Family doctor Dmitriy Rozumiy struggles to bridge the gap between what his patients in rural Ukraine need and what the country's cash-strapped healthcare system can provide.
His clinic in the village of Ivankovichy, 35 kilometres outside Kiev, uses Soviet-era medical equipment and lacks basic supplies. Life expectancy in Ukraine is on average five years shorter than the European average, according to the World Health Organization.
. Ivankovichy, Ukraine. Reuters/Gleb Garanich
Rozumiy, 51, has worked as a general practitioner since 2014. Before that, he worked as a cancer surgeon but he gave up because budget cuts were causing late diagnoses and leading to lower survival rates.
His current patients are mostly children and pensioners. Many working age adults choose not to be treated because they often cannot afford the medicines that are available.
. Zeleniy Bir, Ukraine. Reuters/Gleb Garanich
Recently, Rozumiy said he has seen some improvements since the start of a Western-backed reform drive.
"There's a desperate need," he said, expressing a hope for faster change. Patchy implementation of the reform drive has raised questions about Ukraine's ability to modernise after a pro-European uprising in 2013-2014.
Last October, parliament approved a long-delayed overhaul of the health system following international pressure to speed up reform.
"I hope ... this will give us a chance but if this turns out to be yet another bluff, well then we'll lose everything," Rozumiy said.
. Markhalivka, Ukraine. Reuters/Gleb Garanich
Rozumiy fills his car with gas while his children wait inside the car.
He said recent positive changes include the launch of programmes to improve treatment for military veterans and help pensioners gain access to certain medicines.
But times remain tough, forcing Rozumiy to consider halting some home visits as he cannot afford the petrol costs for his car on a salary of around 6000 hryvnias ($230) per month.
. Ivankovichy, Ukraine. Reuters/Gleb Garanich
People wait to see doctor Rozumiy in a small clinic.
His clinic's decrepit central heating system occasionally fails in the middle of winter, prompting parents to keep their children bundled up in snow-suits during consultations.
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Slideshow
. Ivankovichy, Ukraine. Reuters/Gleb Garanich
Doctor Rozumiy examines a patient.
. Gvozdyv, Ukraine. Reuters/Gleb Garanich
Images of religious icons are displayed alongside old equipment.
. Markhalivka, Ukraine. Reuters/Gleb Garanich
Doctor Rozumiy shops in a supermarket with his children.
. Markhalivka, Ukraine. Reuters/Gleb Garanich
Doctor Rozumiy helps his children with their homework.
. Ivankovichy, Ukraine. Reuters/Gleb Garanich
Medical records of patients are stored on shelves.
. Zeleniy Bir, Ukraine. Reuters/Gleb Garanich
Doctor Rozumiy interacts with a woman while examining a baby.
. Ivankovichy, Ukraine. Reuters/Gleb Garanich
Doctor Rozumiy examines a patient at her home.
. Zeleniy Bir, Ukraine. Reuters/Gleb Garanich
A patient waits during a visit from doctor Rozumiy.
. Ivankovichy, Ukraine. Reuters/Gleb Garanich
A woman stands outside an auto shop.
. Ivankovichy, Ukraine. Reuters/Gleb Garanich
Doctor Rozumiy drives to see a patient near the village.
. Ivankovichy, Ukraine. Reuters/Gleb Garanich
A man stands in icy water as part of a religious ceremony during Orthodox Epiphany celebrations.
Story
Ivankovichy is far from unique. Hospitals across the country of 42 million are crumbling, underpayment of medical staff has prompted many to quit and Ukraine's vaccination rate is one of the worst in Europe.