UKRAINE – When war broke out in February 2022, German paramedic Marc Friedrich was in disbelief.

“We had imagined that there would be no more war in Europe, and then suddenly Russia attacked,” he recalled.

That disbelief soon gave way to determination.

On March 9, an airstrike struck Mariupol’s Maternity Hospital No. 3, killing four people and injuring at least 16 others.

“That was a trigger moment for me,” said Friedrich, who left his role as emergency services paramedic chief near Düsseldorf to establish a dedicated ambulance service for children in Ukraine.

“I wanted to configure an ambulance specially to the needs of children, where the equipment doesn’t have to be specially prepared for them but is rather the standard,” said Friedrich, founder of Ambulance for Kids. Such emergency service vehicles are very rare in both Germany and Ukraine, Friedrich notes.

Acquiring an ambulance and equipping it for pediatric care cost at least $350,000. With support from a range of partners, the NGO began operating on the ground in July 2023. Direct Relief joined in 2025 with a grant to help sustain operations.

The final touch was the interior decor. “We conducted an action in Western Ukraine with a local artist to get the inside painted by children for children, so that it looks beautiful for patients, not just white,” said Friedrich.

90,000 Miles Later: A Lifeline for Children Under Fire

Today, Ambulance for Kids operates with a core team of German and Ukrainian staff, supported by short-term deployments from emergency workers in Denmark. Based near Kyiv, the team evacuates seriously ill and injured children from across Ukraine to safer cities or, when necessary, to medical facilities in the European Union. The work is demanding and travel-intensive: since relocating to Ukraine in 2024, the team has logged more than 144,000 kilometers (89,500 miles) in their converted ambulance and support vehicle.

With the support of a pediatric anesthesiologist, the NGO transported approximately 30 patients in the first half of 2025—children with serious medical conditions and their close family members, many from heavily shelled front-line areas. All services are provided free of charge.

In addition to transportation, each medical evacuation requires securing a receiving clinic willing to accept the patient. The organization also verifies travel documentation for accompanying family members.

So far this year, eight patients have been transferred to facilities in Poland, Germany, and the Netherlands for advanced treatment. Cases have included a one-year-old with a rare congenital malformation of the lower jaw and a 10-year-old girl with stage 3 cancer. When further evacuation within the E.U. by air ambulance is required, border crossings must be carefully coordinated in advance.

The team remains highly responsive and able to deploy on short notice—as demonstrated when a Ukrainian NGO requested urgent assistance for a family in Odesa.

Defying Harsh Prognoses

In March, during a mission accompanied by Direct Relief staff, Ambulance for Kids transferred 17-year-old Ilya Sekov from the southern port city of Odesa to Lviv for follow-up procedures after brain tumor surgery in 2024.

Ilya currently lives with a breathing tube because he lost his ability to swallow, a function expected to return over time. He cannot yet walk independently and must be driven in a specially equipped vehicle.

That’s where Ambulance for Kids stepped in, first transporting Ilya and his mother, Olena, 800 kilometers (500 miles) to Lviv, and then to a nearby rehabilitation center where he was expected to spend several months recovering.

In addition to the 14-hour transfer, the team has continued, when possible, to transport Ilya between medical appointments, despite the long distance from their base in Kyiv.

“Marc is the first [medical professional] who believed in me and my son, that despite the complexity of his condition, he will be able to return to a full life,” Olena said by phone. “And he didn’t just believe himself but also instilled this unshakeable faith in us, too.”

Coordinating expert care amid ongoing conflict has tested the family’s resolve. With many medical resources unavailable or prohibitively expensive, and frequent air attacks disrupting plans, Olena said the most difficult part was knowing her son still had to prove multiple doctors wrong.

“The initial prognoses we received were bad, that he wouldn’t even be able to sit up, and that his cognitive functions would suffer,” said Olena. “But despite everything, we have already crossed this line and more – with his intellect fully preserved, we are trying to walk, eat, and we will continue to go further.”

Stepping Up Where Needed

On June 17, a missile strike destroyed an entire section of a nine-story apartment building in Kyiv, killing at least 23 civilians in the middle of the night. Responding to the aftermath, Friedrich’s NGO arrived with a Ukrainian pediatric anesthetist and traumatologist and offered support to state emergency responders.

“We only went there in the morning on the off chance. I hadn’t expected us to do anything at all, but our help was gratefully accepted,” Friedrich said, after the team transported an elderly resident of the damaged building to the hospital for examination. “In the event of such attacks, we will also go out in the future.”