Voicenote from Mariia Khvalbota, MSF anaesthesiologist

This shard of glass you see in this photo was removed from a woman’s neck. After a shell exploded near her home in eastern Ukraine, the windows shattered and a large piece of glass was lodged just millimetres from her carotid artery. Had she touched the wound herself, she might not have survived.

In Dnipropetrovsk we treat growing numbers of people with war-related injuries. More than 200 patients were admitted for surgery and treatments of chronic disease in the last two weeks. Many are wounded when shells, bombs or drones hit their homes, workplace or public transport.

One couple was admitted with multiple shrapnel injuries; their home had been bombed as they slept. During treatment, the woman quietly told us she might be pregnant. An ultrasound confirmed she was four months along. With her severe wounds and an allergy to all antibiotics, stabilising her was extremely complex. However, we managed, and both she and her husband were later evacuated to Dnipro.

These cases highlight a wider crisis: access to medical care is shrinking in frontline regions. In Kostiantynivka, Donetsk region, a hospital MSF supported for two years was forced to close because of staff shortages and insecurity. For many people still living close to the fighting, there are fewer and fewer places left to seek urgent care.

As the frontline shifts, access to life-saving medical treatment becomes ever more limited.