From left to right are Pulmonologist Dr. Iryna Zhovtonizhko, Hospital Manager Denys Matsko, TB Physician Dr. Tetyana Shapoval, Medical Director Zhanna Karpenko and TB Physician Dr. Antonina Krasnenko.
A few months after fighting in the Chernihiv region of Ukraine subsided, Zhanna Karpenko shudders during a summer thunderstorm.
"Is it thunder or shelling?" she asks.
Zhanna is the medical director of a hospital in Chernihiv that provides tuberculosis (TB) diagnosis and treatment. Prior to the war, the facility had a TB dispensary that supported people with TB in serious condition who stayed at the hospital, as well as people on TB treatment within the community. The health facility also had one of Ukraine’s most sophisticated medical laboratories.
Today, the entire facility is destroyed.
Chernihiv was under siege for more than a month and suffered severe shelling and destruction. Patients and staff at the hospital survived an unimaginable ordeal, including having to hide in bomb shelters and evacuate under fire - twice.
"We could never imagine we would witness such an intense war," Zhanna says.
When the fighting began in Chernihiv, 54 people with TB and 15 health workers remained in the hospital. Explosions were only two kilometers away and continued to get louder every day.
Volodymyr Barkov, a patient at the hospital with drug-resistant TB remembers looking out the hospital window and seeing the roofs of neighboring homes on fire.
“In the morning I heard explosions — at first, they were distant, but then they came closer and closer,” says Volodymyr. “I did not feel any fear as I had already experienced the first stage of the war in the Luhansk region. The shelling went on for several days, and then everyone packed up and we were evacuated, twice.”
Some of the patients and health workers took cover in the makeshift bomb shelter, which was an underground room previously used to store vegetables.
When TB patient Sashko Ryzhenko returned from the bomb shelter to his room he saw a shell fragment sticking out of his pillow.
Other patients with mobility challenges or fears that being in a damp overcrowded basement would worsen their health, stayed in the building. Health care workers stayed with the patients in the hospital as well.
During this time, Zhanna and her colleagues were organizing an emergency evacuation. Two buses and two ambulances arrived, and all of the patients were transported to the district hospital. The ambulances came under direct fire, but nobody was injured.
All of the medications stored at the TB dispensary were destroyed when the building came under attack, which resulted in every TB patient that depended on the dispensary being cut off from their treatment.
While in the district hospital, patients had no way to communicate because the internet and electricity were both down. They drank water from a nearby well, food was cooked over a fire and toilets were dug in the street.
A few days after the first evacuation a bomb landed on the police station next door. Two weeks later, the patients and health workers were forced to evacuate again.
This time they moved to the children's infectious disease ward of another hospital in Chernihiv, which is where they remain today.
“It was important for me to stay by my patients and fellow staff, to support them. Patients must not feel abandoned because war adds stress, which is a risk for TB patients,” says Dr. Tetyana Shapoval.
The Global Fund Partnership responded rapidly to the war in Ukraine.
This included working alongside the Ministry of Health of Ukraine and local and international partners to arrange an emergency transfer of two loads of TB medicines to Chernihiv. The shipments came from Lviv and Dnipro, and all of the TB patients in Chernihiv were back on treatment within a week of the first evacuation.
In addition to providing life-saving medications, the Global Fund and partners have supported the delivery of essential equipment and supplies including generators to power health facilities cut-off from electricity as well as food and care packages for people with TB and HIV.
The Global Fund is also supporting partners to locate appropriate accommodation for those who need it, including people with drug-resistant TB, and is supporting mental health care services, with a particular focus on women who have suffered sexual violence as a result of the war.
In early April, health care workers returned to the destroyed hospital and TB dispensary in Chernihiv.
"The trees had been knocked over and the asphalt was covered with broken glass and shell fragments. I pulled out the ultrasound machine, the most expensive piece of equipment that remained undamaged. Then we came back to take whatever supplies survived - ventilators, defibrillators - we even dragged beds to make our patients comfortable," says Hospital Manager Denys Matsko.
Since the invasion at the end of February, more than 320 health facilities have been damaged or destroyed in Ukraine.
The Global Fund approved US$15 million in emergency funding to Ukraine and over US$26 million to reprogram existing grants to respond and adapt to the country’s current needs.
© 2026 The Global Fund
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