One hour from the front line, Ukrainian professors of medicine are using their training to treat the wounded fleeing the war with Russia.
With the fighting closing in around them, these academics from a southern Ukrainian city have become combat medics, helping people from neighbouring cities evacuated after Russian attacks.
Zaporizhzhia is the last big city in the region under Ukrainian control.
It has, so far, been a safe haven for people escaping the Russian assault on Mariupol and Kharkiv, towns in the Donbas region, and is home to Europe’s largest nuclear plant.
That sense of security has come under threat over the past few days.
22 hour work days
Attacks on the city have intensified with three air strikes on Tuesday, according to Ukraine’s regional military administration broadcasts.
Residents in the south-east of the city can often hear shelling on the front line.
Air-raid alarms are commonplace, with sirens going off three times a day, doubling at the weekend.
Natalia Pidkovych, assistant rector at Zaporizhzhia State Medical University, said: “When cruise missiles arrive, the whole city hears.”
The battlefront is less than an hour’s drive away but teaching and administrative staff at the university plan to stand their ground.
Orthopaedic surgeon Maksym Kozhemiaka operates in the city’s military hospital and teaches about 100 Ukrainian interns who remain as volunteers.
“In the first few weeks we lived like robots, like zombies. There were a lot of injured soldiers, a catastrophic lack of resources, we slept two-three hours a day,” Dr Kozhemiaka, an associate professor in traumatology at ZSMU, told The National.
Treating wartime injuries
The wounds the professors tend to have been horrific, caused by exploding artillery shells, air bombing and landmine blasts.
“We see all wartime injuries, we see it every day. It’s been really, really terrible,” Dr Kozhemiaka said.
“But the worst situation is for doctors in the civilian hospital with [wounded] women, children, the old.
“We must help our soldiers, our civilians and our students.”
But education is always on the doctors' minds.
The operations performed are used in video broadcasts to teach students. The demanding procedures in the military hospital are also shared with peers in online presentations at European medical conferences.
“Despite our daily intensive work in the hospital with the soldiers, we don’t forget our teaching activities,” Dr Kozhemiaka said.
“We prepare lecture materials, practical exercises and every day we give this material online for our students, Ukrainian and foreign.
“We show operations in video broadcasts. This experience is unique, it is priceless and gained with sweat and blood.”
‘We are with you’
Professors at one of the oldest public medical institutions have been conducting online classes since February when Russia invaded of the country, causing students to flee.
After the Russian invasion began on February 24, the university sent out posts on social media that online classes would soon resume.
“We are with you. The university works,” one message said.
In a video with faculty gathered around a large conference table, a professor assured students their education would not be interrupted.
The institution caters for more than 14,000 students, including 3,500 from overseas.
Most Ukrainian students have fled to safer regions and foreign students are back home.
“Dear foreign students,” Ms Pidkovych said in the broadcast. “We are really happy you are safe at home. Thank you for your messages and for your letters.
“University authorities [will do] everything to finish your education in time. You will get your diplomas in time in June.”
Affordable fees, low living costs, high-quality teaching and a degree that is valid in Europe are why medical colleges in Ukraine are popular with students from countries such as India, the UAE, Morocco, Ecuador, Zambia and Nigeria.
Indians are among the largest group of foreign students in Ukraine with more than 18,000 registered in colleges.
“We read about missile attacks narrowly missing places we know well,” said Adil Javad, who took one of the last flights out of the capital Kiev back to his home in Dubai before the war began.
“We worry about the professors and are concerned about their safety.”
The 20-year-old student now signs in daily for the online classes.
Several students who left Zaporizhzhia later were caught in the crossfire in Kiev as they waited to board flights home.
Sanabil SP witnessed explosions in Kiev as he and a group of students walked, terrified, to the railway station for a train to take them to safety along the Romanian border.
“It was frightening, there was a lot of firing. I told myself whatever happens just make it to the railway station,” said the 23-year-old from Kannur, Kerala.
“Despite everything our teachers are going through, they are still teaching. That is the reason we have not transferred out and are hanging on to the online classes.”
The professors divide their time between caring for the wounded and ensuring students complete the academic year that ends this month.
In more than 70 classes a day, students watch live lectures or listen in to recorded lessons on subjects including cardiology, paediatrics, infectious diseases, gynaecology and dentistry.
Class sizes vary from 15 to more than 300, depending on the subject.
Medical students are keen to show solidarity with their professors but with the war intensifying, most will need to decide about transfers in coming months.
University authorities acknowledge online learning does not replace practical clinical experience but say they are doing their best to impart knowledge despite the continuing hostilities.
Svitlana Morhuntsova, vice-rector and associate professor, said the university is already preparing for the next academic year and is in contact with other Ukrainian medical institutions that are also conducting online courses.
“Zaporizhzhia is staying strong and our university is staying strong,” she said.
“Daily, our teaching staff and administrative staff come in to work.
“Of course we hope students will be able to come back and continue their classes offline. We want to make sure everything is ready when they come back when everything will be calm.”
Peace appears a long way off with no end in sight to hostilities.
The college offers consultations with psychiatric professors to help people living in Ukraine cope with the war.
Video explainers show people who experience panic attacks how to handle reactions that might feel like heart attacks.
“The stress of the war has led to a rise of chronic diseases in our civilian citizens. They really need our care,” said Prof Mykhailo Kolesnyk, a cardiologist who teaches postgraduate interns.
He also works at the university clinic where wounded civilians and Ukrainian residents come in for MRI examinations, X-rays, laboratory tests and consultations.
Humanitarian aid from the international community has helped to treat thousands of wounded.
“It was quite challenging in the first days of the war because nobody could even imagine that this could happen,” the Prof Kolesnyk said.
“But now we continue our work every day in the hospital. Work, work and work — it really helps to overcome stress.
“We want to thank the international community, professional organisations for their support.
“It’s very important for us to know that we are not alone.”