine war

Grim, filthy and dilapidated, many buildings constructed in Ukraine during the Soviet era hold basement shelters that were originally built to protect people from possible attacks. But one of these shelters, below a supermarket in Kharkiv, now contains a spotless white space, and is the only bunker of its kind in the country. Inside, some €6 million ($6.56 million) of medicines are stored under strictly maintained conditions. Almost all of them are destined for cancer patients who will continue receiving attention in the middle of the war. Behind the initiative is Rostislav Filippenko, a 32-year-old Ukrainian mathematician residing in Spain. The war caught up with him in his home city, where he was preparing his final project for his masters at the Autonomous University of Madrid by the warmth of his grandparents’ fireplace.

Moved by the tsunami of solidarity toward Ukraine from the beginning of the Russian invasion, Filippenko went to a hospital to ask what was needed. Within just four days, encouraged by his friends and contacts in Spain, he founded the NGO Mission Kharkiv to facilitate the distribution of medicine. Behind the deaths, the wounded, those who have lost their homes, who are hungry and thirsty and displaced, there are a series of forgotten victims: those who, as a result of the armed conflict, have seen the medical treatment that their lives depend on interrupted. “Some don’t even have their documentation because a missile destroyed their homes,” Filippenko says.

In the city of Kharkiv, the second-largest in the country, 30 cancer patients a day, from Monday to Friday, can be treated. Each one arrives at their appointment with an insulated bag so that the medicine’s cold storage chain is not disrupted. The distribution takes place in the National Institute of Medical Radiography. From there, the patients go to other hospitals to receive treatment. “All of our country’s resources are redirected to the army because we want to survive,” acknowledges Arman Kacharian, head of cancer control in Ukraine’s Health Ministry, in declarations during a visit to the United States published on Friday by HealthDay.

Since February of last year, Mission Kharkiv has delivered more than 180 tons of medication, mostly from Spain, and directly attended to over 60,000 people. Their database includes more than 1,200 cancer patients. “This box here is equivalent to a person’s salary,” Filippenko says, holding up a container of Rituximab, a cancer medication that is stored in one of the refrigerated chambers at between 2º and 8º degrees Celsius (35ºF-46ºF).

Some of the program’s beneficiaries live in areas far from Kharkiv and in some cases close to the front lines. In total, Filippenko calculates, there are some 70 patients spread around those rural areas. “That is the hardest thing for us, because we are an NGO that directly attends to the patient. The most complicated part is to get someone in the town with medical knowledge.” The established protocol, he explains, obliges them to prepare individualized packages with the name of the patient, who must receive the medication in their own hands. Coordinating that process in a war zone is not simple. “In the case of oncology, we need eight documents, seven from the patient and one from the doctor,” he explains.

His mathematician’s soul — he had no previous experience with medicine or pharmaceuticals — led Filippenko to gather the data of cancer patients in the region of Kharkiv, which was occupied by the Russian army early in the invasion and is still one of the main battlefronts of the war. He says that he has better information than the government itself, but that the organization’s objective is to collaborate with the authorities, never to substitute them, “to save as many lives as possible.”

One of the objectives, he says, is to improve that collaboration and put down roots beyond Kharkiv, developing long-term plans. Filippenko does not hide that he doesn’t currently plan to finish his masters’ program or work as a mathematician. The NGO now has a team of a dozen people, some working from abroad.

“We collaborated with other NGOs like Doctors Without Borders, Doctors of the World and others from the United States. We’ll see if we can replicate this in other countries when this war ends,” he says. “Although first we need to replicate it in other Ukrainian cities, and for that, we need funding.” Before the arrival of patients from other cities in the country, the employees of Mission Kharkiv had driven an ambulance full of cancer medication to Lviv, some 1,100 kilometers (680 miles) from Kharkiv. “The ideal would be to have another bunker there. With $30,000 we can do it in any city,” he adds, citing the growing necessities in the capital, Kyiv, and in other cities like Lviv, Odesa and Zaporizhzhia.

He stresses that what they need most are cancer medicines, because “there were problems in that area before the war and there will continue to be problems afterwards.” But he is constantly thinking of new needs to be met. The organization has developed a program to distribute first aid kits for hemorrhages to employees in critical infrastructure sectors such as power plants, which are frequently bombed by the Russians. “Surprisingly, they are also needed for emergency services. We are already covering the three most important power plants in Kharkiv, and we have demand from Kyiv and Zaporizhzhia. They have their first-aid kits, but they are not suitable for wartime,” says Filippenko as he closes the door of the refrigerated bunker.

In stark contrast to the facilities he has just left behind, his shadow moves through the corridors of the unrenovated old basement, and the narrow passages amplify his voice. Most of these shelters today have huge rusty iron gates and locks with a big wheel that barely turns. They do not provide adequate insulation in case of nuclear emergency. Nevertheless, many of them have served — and continue to serve — as shelters for the population in the current Russian bombing campaign.

The founder of Mission Kharkiv prefers not to refer to the high levels of corruption in Ukraine and that are often noted as one of the obstacles to its integration into the European institutions. But, at the same time, he stresses that transparency and a good reputation are two essential pillars that have contributed to the NGO’s growth. “Transparency is one of the most important aspects in the humanitarian world,” he stresses. He has set up a system in which donors can access information at all times, except for each patient’s personal data, for which special permissions are required. “We are a very tiny organization, but they trust us because we are raising the standards of other Ukrainian NGOs,” he adds.

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