“Never in history have there been so many millions of people depending on humanitarian aid to be able to live”


“We always try to reach the most vulnerable populations and look for areas where no-one is working”, explains Paula Gil, a nurse and president of Doctors Without Borders Spain, describing the organization’s activities. Their mandate is clear: to work primarily in areas of armed conflict, or to care for victims of other forms of violence. “We are doctors, logisticians, nurses, and what we provide is humanitarian medical care”, she says. Currently, the closest and most destabilizing war for all of us is the one raging in Ukraine. There, the Spanish organization came up with a brilliant idea for transporting the wounded and other vulnerable people from the front line to the west of the country: a medical train that has already managed to help more than 1,800 victims. An idea that became a reality and which won the Fundación MAPFRE award for the Best Project or Initiative for its Social Impact.

How does it feel when, like in this war in Ukraine, you see that a hospital can be bombed?
It is very painful. Unfortunately, it is something that happens repeatedly. We witnessed a bombing in Mykolaiv a few months ago, our team was there.

In your experience of armed conflicts, is it normal to transgress these humanitarian limits?
The rules of war have to be respected, that’s the way it is. And it is the mandate of all armed groups involved to protect the civilian population. But this is something that is not happening in this war, just as it is not happening in many others. And it is especially painful because of the impact it has on people.

Bombing a hospital also sends a message: nowhere is safe Right now
You cannot say that there are any safe zones in Ukraine, I sincerely doubt it anyway, and this is reflected in the type of patients we are transporting: very old people and young children who have suffered injuries, amputees who have had their treatments interrupted, for whom it was not a good time to leave for a thousand different reasons.

There were reports from international organizations (prior to the pandemic) that spoke of a downward trend in armed conflicts. Are you equally optimistic?
We see things a little differently. To begin with, there is one hard fact. In the world today, there are 100 million people who have been forced to leave their homes to protect themselves from conflicts and situations in which they could no longer live. This figure has never been reached before in human history. Last year it was 84 million. Let’s see what happens next year.

These are very impactful figures…
It gives us an idea of what is happening. Never in history have so many millions of people depended on humanitarian aid to be able to live.

What can we do as citizens in this situation?
Spanish society, I am very proud to say, is really generous. We have almost 500,000 members in Spain. That is wonderful, it gives you legitimacy, they are committed people who want to channel their solidarity through our organization.

Do you receive any public support?
Our funding is entirely private. We have hardly any public funds. To date, almost 97% of our funding is private, donations, or comes through awards such as the one we have received today from

Fundación MAPFRE. How did the medical train project come about?
There was a need to relieve the pressure on the hospitals in the east and south of the country, which were obviously receiving a much greater flow of patients than those in the west, which were in better condition. And the idea came up to transfer patients using a commuter train, so to speak.

Is this the first time you have implemented something like this?
Yes, unfortunately, in many places where we work, there is no railway network or it is badly damaged. This is not the case in Ukraine. At first, we used the train to transport medical supplies, and we realized that we could transport people as well.

In what condition are the patients who are being transferred?
There are two trains: one in which we transport people who are medically more stable, who do not require, let’s say, continuous treatment, who can take medicine during the trip, who can sit down, for example. And then we transport patients who require hospitalization.

How many Spaniards are working there now?
Our staff is not only Spanish, in fact, we have 170 different nationalities working for us, who form part of the Doctors Without Borders’ global workforce, we are talking about 7,000 people in total. In Ukraine, there are about 120 international staff members, including some Spanish nationals, but the number fluctuates greatly, and there are about 500 local men and women.