Humanitarian/Medical - CANADA-UKRAINE FOUNDATION

Medical mission sees volunteers providing reconstructive surgery to wounded soldiers and civilians

A team of 20 Canadian medical professionals, including surgeons, anesthetists, and nurses, are in Ukraine on a mission to offer reconstructive surgery to soldiers and civilians wounded in the conflict in the country’s eastern regions.

Dr. Steve McCabe and Dr. Reid Chambers complete a hand surgery in the Central Military Hospital in Kyiv, Ukraine. (Anton Skyba)

During the summer of 2016, in one tragic moment, Evgen Redka lost his friend, his left eye, and the ability to anonymously walk the streets without the concentrated stares of strangers.

The young Ukrainian soldier was nearly killed when the vehicle he was in drove over an anti-tank mine in Eastern Ukraine.

The blast left Redka with excruciating scarring on his face and body, but with help from a specialized team of Canadian medical professionals, there’s hope that Redka will once again be able to lead a more normal life.

A team of 20 Canadian medical professionals, including surgeons, anesthesiologists and nurses, worked out of an old Soviet-built hospital in Kyiv on a 10-day mission to offer reconstructive surgery to soldiers and civilians wounded during the conflict in the country’s eastern regions.

Dr. Oleh Antoyshyn, head surgeon of the mission, fills out a medical record for Evgen Redka before the soldier undergoes an operation. (Anton Skyba)

The workload is unprecedented, but there is no shortage of volunteers willing to work long hours for free, said Oleh Antonyshyn, head of the Adult Craniofacial Program at Sunnybrook Health Sciences Centre and a professor of plastic surgery at the University of Toronto.

“The days are 12, 14 or 16 hours long,” Dr. Antonyshyn told CBC News, shortly before an aide whisked him away to inspect another traumatic case. “But still we have many, many more people applying than we have room for.”

Torontonian Dr. Harry Foster and Winnipeg native Dr. Adrian Hawaleshka are veterans of the mission, which has been in Ukraine three times in the last five years.

I’m just hoping I can use my skills to give them back a bit of hope.

– Dr. Harry Foster

While the missions, organized by the Canada-Ukraine Foundation, are mainly funded by private donations, the team did receive government support in 2016. They’re also supported by Stryker Canada, which provides all surgical hardware and implant materials for the medical procedures.

Dr. Hawaleshka feels connected here as a Canadian of Ukrainian heritage, but both doctors say they want the chance to make a lifelong impact in the lives of people who otherwise would likely never get the specialized care the Canadians can offer.

Nurse Ella Bakh, centre, records patient details after a surgery. (Anton Skyba)

“A lot of these guys are solemn, and you can tell that they’ve lost hope at a young age,” says Dr. Foster. “I’m just hoping I can use my skills to give them back a bit of hope.”

Canadian medical professionals — including craniofacial reconstructive plastic surgeons, microsurgeons, neurosurgeons, anesthesiologists, GPs, nurses and physical therapists — have now completed over 300 reconstructive procedures on a total of 127 patients through the mission.

Operating on 10-year-old Mykola

In 2015, they operated on a 10-year-old boy named Mykola, who was wounded by a blast in Eastern Ukraine. The boy lost both of his legs and one arm, and sustained dramatic shrapnel damage to his face and body.

He was brought via train to the Canadian doctors by a Ukrainian volunteer who’d heard about the medical mission on the news. The doctors operated on him almost immediately to help alleviate some of the scarring on the young boy’s face and to pull bits of shrapnel from his body.

Eventually, they helped send him to Shriners Hospital for Children in Montreal, where he stayed for one year while receiving prosthetic limbs and relearning how to walk.

Dr. Oleh Antonshyn, head surgeon for the mission, checks X-rays during the pre-op day. (Anton Skyba)

At first, the patients included civilians shot by government snipers during Ukraine’s 2014 Maidan revolution, but now virtually all the patients are Ukrainian soldiers. Their injuries are all sustained on the front lines and run the gauntlet from almost inconceivable burns and disquieting cases of facial trauma, to more minor but still debilitating wounds.

The soldiers are victims of the war in Eastern Ukraine, which began in the early spring of 2014 after Russia annexed Ukraine’s Crimean peninsula and quietly began sending troops and military equipment across the border into Ukrainian territory.

Combined Russian-separatist forces have fought the Ukrainian military since the spring of 2014. The fighting has now taken the lives of more than 9,750 people and wounded over 20,000 according to official UN figures, while displacing more than 1.8 million people from their homes.

Soldier trained by Canadians

Most of the Ukrainian soldiers seeking treatment will never be able to serve again.

At least one, Valeri Skachka, 24, recalled being trained by Canadian soldiers stationed in Western Ukraine during Operation Unifier.

