To Treat Ukraine’s Injured and Sick, This Medical System Put Profit Aside

Before war broke out in Ukraine, Dobrobut was a force to be reckoned with.

The for-profit medical system, based in Kyiv, boasted two hospitals, 17 outpatient clinics, 30% growth, 2,800 employees, a fleet of 22 ambulances, and “very big plans in terms of becoming a national provider,” said COO Vadim Shekman. “We’re socially conscious, but we were in a business to make a profit.”

Shekman, who is Ukrainian but had spent 30 years in Chicago, came back to his home country specifically to work at Dobrobut. “Life was full of potential,” he said.

Most patients paid out of pocket, with approximately 10% to 15% using some sort of private insurance.

But when the Russian invasion loomed, Shekman and his colleagues decided the time had come for a pivot. People were going to be injured and sick, and they wanted to help – never mind turning a profit.

“It just felt right,” Shekman said. “You can’t make money during a war on the misery of others.”

When Russia invaded, many of Dobrobut’s clinics in Kyiv and the surrounding areas became unsafe. Some staff members fled – although Shekman tells the story of two of his doctors, on a trip to Turkey when the war broke out, who immediately flew to Moldova and took multiple buses to get back to Kyiv so they could start treating patients. Twelve of their ambulances went to the military for their operations.

Dobrobut’s leaders decided to focus their efforts on a single hospital, where they would see members of the military for free, and ask civilians to pay for their care only if they could – no one would be turned away.

Injured and sick people reached out to them on social media or asked for help through the country’s volunteer networks, and Dobrobut sent its remaining 10 ambulances out, both in Kyiv and around the country, to rescue them, bringing them either back to their facility or to hospitals in Italy, Germany, the Netherlands, and Poland, which were all receiving patients.

War made it too dangerous for Dobrobut’s doctors to go home between shifts, so the company converted a wing of the hospital into sleeping quarters. “It ended up being a big family,” Shekman recalled. At one point, an ambulance brought in a hairdresser, who stayed for a day to groom Dobrobut’s staff members.

Medical needs have changed over time. “When Russians were at the Kyiv walls, we had a lot of injuries from bombings and things like that,” Shekman said. His staff members have terrible things: children with missing limbs and a brain injury. Patients with extensive damage to their lower bodies after the Kramatorsk station attack.

“The story I keep hearing, it’s the story of a person who can’t leave…because they have a bedridden father or mother or other relative, and then they end up being killed,” said Shekman.

Now that the Russians have been pushed away from Kyiv, Dobrobut’s medical staff are seeing people who need heart surgeries and oncology treatments, people with neurological issues or unmanaged chronic diseases, and the occasional Covid-19 case.

But money was quickly becoming a problem. “Our doctors, as heroic as they are, they still have families. We still need to feed them,” Shekman explained. “When people have that much dedication to their hospital and their patients, you want to do what you can for them.”

Dobrobut’s leaders decided to pivot again, hoping that they’d be able to find funding to pay and feed their staff members – and, with any luck, provide free care to every patient who had been injured or was sick.

Then they heard about Direct Relief. The NGO provided Dobrobut with $750,000 to pay salaries and buy food for staff members. “We are able to provide surgical and hospitalization care to our patients in Ukraine for free, thanks to the generosity of Direct Relief,” Shekman said.

The funding is particularly valuable, he explained, because it bolsters Ukraine’s existing medical infrastructure. Where a nonprofit “could have brought a field hospital with volunteer doctors, it could have squeezed out regular doctors…after the war ends, it will be easier for the system to come back to life.”

Dobrobut began its new program on April 1. When they explained to patients that there would be no fee for their care, many thought it was an April Fools’ Day joke.

But not everyone was surprised. An anonymous writer left a note for doctors at the hospital, saying that they’d expected nothing less of Dobrobut.

The medical system is still encountering challenges. Shutdowns and logistical problems have made it difficult to get medications and supplies. Direct Relief has also provided Dobrobut with more than 1,900 pounds of medical aid, including insulin and emergency medicines intended for use during a major disaster.

For Shekman, seeing people step up to provide for, treat, and transport those affected by the war makes the situation a little more tolerable. He admired the bravery of Dobrobut’s staff members, as well as the volunteer networks working throughout the country to help people who are injured and sick.

“Obviously the war is a horrible thing,” he said. “But if there’s a silver lining in the war, it’s how much care people have for other human beings.”