From the initial alert to the moment when a patient with complex injuries receives essential care abroad, dozens of professionals and processes work in sync to secure what matters most: a chance for the patient to receive timely treatment and recover.
MEDEVAC is a complex, multi-layered medical evacuation system, designed in response to the full-scale war in Ukraine.
Medical evacuation is not only about transportation. It is about sustaining life through a system that works seamlessly across multiple levels. Every step in the process, and every individual, plays a critical role. Coordination and trust are essential.
A critical mechanism
The first step of the MEDEVAC process is to submit requests via the Emergency Response Coordination Centre. A team of 32 professionals within Ukraine’s Ministry of Health work on compiling lists of those who require treatment or rehabilitation not available in Ukraine due to the war. Partner countries from the European Union and European Economic Area then determine their capacity to receive patients and the types of care they can provide.
When a patient is stable enough to be moved from the hospital in Ukraine where they are receiving treatment, Regional Emergency Medical Services (under the oversight of the Ministry of Health) work together to support their evacuation to the MEDEVAC hub in Lviv, from where they are transported out of Ukraine on a medical bus to hospitals in which they can access care abroad under temporary protection mechanisms.
As of early 2026, Ukrainian patients have been evacuated through MEDEVAC to receive free care in health facilities across 33 countries.
Throughout the process, WHO provides technical and expert assistance, and the European Union delivers financial and operational support.
Part of a seamless system
“Our hospital receives patients from frontline and nearby regions, with complex medical conditions requiring long-term rehabilitation and specialized care,” explains Oleksandr Tolubaiev, Medical Director of the I.I. Mechnikov Hospital.
“We play a key role in identifying these patients and compiling lists for medical evacuation. Strong coordination and close collaboration between health-care facilities and partners is important to ensure patients receive the care they need in a timely and effective manner.”
On the other side of the country, Yuliia Koshtovska, an emergency medicine physician, works on the medical evacuation team of the Lviv Regional Emergency Medical Service.
“I have been involved in medical evacuations since my very first month working here. On average, I take part in an evacuation once a month. The one that stays with me most is the very first one; it involved patients with severe burn injuries. Our patients give us strength and motivation. Seeing what they have been through and the condition they are in, yet how they continue to believe, remain strong and keep fighting, is incredibly powerful,” Yuliia says.
Coordination, resilience and responsibility
Yarema Kachmar is Deputy Director of Lviv’s Regional Emergency Medical Services, responsible for the large teams of emergency medical personnel and coordinators actively engaged in the final steps of MEDEVAC on the Ukrainian side of the border. He describes the challenges of working with patients with complex medical needs.
“Long transport times, often many hours, increase the risk of complications and require stabilizing patients over long distances, including managing intensive care. Patients are often unstable and require constant monitoring and medical interventions on route. Diagnostic and intensive care capabilities during transport are limited compared to hospital settings. At the same time, teams must support critically ill patients, providing ventilation, infusion therapy and pain management without access to in-patient care. International medical evacuation combines medicine, logistics and crisis management, requiring emergency medical teams to demonstrate not only clinical expertise, but also a high level of coordination, resilience and responsibility,” Yarema explains.
Teamwork remains a key source of strength built on mutual trust, strong peer support and clear coordination between dispatchers, Regional Emergency Medical Services teams and health-care facilities. Communication with patients and their families is equally important, notes Yarema.
“Medical evacuation is an integral part of the continuum of care. Recognizing our role as a critical link between rescue and recovery keeps us moving forward. Even a message confirming successful treatment after evacuation can restore our inner resources and remind us why this work matters,” Yarema adds.