LOS ANGELES — Two days after Russian forces invaded Ukraine, the World Health Organization issued a global request: The war-torn country needed doctors, nurses and EMTs with experience in complex emergencies.
Within days, a 22-person group from Team Rubicon, an international disaster-response nonprofit based near Los Angeles International Airport, flew to Krakow, Poland.
The team of doctors, nurses and other skilled professionals drove rented cars about 160 miles to the border. They crossed on foot into Ukraine, where a fleet of vehicles was waiting. Splitting up into smaller groups, they fanned out across the western reaches of the country, visiting hospitals and field clinics.
Team Rubicon has since sent three waves of replacements to Ukraine. Each team has been carefully selected, a key step in the relief effort. Thousands of people around the world want to help in Ukraine, but they don't have the skills, experience or credentials to work with an international aid organization.
As it's done in communities in need from Mississippi to Mozambique since its founding 12 years ago, Team Rubicon expects to continue to fuel the response effort in Ukraine for as long as its teams are welcome and can be of assistance.
Which could be a long time.
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From a windowless underground bunker in western Ukraine in late March, Dr. Erica Nelson and Dan Freiberg, their faces illuminated only by the light of a laptop screen, gave a live update on their activities while air raid sirens blared above.
As Team Rubicon's deputy medical director and team lead, respectively, they were part of the organization's first medical response squad dispatched to Ukraine for three weeks beginning in early March.
"When you have five air raids, you're pretty limited on how much you can get done, but in the last 24 (hours) I think those guys saw 27 patients," Freiberg said, referring to a small sub-unit of the team. He had put his job as a fire department captain in Goodyear, Ariz., on hold for the better part of a month to help.
"We're all trying to use every connection or resource we have to really find places where we can be most effective," he said. "We're pretty well prepped and primed for tomorrow. Now we're spending the night in the shelter."
Moments before, Brian McAchran had given an update from his post near the Ukrainian border in northeastern Hungary, where his team was treating refugees and training local medical personnel in trauma care. Early in the conflict, Team Rubicon had sent small groups to neighboring Eastern European countries, but it no longer has teams in Hungary, Poland or Moldova.
"Today was a huge success," said McAchran, a coordination lead for Team Rubicon. "Our doctor Vitaliy (Belyshev) has been down in the clinic two days now. … And we identified some issues that we could cross train them in, things that our medical staff are experts in, such as stop the bleed. They set up for that training."
Every weekday, scenes like these stream in real time from bunkers, hotels and medical facilities in Eastern Europe onto an oversize video screen in a sleek conference room in the nonprofit's headquarters.
Nelson was on leave from her job as an ER doctor at Brigham and Women's Hospital in Boston. As she spoke from the bunker in western Ukraine, her voice rose over the din of others taking cover from shelling by Russian forces.
"I think even though … we haven't seen hundreds upon hundreds of patients," said Nelson, who has provided aid in places including the Palestinian territories, Sudan and Jamaica, "we are hearing that it is important that we've been here to support them."
Most of the patients she and her colleagues have assisted did not have the bullet and shrapnel wounds one might expect. The majority were women and children in need of medical attention for existing conditions such as asthma and diabetes after fleeing their homes elsewhere in the country.
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Team Rubicon's operations in Ukraine are guided by a set of principles aimed at "adding value instead of creating cost," said Art delaCruz, the organization's chief executive.
The goal is to find and deploy highly trained, experienced professionals to have as much impact as possible while not being a burden or draining local resources.
"Everyone can get off a sofa and say, 'I can do this.' But then the reality is, maybe they can't," said delaCruz, a retired naval officer. "If we're responding to a tornado where a bunch of trees are knocked over, don't send someone who can't use a chainsaw when you can send someone who can."
David Malet, a professor at American University who has published two books on foreign fighters and non-combatants who travel to war zones, agreed.
"A lot of organizations prefer to receive money and resources rather than foreigners who are either inexperienced and can become liabilities or, alternatively, try to shoulder local leadership aside," he said in an email.
Many who lack the necessary skills give up and find different ways to help the relief effort in Ukraine. Others travel to Eastern Europe on their own, hoping to find a way to lend a hand once they're on the ground.
"Some people really feel a personal responsibility," said Ken Keen, a retired U.S. Army lieutenant general and associate dean for leadership at Emory University's business school. They "want to do good and want to respond."
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On April 3, Lars Whelan boarded a nonstop LOT Polish Airlines flight from Los Angeles International Airport to Warsaw.
Along with his toothbrush and other standard travel items, the burly, 48-year-old packed a ballistic vest, camouflage clothing and Juno — his toy poodle, known in Whelan's Hollywood Hills apartment complex for her poof of pink-dyed fur.
For weeks after fighting broke out in Ukraine, Whelan had tried to link up with an aid organization that could put his experience with international logistics, humanitarian aid and crisis management to good use.
"The first thing that I saw was the call for people with specific experience. And what I thought was, 'I could be really useful,'" he said. "My preference would obviously not be to show up and somebody hands me an AK-47."
Whelan has managed logistics and security in countries including Gabon and Cameroon. In 2016, he traveled to Greece to help with the arrival of Syrian war refugees. The colorful map over his desk is crisscrossed with lines connecting the dozens of countries he's been to.
A member of the U.S. Merchant Marine since 1995, Whelan is also a certified medical care provider. And he has helped with Team Rubicon's COVID-19 response in California, pitching in with relief efforts at food pantries.
So he submitted his name when the group put out a call for qualified professionals. He has not yet been tapped by the organization, or any of the others he reached out to.
David Burke, Team Rubicon's chief programs officer, said that despite Whelan's background, he has yet to be a good fit for one of the organization's teams.
"Prior participation is always valued and appreciated. The rest of the vetting and application process is to make sure we don't put anyone in situations where they would be uncomfortable and unsafe," Burke said.
After being turned away by relief groups, Whelan decided to travel to Poland on his own. Two days after he landed in Warsaw, he had already found a way to be useful.
Operating out of the Polish capital's central train station, he was issued a neon-yellow vest and a paper badge with the word "Volunteer" and its Polish and Ukrainian translations.
As refugees from Ukraine arrived by the hundreds, Whelan — and Juno, who he tucked into his jacket — helped direct them to desks offering services including travel coordination, government resources and temporary housing.
"There's periods where it slows down," Whelan said in a WhatsApp message, "and then periods where you have hordes of people trying to get information."
But even the skills of Team Rubicon's carefully selected squads are not always used in the ways they expected.
"We came here expecting something that was not the reality, so I think we had to take a beat, and we had to check our assumptions and engage in a very humble, thoughtful way," Nelson said.
From the dark, eerie bunker, she had some advice for anyone considering travel to Ukraine.
"Don't just show up," Nelson said. "There are too many mavericks here. There are too many people who are like, 'I'm a paramedic, I'm a veteran, I'm going to come here and help.' Find, legitimize and apply to the right organization."
Or perhaps stay home.
"Maybe just donating your money to organizations that know what they're doing and are engaging the community is the best thing to do," she said.
