WARSAW, Poland — Warsaw’s biggest pediatric hospital has put patients from Ukraine on its waiting list for liver transplants, sometimes ahead of Polish children. Schools in Poland’s capital have had to search for extra teachers to keep up with the influx of new pupils. Public transport has risked buckling under the strain of so many new residents.

Yet, to just about everyone’s surprise, Warsaw has kept working, defying predictions of a breakdown and an angry public backlash. The city, which has welcomed hundreds of thousands of fleeing refugees, has decked itself with Ukrainian flags and banners of support for Poland’s war-ravaged eastern neighbor.

But just as the tsunami of refugees, which increased the capital’s population by nearly 20% in just a few weeks, seemed to be receding, Warsaw’s mayor, Rafal Trzaskowski, is now bracing for a possible new influx as Russia’s military pushes to achieve what Russian President Vladimir Putin last week vowed would be the “full completion” of his war in Ukraine.

“Warsaw is at capacity,” Trzaskowski, a liberal opponent of Poland’s conservative governing party, Law and Justice, said in an interview. “We accepted more than 300,000 people but we cannot accept more. With the escalation by Russia in eastern Ukraine we could have a second wave.”

More about Russia’s war on Ukraine

It looked for a few days as if the rush into Poland was over as Russia’s retreat from Ukraine’s capital, Kyiv, encouraged some Ukrainians to risk returning home and others to stay put. For the first time since Russia invaded Ukraine, on Feb. 24, Poland’s border service announced in April that the number of people arriving from Ukraine had been outnumbered by those crossing the other way.


But that trend, the mayor fears, is unlikely to hold and, if significantly reversed with a new surge of refugees, could push an already strained city beyond its limits.

“Imagine your city suddenly increased by 15 to 20%: what an incredible pressure this would be and what it would cost to normal services of the city like public transportation, sanitation, education and so on,” Trzaskowski said. “These costs run to hundreds of millions of dollars.”

At Warsaw’s central railway station on Friday, a major hub of Ukrainians going in either direction, Natalia Glinskaya, 54, said she left Ukraine in March, moved on to Sweden via Poland and returned to Warsaw this week with plans to take a train back home.

But after learning that Russian shells had fallen early Friday on her hometown east of Dnipro, she put that plan on hold. Though a Russian speaker, like most Ukrainians in the east of the country, she cursed Putin, who claims to be defending Russian speakers from persecution, calling him a “crazy terrorist” capable of anything.

“I’m going back and forth about what to do now,” she said, predicting that Russia’s offensive in the east would deter many Ukrainians from returning home and encourage others to leave, particularly after Sunday’s Orthodox Easter, an important family holiday.

“Then there will be a second wave,” she said.

Figures released this past week by Poland’s border authorities showed the number of Ukrainians leaving and arriving roughly balancing out on some days. As Orthodox Easter drew nearer, however, more people returned to be with their families in Ukraine than arrived, with the Polish border service reporting on Saturday that 19,900 people had crossed into Poland from Ukraine the previous day, while 23,800 went the other way.


After a peak of more than 30,000 Ukrainians arriving in Warsaw each day last month, the number declined to just a few hundred last week. The figure is now creeping up again, with 2,000 or 3,000 refugees now coming to the capital each day, mostly from the eastern Donbas region.

Many Ukrainians who have fled to Poland since Russia invaded are agog at how well they have been received.

“It is wonderful to have a kind neighbor like this when our neighbor to the east attacks us with such cruelty,” said Roksolana Tyymochko-Voloshyn, 34, who arrived last month with her cancer-stricken 7-year-old son, Volodymyr.

Driven from the border straight to Warsaw in an ambulance, they were taken to the Children’s Memorial Health Institute, a sprawling medical complex southeast of the capital, to treat her son’s eye tumor. He was halfway through a course of 25 radiation treatments in Kyiv when they fled Ukraine. His mother, who left her husband behind to fight, is at his bedside day and night.

Marek Migdal, director of the pediatric hospital, said that patients from Ukraine “get exactly the same rights to treatment as Polish citizens,” and he initially worried that “if their number increases our capacity will not be sufficient.”

The number of Ukrainian admissions, however, stabilized as hospitals elsewhere in Poland and abroad took in Ukrainian children in desperate need of medical care.


Few of the Ukrainian children admitted to the Warsaw pediatric hospital needed treatment for war wounds. But the war, by choking supplies of medicine and diverting doctors, has put their lives at risk. “If we cannot help these children, we will be responsible for their deaths,” said Piotr Socha, a Polish doctor at the health institute responsible for a ward treating liver disease. “Ukraine cannot help them. We have to help.”

That extraordinary welcome mat rolled out by millions of ordinary Poles in the early weeks of the war could well fray, Warsaw’s mayor said, if another wave of traumatized people crashes over his city and the national government, which has so far left most of the heavy lifting to private charities and individuals, does not step up with a clear plan.

“Numbers went down considerably, but now they are going up a bit,” Trzaskowski said. An upsurge of fighting in eastern Ukraine, he added, could prompt a new exodus to Poland by people who had previously decided to remain but who “have seen the atrocities in Bucha, Irpin and other places and are on now the move” as Russian forces bear down on villages and cities in the east.

“We cannot improvise any more,” he said, recalling how, in the absence of a clear national strategy, he had to call fellow mayors and beg them to send buses to Warsaw to help relieve the strain on the capital.

Most of the help for Ukrainian refugees, the mayor said, has come from local governments, private citizens and “exactly the same kind of organizations that were deprived of financing by the central government for years because they were fighting for refugees, for women’s rights, the LGBT community and all the minorities.”

“These are the nongovernmental groups that have saved us,” he said.


In all, Poland has taken in nearly 3 million Ukrainians, winning the country widespread praise abroad and helping the central government shake off it reputation as callous and hostile to foreigners. Just a few months ago, Polish border guards and soldiers used batons and water cannons to prevent would-be asylum-seekers, many from the Middle East, from sneaking across the border from Belarus.

Trzaskowski, a longtime foe of the conservative national government, will visit the United States next week looking for help with lifting his city’s heavy burdens.

“It is great if Poland’s image is improving,” he said. But, referring to the governing Law and Justice party, he added that “one should not forget that these guys are still breaking the rule of law and attacking independent institutions.”

The city government provided temporary housing for more than 70,000 Ukrainians in unused office blocks and sports halls but, Trzaskowski said, far more refugees found shelter with family and friends or with “complete strangers who, in a month or two, might say, ‘I cannot prolong this offer for much longer.’”

Those with sick children often sleep at the hospital. Alina Babyna, who traveled to Poland seeking treatment for her 11-year-old son, Yevgenii, gravely ill with a rare liver disease, sleeps at her son’s bedside and has no plans to stay in Poland indefinitely, saying she left Ukraine only after doctors at a Kyiv hospital where her son was being treated left to treat wounded soldiers near the front line.

“I will definitely go home when we win the war,” she said. “Fate will decide. But I believe in God. I hope and know that he will help.”