The settlement of Vorontsovo is one of the most remote places in Russia, perched above the Arctic Circle on the massive inlet where the Yenisei River pours into the Kara Sea. The only way in is by boat -- in the short summer weeks -- or by helicopter, which flies regularly twice a month. Even in fair weather, it takes more than 24 hours to reach Vorontsovo from the regional capital, Krasnoyarsk, some 1,800 kilometers to the south.
The closest thing the settlement has to a doctor is 25-year-old paramedic Alyona Kirilovskaya.
"I work alone," she told RFE/RL in a telephone interview. "There used to be a hospital here, but it has been turned into a first-aid/maternity station (FAP), for whatever reason. There are about 250 to 270 people here, if you count those who live out on the tundra. Everything is up to me."
After graduating from a medical college in 2018 in Barnaul, the capital of the Altai region, Kirilovskaya worked for a couple years "on the mainland" -- as Russians in barely accessible areas call the rest of the country -- before requesting a post in the Far North for the sake of "adventure."
"They say the 'north beckons' with its nature and its harsh winters," she said. "I don't have any children and I'm not married. While I have the chance, I'd like to see how people live in other places…. Most people never make it to the tundra."
On August 3, river cargo vessel OT-2069 pushed its contingent of barges into Vorontsovo and weighed anchor. The crew of 15 had a serious medical problem and no doctor on board.
"The first one to fall sick was the navigator from the Ob-Irtysh Shipping Line," said OT-2069 crewmember Natalya Lopatina. "When we invited Alyona aboard, his oxygen saturation level was 75 percent, and he was unable to get out of bed."
The navigator had flown in from afar and boarded OT-2069 at Sabetta, a port city on the east coast of the Yamal Peninsula, on July 23. On July 27, the vessel set course for Dudinka on the Yenisei, about 50 kilometers west of Norilsk, a sizable city in the Far North.
"He already began coughing and he stopped coming to meals," Lopatina recalled. "He didn't leave his cabin…. He got steadily worse and on August 3 in Vorontsovo the captain himself went to the FAP and explained everything to Alyona Aleksandrovna [Kirilovskaya]."
Kirilovskaya traveled to the ship and assessed the situation. The navigator was immediately hospitalized at the FAP, and Kirilovskaya arranged an emergency helicopter evacuation to Norilsk. She began treating several other crew members, whom she diagnosed with mild cases of COVID-19.
"He was in very serious condition," Kirilovskaya recalled. "I immediately called for a medical helicopter. But I was really relying just on myself. No one could help me there, and you don't want to just watch someone die in front of you."
"Within a few days, everyone was sick," she said. "I would go there after my working shift, and all day long I was in communication with them. Sometimes, those who were able would come to me. I ended up sending two others to the hospital."
One of those who fell ill was Lopatina, a 30-year veteran of Russia's river fleet.
"[Kirilovskaya] took all the necessary measures," Lopatina said. "She didn't scorn us. She was such a professional. She told us immediately that it was most likely COVID-19 and prescribed antibiotics. I helped the two sickest ones and, as a result, I fell ill myself."
Before the August outbreak, the OT-2069 crew did not take the coronavirus seriously, and none of them was vaccinated. The entire crew tested negative on July 19.
"I got a lot worse very quickly," Lopatina said. "My saturation fell and I couldn't breathe. Alyona said I had to be evacuated or I would die. On August 9, one young sailor and I were evacuated. He had double pneumonia. I made it to the helicopter with difficulty, but without oxygen."
Lopatina was released from the hospital in Norilsk on August 26. The sailor recovered and is now back home in Izhevsk. Two other OT-2069 crew members were later hospitalized and have since recovered. The navigator remains hospitalized but is expected to recover.
"At first, I was skeptical about COVID," Lopatina conceded. "But after the hell I went through, I'm ready to do anything. I wouldn't wish what happened to me with COVID on my worst enemy. I wasn't allowed to speak because as soon as I'd utter one word, my oxygen saturation would plummet. The first three days, you just lie on your stomach and pray…. You just weep over what is happening to you. And you pray for the strength to bear it. When they told me my condition had stabilized…I wept from joy.
"As soon as they gave me my telephone when I was in recovery, I wrote to [Kirilovskaya] immediately: 'You are my guardian angel.' I'll pray for her the rest of my life."
Although almost everyone in Vorontsovo had been vaccinated and there had been no serious COVID-19 cases registered there, locals were frightened by the ship and the sick sailors who passed through the settlement on the way to the FAP.
"That's the way it is with the pandemic in Russia," Kirilovskaya said. "Everyone is afraid. I had to tell them that we were being very careful and that the FAP was sanitized after every visit…. I can understand that they were afraid for their health, and they were afraid that the medic who comes into their homes might get sick as well."
At first, I was skeptical about COVID. But after the hell I went through, I'm ready to do anything. I wouldn't wish what happened to me with COVID on my worst enemy."-- OT-2069 crewmember Natalya Lopatina
When the ship was finally able to get under way again, the captain sent a message of gratitude to the Krasnoyarsk regional Health Ministry. It said: "On behalf of the entire crew of vessel OT-2069 and myself personally, I would like to express enormous gratitude to Alyona Kirilovskaya, a medic at the FAP in the settlement of Vorontsovo at the mouth of the Yenisei River, for her invaluable assistance, labor, professionalism, and the conscientious fulfillment of her professional duties.
"For more than 10 days, Alyona Aleksandrovna cared for the entire crew of this vessel and was instrumental in their treatment, quickly diagnosing them and taking all necessary measures to save the lives of two people. Thank you for your work. We wish you good health and all successes in your professional and personal lives."
For her part, Kirilovskaya takes such praise in stride.
"They think I'm an angel, but, of course, I'm not," she said. "How could I abandon them? It is my job, and I don't see anything special about this case…. I just did my job and my duty."