Donetsk (Ukraine) (AFP) - Facing frequent shelling and desperate conditions, staff and patients at Donetsk's Hospital 21 in eastern Ukraine say they have no choice but to hunker down, stay put and cling to life as best they can.

The greying, Soviet-era hospital only holds a handful of patients, many elderly or dying, but is struggling to keep going as the seven months of unrest between pro-Moscow rebels and Ukrainian forces drags on around it.

Only one doctor is on duty: Maxim Chegodayev, a 37-year-old surgeon with a serious face and a flat voice.

"We have no choice but to keep on working for the people here," he explains, not even flinching as the sound of fresh shelling echoes around the run-down building.

"I have no prospects, no hope of going elsewhere. That's why I stay here. Even in Ukraine, my salary isn't enough to allow me to rent a flat."

Even when he is paid, that is -- Chegodayev says securing his salary from the Ukrainian government has been an uphill struggle for the last four months.

This hospital does not typically receive injured rebels -- instead, they are taken to a modern facility in the city centre.

Here at Hospital 21, though, everything is dirty and outdated. Chegodayev says that patients leave "as soon as they can".

He claims there is "enough medicine for everyone" thanks to aid convoys from Russia.

But the shelves in the hospital's pharmacy are almost empty -- a couple of boxes of painkillers, some sachets for treating diarrhoea and unlabelled tubes of gel.

The funding situation could be set to worsen.

Ukrainian President Petro Poroshenko issued a decree Saturday ordering the withdrawal of all state services, including hospitals, from rebel-held eastern regions.

The move seemed to be a fresh acknowledgement that the self-proclaimed rebel statelets of Donetsk and Lugansk are effectively breaking away from the rest of Ukraine.





- 'Nowhere else to go' -





The hospital does not only house the sick. Around ten people, fleeing unrest in the neighbourhood, have been living in a single, stuffy room in the basement for weeks.

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Most of the patients are not casualties of war, although Hospital 21 has treated some 160 civilians injured in the conflict.

Only one remains -- 60-year-old Nikolai Klimenko, whose leg was fractured in October in a bombardment near the airport, scene of some of the fiercest exchanges between rebels and Ukrainian forces.

Sitting on a rickety bed, his leg in a cast, he says he has "nowhere else to go".

In another shabby room, Sergei Grichenko, who is recovering after a hernia operation, says he has "got used to" the shelling.

"When it gets dangerous, we go down to the basement," he says, his hand behind his head revealing a large Orthodox cross tattooed on his forearm.

"We're familiar with the sounds and we know when there's a problem."

An explosion shakes the walls. "That, for example, is nothing to worry about," he explains.

One floor down, an elderly nurse with sad eyes walks along a corridor smelling of urine. Many patients on this floor are terminally ill.

In one room, a skeletal elderly patient groans under a thin, beige blanket. Another chokes while trying to eat a meal of dry bread and pureed boiled beans.

Shelling or no shelling, there is little doubt of their fate.