The United Hatzalah rescue service transported an elderly Jewish woman with severe medical problems from Ukraine to Israel last week, in a particularly complex and, at times, dangerous operation, the commander of the mission told eJewishPhilanthropy.

The effort began some two months ago when United Hatzalah received a request from the woman’s family to bring her to Israel largely because of her medical condition, caused by a severe lack of staff and medication at the facility where she had been living in the city of Nikolaev, which has seen heavy bombardments over the course of the war.

The 77-year-old woman, Yelena, had undergone heart surgery a few weeks before and the medical facility where she was living was not able to properly care for her. “Her condition was deteriorating so rapidly that we really didn’t know if we would get there in time,” said David Krispil, the deputy vice president of operations for United Hatzalah, who led the rescue effort.

Krispil said he and his team began working to get Yelena (for privacy reasons, Krispil did not give her last name) the approvals she needed to make aliyah, working with the Jewish Agency for Israel, the Immigration and Absorption Ministry, Health Ministry and Israel’s National Insurance Institute. “It was not an easy bureaucratic process,” Krispil said, adding that it was often made more complicated by the fact that they were unable to be in constant contact with Yelena because of conditions on the ground in Ukraine.

Since Russia invaded Ukraine last February, United Hatzalah and other Jewish and Israeli aid groups have organized a number of rescue operations to bring people with serious medical conditions or physical disabilities to Israel, sometimes renting entire flights and converting the planes to makeshift flying ambulances to provide them with medical care en route.

Krispil said United Hatzalah had to not only get Yelena permission to immigrate, but also sort out exactly where she was going to go once she got to Israel. “You can’t bring someone from Ukraine if you don’t know where they are going to be going in Israel,” he said.

Once the authorizations were obtained from the relevant ministries and government offices, Krispil and his team focused on the logistics of moving Yelena, who required round-the-clock medical care, from Nikolaev to Israel.

In the past, Krispil said his organization generally brought people in Yelena’s condition to Moldova – an approximately 120-mile journey – but the company that he had worked with in the past was no longer available. So instead they had to use an alternative route, going by ferry across the Black Sea to Romania and then from Bucharest to Israel.

The operation lasted roughly three and a half days, beginning Monday when a United Hatzalah ambulance – the organization has a small fleet in Ukraine – set out from its base in Uman and made the nearly 200-mile trip to Nikolaev. “There were two drivers so they could drive straight through without having to stop to rest and a local Ukrainian nurse,” Krispil said.

They loaded Yelena into the ambulance in Nikolaev and drove to Odesa, staying in a hotel room where doctors did blood tests and other checks to make sure that she was healthy enough for the rest of the trip. A day later, Russia targeted Odesa with cruise missiles, killing at least one person and injuring two more. “By a miracle, they weren’t there when it happened,” Krispil said.

Once the United Hatzalah medics got the green light, they boarded the ferry from Odesa to Romania. “It was very moving. On the way, she told them that she hadn’t been outside in months because of her condition. So they opened the doors of the ambulance so that she could see the sea after months of not seeing sunshine,” Krispil said.

They spent the night in Bucharest on Wednesday, performing more tests on Yelena, and set out for the airport the following morning. The El Al plane was specially outfitted with a gurney, oxygen tanks, monitors and other medical equipment. “She had two emergency medical situations on the flight. They had to give her oxygen and medication, but she stabilized,” Krispil said.

Landing in Israel on Thursday afternoon, the Ukrainian team handed Yelena over to Israeli medics who transported her to the Shmuel HaRofe Geriatric Medical Center in the central Israeli town of Be’er Ya’akov, where Yelena had received permission to stay. According to United Hatzlah, Yelena’s condition is now “steadily improving.”