“They just operated at such a serious level,” said Skachka of his time with the Canadian troops. “It was eye-opening to see that level of organization and equipment.”

Valeri Skachka shows his certificate of participation in Unifier traning, a day after he had hand surgery from the Canadian surgery mission to Ukraine. (Anton Skyba)

Skachka is currently eager to return to the fighting, after surgery on his hand.

In two days of consultations, Dr. Antonyshyn and his team saw dozens of patients to determine whether they can be offered treatment. That’s followed by five gruelling days of intricate surgery.

And although U.S. President Trump’s commitment to Ukraine in the conflict, established under the Obama administration, has been called into question, a set of U.S. Army onlookers joined the Canadian team for this mission.

U.S. Army Major Justin Miller made the trip from Germany as part of a six-person detachment from the American military who are hoping to replicate the Canadian medical mission for their own standalone aid program for Ukraine.

“We’re in the early stages of planning for the U.S. mission,” Miller, a veteran of the Iraq War, told CBC News. “But being here and seeing the amount of injuries and disfigurements from war, I can tell you it’s been awhile since we’ve seen this on our side.”

Dr. Todd Mainprize, head of neurosurgery at Sunnybrook Health Sciences, finishes his operation in Kyiv Central Military Hospital. (Anton Skyba)

Canada-Ukraine Foundation’s (CUF) medical missions in Ukraine have been widely popularised by Victor Malarek on the CTV’s W5 show. Since 2014, CUF has sponsored four missions and the fifth mission to Ukraine started on February 25, 2017. Within the CUF missions, Canadian surgeons and nurses have completed 244 operations on 137 Ukrainian activists and soldiers wounded during the Maidan revolution in 2014 and the subsequent war in Eastern Ukraine.

Every mission lasts for about one week, during which the Canadians try to help as many patients as humanly possible which means a lot of gruelling work with very little rest. But it is also a very gratifying work as the Canadian medics are curing the patients which have very little hope of being helped in Ukraine because of the limitations of the Ukrainian hospitals. The Canadians mainly accept the most difficult cases that require cranial and facial operations, as well as hand therapy. When the mission comes back, the doctors invite previous patients for checkups. As Victor Hetmanczuk, CUF president, put it, “Our help is impactful on the people and their families because we are changing their quality of life.”

This time, the Canadian mission includes six US military medical professionals, a surgeon and five nurses, who are observing how CUF runs a mission in Ukraine. As Victor Hetmanczuk told us, the US military doctors would like to do orthopaedic master classes in Ukraine. CUF’s mission is showing the American doctors how to interface with the Ukrainian medical military structure to have their own missions in the future.

How did CUF manage to establish such good relations with the Ukrainian side that other parties are using their connections now? “Боже провидіння (God’s providence),” said Victor, and provided some details: “The mission started in 2014. In April, 2014, we sent six doctors to Ukraine who toured all over the country and picked the best site to have these operations – the Kyiv Military Hospital. There are military hospitals in Odesa, in Dnipro and in Lviv, but we decided that the best facility was in Kyiv. The military medical structure – because they were treating all the wounded from the front – decided to take the chance. The Kyiv Hospital gave up three operating rooms for a whole week. And as a result of our fruitful cooperation, on the last mission, we left them over $700,000 worth of specialized Stryker medical equipment and two years’ worth of spare parts, which we bought through a federal government grant. We also trained them how to use that equipment. We wanted to upgrade the Hospital’s capacity and the only way we can do that is by leaving them the tools to do the job.”

This year, CUF’s medical mission to Ukraine is the biggest so far: 25 Canadian personnel and six Americans. Victor however noted, “I don’t see us as being able to send large missions continuously, we have to re-evaluate our strategy after we come back home. This kind of large mission is very expensive. We are lucky this time to have 25 cranio-facial surgeons, neuro-surgeons and nurses, both pre-op and post-op. We must scale the missions down. We would like to send teams of 5-6 people to hospitals in Lviv, Odesa, Kharkiv and Dnipro to share our expertise. The Americans are having a videographer on their team who will prepare teaching videos for the Ukrainian side and for the American side.”

CUF is having one more new initiative this year, said Victor Hetmanczuk: “The Ukrainian nurses have seen how our nurses are helping the doctors, and they too wanted to upgrade their skills. After one of the missions, we went to talk to the Registered Nurses of Ontario to see if we could transfer their best practices to Ukraine. There are about 46 best practices that we are using in Ontario to improve nurses skills after they got their degree. While in Ukraine, I will interview 3-4 sites that will take this best practices guidelines program and start training their nurses to upgrade their skills. We hope that this program will ultimately reach 400,000 nurses in Ukraine. We also hope that we will be able to help introduce Canadian standards on PTSD into the nursing curriculum in Ukraine. This way we hope to go from individual help to a significant cultural institutional change in the Ukrainian hospital system.