Dr. Olha Konstantynovska is a tuberculosis (TB) physician in Kharkiv and Associate Professor in the Department of Infectious Diseases and Clinical Immunology at V.N Karazin Kharkiv National University, one of the largest universities in Ukraine. For the German Center of Infection Research (DZIF) course "Clinical Tuberculosis" she took the difficult way from Ukraine to Borstel to report about the challenging situation on site and whether tuberculosis care is possible at all in times of war.

We are very pleased that you are our guest in Borstel and that you have come all this way from the East of Ukraine. How did you travel to Germany? How is traveling currently possible in Ukraine at all?

Dr. Olha Konstantynovska: Thanks a lot for such a kind invitation and support! I`m very glad to come, even if it is too complicated - it takes 2 days and nights to get to the nearest airport in Poland, because we have no airports anymore (destroyed), and the sky is closed, it is too dangerous. I spent the night in the train near Kyiv (we were waiting until the missile and drones attack finished. It was like in an apocalypses movie - explosures surrounded us, and we, passengers in the train, were sitting in the dark and were waiting if we would survive). From Lviv I took a bus to Warsaw (10 hours) and next I had to spend a night in Warsaw (because I came at 00:30). Early in the morning I had booked a flight to Hamburg - so that was my way to the Research Center Borstel.

What is the current situation in Kharkiv, especially in your hospital? Is it getting harder to treat patients every day or was it worse in the early stages of the Russian invasion?

Dr. Olha Konstantynovska: For now the hospital is overcrowded with patients and healthcare workers. We even have fun doing our daily work, because we are all in the same situation. I believe all my colleagues are really superheroes, they made a decision to stay and to help each other and our patients. Who will do that if everybody leaves? Who if not us?

In the beginning it was much more difficult - no one knew what would happen next morning? Kharkiv was bombed with aviation, with all weapons ever known. I think many sad movies and heroic films will come about the strongest citizens of our city. We had no food for our patients, and about 20 of our healthcare workers lived in the hospital together with their families, because they lost their houses and apartments.

What is the biggest challenge in patient care at the moment? What is missing the most? Is it even possible to provide TB care in times of war?

Dr. Olha Konstantynovska: The biggest challenges for now are: transportation (patients can`t come to us sometimes, and we have no additional money for fuel to drive to our patients to bring medicines and to collect sputum etc), missiles and drones attacks almost every day, it is always very dangerous to go work. No one is protected, electricity and water and heating problems (but we have electricity generators, it is very much helpful).

We provide TB care in our best, and we are trying not to miss any symptom or investigation. Sometimes we need advice, and we decided together with our friends from Borstel that we will organise online consultations to help us to treat our patients.

There were already a large number of TB cases in Ukraine before the war. What do they think or fear: How will the situation develop in the coming months/years?

Dr. Olha Konstantynovska: Our TB patients want to be healthy anyway. They are very thankful to healthcare workers who stayed in Ukraine and who didn't leave them in the face of not only disease, but war. In the beginning we were afraid we had no food, water and medicines, but that danger is already gone, thanks to our friends from all over the world who sent us humanitarian aid.

And we are very much thankful to Research Center Borstel, Rotary Club in this area and their members, and especially to Professor Lange for their kind support of us in such difficult times!

Did they ever think about leaving the country or did you know from the beginning of the invasion that you would stay as long as possible? What gives you the strength to continue your work?

Dr. Olha Konstantynovska: The majority of our patients never thought about leaving the country. They didn`t know languages, some of them are in very severe condition to travel even to other city. Our patients are vulnerable group, economically nonstable. I think only a small number of patients left the country, people who could travel. And they face very big problems with achieving the medical help in the EU.

I decided to stay as long as possible, because I had my mother and 87-years old grandfather in the occupied territory. They spent more than 7 months there. And I tried to find a way to get them back to Ukraine. Finally, my mother was able to get to us. She travelled from Russia to Belarus, Lithuania and Poland and from there to Ukraine. It took 7 days and nights until she arrived in Kharkiv. Her house is 25 km away. We, together with our friends, were able to book the hotels for her through all her way. My grandfather's house was totally burned, and now he is a homeless person in his 87's. He also travelled all the way and now lives with us.

We live together in the house of my parents (12 people total, including 5 children - 3 my daughters and 2 daughters of my sister).

I believe I need to be here to rebuild my country, to do my job in my best and try to help someone in need.

Thank you very much for the interview and for your time. I wish you and your colleagues all the best!

Dr. Olha Konstantynovska: Thanks a lot! We will never forget your support! And I believe finally we will win! Welcome to us, our city is an example of civilian power!