The mood was festive as hundreds of Ukrainian Americans packed into a community center in northeast Minneapolis last month for a night of celebration, folk dancers in flowered headdresses leaping and twirling across the stage.

But a silence swept the room as the dancers exited. All eyes turned to a big screen showing a closeup video of a gaping wound — and masked doctors in Odesa performing surgery on a wounded Ukrainian using cardiovascular tools sent from Minnesota. Many in the crowd of more than 300 were moved to tears.

The raw footage was a grim reminder of the realities of a war that has left more than 100,000 Ukrainian troops dead or wounded, driven 13.5 million people from their homes, and brought horror to nearly every corner of the country. For organizers of the event, the video was also meant as an urgent call to action. Without more medical supplies, including high-tech suction devices for cleaning wounds, soldiers and civilians would continue to die unnecessarily, organizers said.

"How will we look each other in the eyes if we step away now?" asked Sasha Sakurets, a nurse, business owner and activist in the Ukrainian community. "To do nothing is not an option."

The message also reflected the continued urgency of a medical relief effort launched by the Twin Cities' Ukrainian community at the start of the war.

What began as a small cadre of volunteers shipping suitcases of medical gear to Poland has mushroomed into a sophisticated operation — one that stretches from northeast Minneapolis to the farthest reaches of the battlefield. All told, nearly $4 million in medical supplies has flowed to Ukraine since last spring. The equipment is being deployed in 16 Ukrainian cities, from the capital city of Kyiv to field hospitals near the eastern city of Bakhmut — the site of the longest, bloodiest battle of the war.

As the toll of wounded mounts, the need for more sophisticated medical equipment has become even more acute. The daily missile and drone strikes on apartment buildings, hospitals and other civilian structures have caused particularly gruesome wounds, with short-staffed hospitals racing to save limbs and prevent deadly infections. Many wounded have undergone multiple complex surgeries at hospitals that were not prepared for such grievous injuries, say local volunteers.

The aid goes far beyond what many Ukrainian American community members initially thought possible. Since the war began, volunteers from Stand with Ukraine MN have shipped 6,200 tourniquets, nearly 2,000 compression bandages, and 9,000 hemostatic packets, among other vital supplies. And with money raised locally, they have bought 15 off-road vehicles — capable of rescuing wounded soldiers — and had them driven across the border into Ukraine.

"There are lives and limbs being saved with each one of these deliveries," said Dr. Tanya Melnik, a Stand with Ukraine volunteer and a doctor at the University of Minnesota who cares for women with complicated pregnancies. "There are times when I am in disbelief and I ask, 'Are we actually doing this?' "

Dr. Ihor Stojanowski, a surgeon at a hospital in Lviv in western Ukraine, said the shipments from Minnesota have likely saved "hundreds of limbs" from amputation at his facility. Of particular value, he said, are high-tech vacuum pumps — known as negative pressure wound therapy (NPWT) devices — that suction fluids from wounds and enable patients to heal faster. Stand with Ukraine organizers sent one of the expensive devices to the hospital in Lviv, along with dressings and 250 canisters that collect wound drainage.

Stojanowski said the equipment from Minnesota has also saved lives by preventing sepsis, a blood-borne infection often resulting from untreated wounds. In other cases, wounded soldiers have been able to return to the battlefield more quickly after their surgeries, he said.

"No work is difficult if you have the necessary tools," Stojanowski said over a Zoom call last month from Lviv hospital, which is receiving 30 to 40 wounded soldiers a month. "In some cases, with these [NPWT] devices, we can prevent death and we can prevent amputation, and we can save and restore the functions of organs."

Since last summer, the relief effort has received a boost from an unexpected source: Wounded Ukrainians traveling to Minnesota for specialized treatment.

Nearly 60 people with amputated limbs, most of them soldiers, have flown to the Twin Cities to get fitted with prosthetic limbs and receive physical therapy at the Protez Foundation rehabilitation clinic in Oakdale. The soldiers have come with harrowing accounts of their brushes with death. Many have pointed to the urgent need for tactical medical gear closer to the front lines to prevent infections.

A 20-year-old lieutenant in the Ukrainian military who was held as a prisoner of war by Russian forces arrived in Minnesota after losing four extremities to frostbite – a revelation that prompted Stand with Ukraine volunteers to procure more self-heating gloves and winter coats. Another soldier described escaping an ambush by swimming across a filthy river with an amputated leg, which became badly infected. Volunteers put out another call for high-end tourniquets and hemostatic bandages.

"Now that the soldiers are coming here, they are bringing the war to us," Sakurets said. "We have a much better understanding of what they need and can be more focused in our efforts."

The intensifying effort has turned the Ukrainian American Community Center in northeast Minneapolis into a warehouse for surgical and other medical equipment. Once a week, a dozen volunteers meticulously sort the supplies based on detailed lists provided by the group's network of contacts in Ukraine, including nearly 50 doctors. Since last spring, the group has delivered two 40-foot shipping containers to Ukraine, as well as more than 200 duffel bags packed with medical supplies.

Mykola Sarazhynskyy, 46, a marketing professional who grew up in western Ukraine, is among the leaders of the project. A year ago, as he watched videos of Russian forces advancing toward Kyiv, he considered leaving his wife and comfortable home in Plymouth and joining his native country's territorial defense forces, reserve units of Ukraine's military. But Sarazhynskyy had no combat experience; his stint of military training in high school, in which he learned how to use an AK-47, was a distant memory.

So instead of strapping on a rifle, Sarazhynskyy become an expert in battlefield medicine. On a recent chilly morning, he was busy sorting boxes of discarded medical supplies deep in the basement of the M Health Fairview Masonic Children's Hospital in Minneapolis. There, he made "a great discovery" — a stainless steel medical cart containing hundreds of pounds of orthopedic tools, including drill bits for repairing bones.

"I'm healthy enough to carry 70-pound boxes," Sarazhynskyy said. "But I may not be able to run many miles or dig many trenches."

As the war's humanitarian toll worsens, so too has the pressure to scale up the relief effort. Much of the work is labor-intensive, and involves a handful of volunteers like Sarazhynskyy traveling to hospitals to retrieve medical supplies. Stand with Ukraine organizers said they are talking with state officials, and floating the idea of creating a "sister hospital" program between Ukraine and Minnesota, to facilitate the direct transfer of supplies and medical knowledge.

"Every day I think, 'I'm working in a warm building with friends and not being bombed,'" Sakurets said. "If these Ukrainian heroes can sustain fighting outside in the winter, then we have to sustain our effort too."