Children's hospital in Kyiv faces 'terrible' trauma of war

The horrors of the war in Ukraine can be seen in 13-year-old Volodymyr's empty expression as he lies in the Okhmatdyt children's hospital in Kyiv, playing with a green balloon dog.

His father and his cousin were killed when their car was hit by gunfire two days after Russia's invasion. Volodymyr was shot in his jaw, his back, his arm and his leg.

"He can't walk yet, but the doctors told him that he'd be able to step on his feet later," says his exhausted-looking mother, Natalia, 34, sitting on a bed next to her son in a darkened room.

Before the war, he loved the things that teenagers anywhere in the world might do -- playing on his phone and taking their dog for a walk, she says.

Now he sits listlessly in bed, a livid scar running all the way up from his jaw to the dyed blonde streak of hair that hangs limp over his face.

He whispers that today he is doing "good", but doctors say that after three weeks in hospital, Volodymyr still faces more surgery.

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They show AFP journalists a graphic picture on a mobile phone of the wound in his face when he was brought in.

The war was only two days old when the family's blue Lada car was caught up in a gun battle when Russian reconnaissance forces tried to push into Kyiv.

"We didn't realise who was shooting. As soon as everything ends, we will find out the details. They will be punished," his mother says, compulsively rubbing her arm.

She was also wounded. "My injuries will heal, but I can't revive my husband, and I can't revive my nephew too. He was six years old."

Ukraine's largest children's hospital is feeling the trauma of the war.

"It is really terrible, it is challenging, it is awful," says paediatrician Svitlana Onysko.

"We live in the hospital, we don't go home; we are available 24/7, at any time -- day, night, morning, evening, we hurry up to help the kids, and it's really terrible and difficult."

"It is difficult psychologically and morally because these are children. But, for us, adults, it is also difficult because it is war."

Russian President Vladimir Putin said his invasion was meant to "demilitarise and de-nazify" Ukraine, but the toll on the country's civilians has been heavy.

Kyiv has so far been spared the worst of the Russian bombardment, however the city administration says four children have been killed and 16 wounded in the capital.

Most are brought to Okhmatdyt for treatment. The staff say the memories haunt them.

There was the mother called Olga who shielded her one-month-old baby daughter after a shell hit their apartment building and caused damage to a nearby kindergarten in Kyiv. Doctors removed multiple pieces of shrapnel from Olga's body and treated her husband's injured leg.

There was the blonde four-year-old boy who suffered severe shrapnel wounds from a strike in Kyiv, rushed in on a stretcher. And the six-year-old girl whose legs were injured in a blast whose mother died in a missile strike in Hostomel, a town just outside the capital.

The hospital's neonatal unit itself was hit by shrapnel by one strike.

In the early days of the war mothers and babies were even forced to take shelter in the basement whenever air raid sirens rang out.

The hospital's hardworking staff are trying to put on a brave face as they deal with what orthopaedic surgeon Vlasii Pylypko calls "terrible injuries".

"Since the war started, we treat injured, wounded people. It's children and adults also, with injuries from missiles, from bullets, from rockets," he said.

Most of the hospital's staff had no real experience of war.

"Many of my colleagues who treat with surgery, we try to abstract, to isolate our feelings," said Pylypko.

"And maybe after the war some of us will need psycho-support, but now we only focus on people's treatment, children's treatment."

One of them will be Volodymyr, who still faces a long road to recovery.

"He has to have another surgery, another treatment, he has bullets lying near the vertebral column."