Insulin has to be stored between 5 and 15 degrees Celsius. The only way to transport something over 1,000 km at that temperature during a record-breaking heat wave is a refrigerated truck, which I happen to have. That is why I find myself at the other end of Ukraine this morning, about 20km from the front lines with the near constant echo of explosions in the distance.

I’m here at the house of my friend Nick, who fled this city with many others in the first week of the Russian invasion, although he has since returned many times to deliver lifesaving humanitarian aid to displaced persons here. His in-laws, who are staying in his house and hosting us, had most of their neighborhood destroyed by the initial shelling, and have also lost their summer home to Russian occupation.

Driving through the city yesterday, I was given a brief but intense tour of the various offices, municipal buildings, churches, malls and apartments that have been destroyed in the last few months under almost nonstop Russian artillery fire. “That was the main courthouse,” he said, pointing to an empty shell of a building next to a block-sized heap of mangled metal and rubble. I didn’t realize that the rockets had such a large blast radius, and apartments a block away all have significant damage and most of their windows smashed out, too. Even if the Russians are only ostensibly hitting military targets — which we know they are not — the civilian collateral damage is unavoidable.

And the physical damage is only part of the destruction. It’s hard for Nick to hide his sense of loss as he surveys the abandoned streets and shops of his hometown. “I used to spend 30 minutes in traffic here every morning,” Nick remarked sadly while we flew down the main avenue through dead traffic lights. There are people about, but very few shops open. Concrete and steel barricades block up the roads at key intervals, diverting what little traffic there is into snaking patterns around (currently abandoned) military outposts. Although it does seem like the skeleton economy here mostly exists to support the military defense, there are some faint signs of life as well, like the coffee shop where we enjoyed mojitos last night. There’s a sense of resilience in the streets.

It isn’t until you’re on the ground that you realize how large these cities are, and the apparent folly of trying to conquer one by force. The Russians could destroy an entire block every day and still would take weeks to reach the city center. That’s why although so much has been destroyed, many more buildings remain standing and it seems like it would be actually impossible to capture such a place under heavy resistance. I suppose this is one of the reasons Kharkiv successfully repelled the Russians, although from the explosions in the distance, it doesn’t sound like it.

Which brings us back to the insulin. Because of the war, medicine has been especially needed and especially short, and transporting it to this part of the country is expensive or impossible. The hospitals here in Kharkiv are constantly out of critical medications, of which insulin has been a constant need. That’s why our doctor friend in Lviv helped source the largest batch of insulin to date — several hundred one-month injectors — and we’ve been dutifully watching the temperature on the refrigeration unit for the last two days. The scariest times are when we had to open the truck to unload the other cold storage supplies we brought with us — fresh veggies, yogurt and milk — and the outdoor heat would rush in. Thankfully, we managed to keep the temperature from spiking above 15 and happily delivered the insulin, along with many other medical supplies, to the main hospital here yesterday. We also offloaded a couple hundred kg of support into SUVs bound for the front lines, including the remaining combat tourniquets.

After two days of driving, I’m finding myself drained. I’m not the only one. On the ground, the ceaseless adrenaline of the first month has yielded to an uneasy new calm for the Ukrainians here. People have returned to jobs and their families, and behind the front lines live relatively normal lives, albeit often in a new city. The stalemate at the front has become a form of background anxiety for everyone here, much like I imagine it has felt living in many places in the past during wartime. Most everyone has friends or family at the front, and every once in a while the news is punctuated by unexpected developments, like this week’s rocket attack in Vinnytsia. But for the most part, in places even this close to the fighting, people are out again, playing sports again, dating again, and getting speeding tickets again.

Which means the economy is back again. When I first came to the border, even basic supplies were proving impossible to find in Kharkiv and elsewhere in the east, and we would work for weeks, with over a hundred volunteers, to get a single 20-ton truck of food aid out here. Hundreds of thousands of people were displaced and thousands were living in the Kharkiv metro, living off of donated food. Now, it’s possible for most people to buy the food they need here and most displaced persons have found temporary homes with friends or family here or abroad. The economic shock of closing supply chains has lessened: Even truck lines at the border have returned to manageable levels. And donations have been pouring in for months, which means the warehouses in the west are stocked with medicine, clothes, food, and hygiene products. The effort and cost of obtaining and moving a couple hundred kilos of humanitarian aid — when it’s not lifesaving medication that can’t be gotten anywhere else — just isn’t worth it in many cases, which is why we have become a lot more selective about what we spend our efforts on to make sure it goes to where help is needed.

And where the help is needed, still, is at the front or near the front lines, where commercial routes are still struggling and villagers are either trapped by the advancing enemy or recently de-occupied. That is why I’m going to be refocusing my efforts on transport and supply to these hard hit regions through the network of front line drivers I’ve built over the last few months, and spending most of your donations on funding these trips, in a country where gas is somewhat available again but prohibitively expensive. Your ongoing support is appreciated and I will continue to keep you posted on our progress.

Thank you as always for your ongoing support of the Ukrainian people!