KHARKIV, UKRAINE – It’s a long trek down – and up – 14 flights of stairs if Larisa Krokul has to go out during the frequent shelling-induced power cuts in Ukraine’s second-largest city, Kharkiv. It is even tougher because the 60-year-old is a peritoneal dialysis patient whose vital home equipment is as prone to outages as her house elevator.

Now, a Ukrainian project supported by Direct Relief has supplied portable power stations for Larisa and 79 other kidney patients in Kharkiv and other parts of the country. This means that even when the city is dark because of the intensified Russian attacks on the power grid, she and others can perform daily health procedures for the essential eight hours uninterrupted.

“This [device] doesn’t just improve life, it prolongs it,” Larisa told Direct Relief during a recent visit, the motif on her t-shirt neatly summing up the change: “Got Super Power.”

Peritoneal dialysis, or PD, is a treatment for kidney failure that uses the lining of the abdomen to filter the blood inside the body via a catheter, through which bags of dialyzing fluid are pumped. The solution is a type of cleansing liquid that contains water, salt and other additives.

Larisa has used a dialysis machine for the past three years. Like the monthly volumes of fluid (5-10 liters per day, depending on the person’s size), it was provided free of charge by the local health service. But without a steady power supply, patients can spend exhausting hours at night manually performing their treatment.

The donated type of unit, an Anker PowerHouse 757, is a 1500W battery that charges when the power supply is on and maintains a steady feed when activated. This means the patient can hook up to the dialysis machine and sleep during the procedure.

That is, if missiles, guided bombs and drones don’t rain down that night. That always wakes people, even when it’s in the distance, but “you get used to it,” said Maksim Chernyak, another Kharkivite who received a station.

Maksim, 31, is living with diabetes, and his condition deteriorated last year after an operation and left him dependent on peritoneal dialysis and at the mercy of power outages. “Because of the shelling, the situation is very unpredictable,” he said, sitting beside his equipment and an impressive collection of Star Wars figures that he amassed from childhood.

He received his power station in March, which happened to coincide with a series of strikes on the city’s electricity infrastructure. Since then, the power usually goes on and off five or six times a day, traffic lights die, causing chaos at road junctions, and lines of generators start up outside shops.

“It was fortunate timing – we were thinking that we had to buy a generator,” said Maksim, who used to work in his uncle’s fabric business until his health failed him. He now leads a very modest life on the state disability allowances paid to him and his father, Yuriy, a former fireman, who was involved in the hazardous cleanup after the Chernobyl nuclear reactor explosion in 1986.

This year, Direct Relief’s core partner in Kharkiv, the Charitable Fund Yevhen Pyvovarov, delivered 37 units in the city and region, which are among the country’s hardest hit in the more than two-year-long war. The initiative originated in Kyiv, from the president of the Ukrainian Association of Nephrologists, Dr. Dmytro Ivanov.

After some number crunching, he found that of the pre-war total of 10,708 people with severe kidney disease in Ukraine, 206 on automated peritoneal dialysis are still in the country and need such power units in the current conditions. Ivanov approached his contacts in nephrological circles for assistance. A batch of 40 stations was donated by the Netherlands and 12 by the Slovenian Society of Nephrologists, while a nephrologist colleague working with Direct Relief helped kickstart a project to supply 80 more. That leaves around 70 still to source, which the doctor will try to do through the same networking route.

“Given the current risk of blackouts, it’s crucial to ensure that all remaining patients using automated peritoneal dialysis have access to charging stations,” said Ivanov. He also wants to create a reserve of charging stations for some 400 patients who do not have dialysis machines and are still on manual PD.

“The ultimate objective is to transition all patients from manual to automated dialysis. Additionally, there’s the challenge of providing PD amid military operations, a responsibility typically shouldered by military medical personnel.”

The third patient visited is Tetyana Kozyna, 63, who, with her husband, Viktor, left their home about 15 kilometers (10 miles) from the border with Russia in June 2022. She recalled how they fled to Kharkiv with what belongings they could carry, not knowing how much of their old life would survive. “In September, we went home to find the whole house gone, walls, roof, everything,” said Tetyana.

She was already living with one kidney when the war broke out, but the organ failed amid the fear and stress caused by the fighting, and she was hospitalized when they reached the city. Then her husband was diagnosed with cancer, which he managed to successfully battle.

“First, I was sick, and he helped me get through it, then he was sick, and I helped him – that’s how we do things,” said Tetyana, with an evident strong love forged over decades of shared life.

They now rent a one-room apartment in Kharkiv while they wait for the war to end. Tetyana also received her power station in March and says that this boost to her dialysis machine affords her a degree of peace of mind that she hasn’t had for a long time.

“It’s thanks to this that I can live on,” she said, echoing Larisa’s words. “It cleans my system and makes everything easier, including going out and doing normal things.”

After everything they endured and still do, they are confident that despite the hardships, they will eventually rebuild their lives.

“We just need peace,” said Viktor. “We will take care of everything else.”