DONETSK, Ukraine -- The road between the last Ukrainian checkpoint and separatist-controlled Donetsk is desolate.
Empty, wet fields line the crumbling road, which is sporadically marked with handmade signs whose painted red skulls warn of the unexploded land mines in open areas between the territories.
The first checkpoint of the self-proclaimed Donetsk People’s Republic comes into view, easily distinguished by the red, blue and black striped flag that struggles to remain attached to its makeshift moorings in the wind and rain.
It’s been a year since the pro-Russian rebels declared their independence from Ukraine.
While Ukraine — like the rest of the international community, with the exception of the Republic of South Ossetia, a partially recognized state in the South Caucasus — does not recognize the self-styled entity, it does stamp the passports of foreigners transiting from Ukraine into rebel-held territory.
Cars slow down and wait to be searched at the first checkpoint of the insurgents.
The heavily guarded, deeply trenched spot forms part of the frontline between the separatists and the Ukrainian army.
“Hello from Moscow!” A young militiamen shouts.
He laughs, raising and opening his arms wide and stumbling backward slightly.
His face is red from the stinging-cold air, and presumably also from the strong potato vodka he exhales with every breath.
He waves the car forward, into the Russian-backed, separatist-controlled region.
The streets of Donetsk, like the shelves of its grocery stores, are mostly empty.
Only a handful of restaurants remain open in the city, which is now cut off from the rest of Ukraine.
The remaining restaurants, along with the banks, clothing stores, movie theaters, markets, shopping malls and other commerce, closed over the past year as residents fled the frequent shelling throughout the city.
More than 6,000 people have died in the year-long conflict.
To the residents who remained in Donetsk the current cease-fire, which was announced at the end of January, is a dark joke.
Shelling can be heard on the city’s outskirts daily, as insurgents and the Ukrainian army exchange sporadic fire.
Abdelsattar Nassar, a cafe owner who moved to Donetsk four years ago, says he hears the shelling every day.
He says that in the early days of the fighting he tried to flee, but he simply can’t afford to close shop and leave, as many of his neighbors have done.
The cost of living in safe Ukrainian cities, such as the capital, Kiev, has gone up threefold in the year since the war began, Nassar tells Haaretz.
In Donetsk he at least has a roof over his head, if he fled he would be living on the street, he says. “I fear for my children every day in this city,” Nassar says, gazing out of the window of his cafe.
“They say there is a cease-fire, but what cease-fire? We see and hear the bombs every day.”
While both sides were supposed to remove heavy artillery from the frontlines at the start of the last cease-fire, each accuses the other of simply shuffling the armaments around.
Alexander Hug, the deputy chief monitor with the Ukraine mission of the Organization for Security and Cooperation in Europe, says neither side is cooperating with the agency’s investigation of compliance with the demand.
“By now both sides of the conflict should have withdrawn their heavy weapons,” Hug said.
“However the OSCE’s special monitoring mission has been unable to verify a credible withdraw because of a lack of cooperation from both sides.”
While the cease-fire is still holding on paper, violations are common, “mainly in and around the airport area of Donetsk and east of Mariupol,” Hug said.
Nassar says it is these violations that frighten him.
He believes the situation is only weeks away from another escalation.
His cafe, in the heart of the city, is filled with dubious-looking separatist fighters.
They can do whatever they want in this city now, Nassar says, there is no law in Donetsk anymore.
Outside of the city center, in the Kievsky district, the true dimensions of the destruction wreaked by the conflict are evident.
There are houses that have been leveled, their roofs torn off, and cars reduced to blackened shells.
The few homes and business the war has left untouched are shuttered, abandoned.
Kievsky is also called the airport district.
The city’s adjacent airport lies in ruins.
The site of fierce battles between rebel and government forces in May, October and January, it was closed to civilian air traffic in May.
In late January the insurgents wrested control of the complex from the Ukrainian armed forces in a particularly bloody battle.
The district’s civilian Hospital No. 21 was not spared from shelling.
There is a large gaping hole in the roof of the main building, evidence of a mortar round that smashed through the structure several months ago.
Shattered glass from blown-out windows lies on the ground outside.
The hospital corridors are dark and cold — the power is out — and the pharmacy’s shelves are bare, but patients still come to be treated by members of the medical staff who have not received a salary in months.
Alekseyenko Aleksandrovich, the head of the hospital’s surgery department, is one such physician.
As the low booms of shelling echo through the building, followed soon after by quick bursts of artillery fire, Aleksandrovich tells Haaretz that the situation in the hospital is approaching critical level.
Medical supplies are running dangerously low, and repairs to restore electricity and heating are needed desperately.
“A lot of shells have hit the hospital. Shrapnel has hit my office several times, some has even hit the pediatric ward,” the surgeon says.
“We have limited amounts of medical supplies and food for our patients.”
Hospital No. 21’s situation is not unique in Donetsk.
Medicine shortages and ruined medical facilities are commonplace in the separatist-controlled territory, according to Doctors Without Borders.
The aid organization is trying to fill in the gaps.
The city receives no medical supplies from the Ukrainian government.
Donetsk’s remaining residents are suffering, Aleksandrovich says, whether they were injured in the war or need medical care for preexisting conditions.
Aleksandrovich says he expects the body count to rise significantly over the following weeks and months.
The cease-fire is failing, he says, but the hospital and its staff will do whatever they can to help the people who remain in the city.
“We are ready for emergencies, we have additional operating rooms in the basements. The surgeons and the nurses are ready for anything,” Aleksandrovich says.