'I want my daughter not to be afraid of me': how American doctors bring war-crippled Ukrainians back to life

The Ukrainian nation is now perhaps the most wounded in the world. Statistics say that in the country about 75 thousand people need operations after various injuries. The lion's share are, of course, soldiers, but many of the victims include civilians. American doctors help Ukrainian surgeons operate on some particularly complex patients. They go to Ukraine on their own vacation, they do not receive a salary for this - they do everything as volunteers. Recently, some of the doctors returned from another trip, which they call a “mission,” and told what they had to face there and what struck them most in the warring country.

Dr. Manoj Abraham is a specialist in facial plastic surgery. He works at Mount Sinai Hospital, teaches at New York Medical College, and also goes on medical missions several times a year. He first came to Ukraine after a full-scale invasion. He says: at first he couldn’t even imagine that he would go to a warring country. He and his colleagues considered different options, one of which was to take Ukrainian patients to Poland and perform operations there. But the main idea of ​​the Face To Face mission was not only to help people, but also to teach local doctors their skills, so the option with Poland was eliminated. The doctor laughs: they say they didn’t even understand how they ended up in Ukraine. The doctors were not taken far to the East - they were based in Ivano-Frankivsk and Lvov.

“That first trip was pretty scary. As soon as we crossed the border by bus, the first thing we saw were anti-tank hedgehogs. And then, when we got to the hospital, we were immediately taken to a bomb shelter located in the basement. This is something I have never experienced before during medical travel. Well, then it was hard to get used to these alarm messages that you constantly receive on your phone when missiles are flying out: you know that they have taken off, but you don’t know where they will fall.”, he shares.

“Five-star missions” to Ukraine

Trips of American doctors to Ukraine have been organized by a team of Razom volunteers for 8 years now. They called their project the Co-Pilot Project. In 2016, the idea of ​​sharing experience with Ukrainian doctors came to the mind of Dr. Luke Tomich. He is a neurosurgeon, clinical director of the New Jersey Epilepsy Institute, and also a native of Ukraine.

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“The idea of ​​going to Ukraine first came to me after talking with Henry Marsh. This is an English neurosurgeon, he has been traveling to Ukraine for the last 20-25 years, and he has many partners there. I had the opportunity to communicate with him at the conference, and after that I definitely decided that I wanted to go there too. After some time, I found like-minded people among my colleagues. Through Henry Marsh, we contacted Ukrainian doctors and began going there on missions. Mostly they did brain surgery. And then, unfortunately, when the full-scale invasion began, the needs of our Ukrainian partners increased. But, on the other hand, there were a lot of American colleagues who expressed a desire to join the mission.”, says Luke Tomic.

With the outbreak of a full-scale war, the project began to grow like a snowball. Neurosurgeons were joined by plastic surgeons, anesthesiologists, orthopedists, speech therapists and intensive care nurses. This year alone, 14 groups of doctors traveled from the United States to Ukraine. Doctors performed 300 operations and advised about 2000 people.

According to the head of the Razom Co-Pilot Project, Yulia Shama, each mission takes 3-4 months to prepare for the trip. Doctors conduct online consultations, choose strategies for operations of certain patients, purchase equipment, plan the educational part - conferences, video lectures, master classes, online streams of the most complex operations. All expenses are covered by Razom and their volunteer partners. So doctors jokingly call trips to Ukraine a “five-star mission,” although the doctors themselves are volunteers. They come on all trips in their free time from work - most often on their own vacation.

“Of course, organizing a trip itself is not an easy task.,” explains Yulia, “ Logistics are complicated by the fact that currently there are no planes flying to Ukraine, so everyone flies to Poland and from there goes by bus. Last time we packed 43 suitcases with medical equipment! The doctors' program is very tight - operations begin at 7 am and end around 10 pm. But we still try to include a cultural component in every trip. On the last trip we even managed to take the team to the Lviv Opera! We really want to show Ukraine not only as a warring country that needs help, but also as a country with great culture and wonderful traditions.”

The main goal is to teach

Dr. Manoj Abraham and his team brought to Ukraine a new technology for the reconstruction of facial bones. It is called a fibula free flap.

"For example, look at a 3D model of the face of a patient who is missing part of the lower jaw. We reconstructed it using a piece of leg bone - the fibula. In this case, we use microvascular surgery because we need to sew the blood vessels together with a thread that is thinner than a human hair”, comments the doctor showing the slides.

In his opinion, the most important thing is not even that they performed operations on several dozen people, but that they trained Ukrainian doctors to do this.

“The procedures were actually broadcast live, that is, there were cameras in the operating rooms, we had microphones on. They could be viewed by doctors even on the front lines! You know, it's this concept: you can either give a person a fish, or you can teach him how to catch that fish, explains the surgeon, We can be there for a few weeks and take care of a certain number of patients. But if we can train local doctors to perform these procedures, then they will be able to perform such operations themselves. A week after our departure from the last mission, on Thanksgiving Day, Ukrainian doctors performed such an operation on their own for the first time! For me this is a good sign that we are going in the right direction.”.

Orthopedic surgeon Ben Berenfeld agrees with his colleague. He specializes in upper limb surgeries and admits that before his trip to Ukraine he had never seen such wounds.

"Obviously, the complexity of the injuries is very, very high. Here in the US we don't see things like this very often. In Ukraine you are dealing with fresh front-line wounds. So the degree of destruction of soft tissue and bones is incredible. Even we were shocked. In addition, due to hostilities, access to immediate medical care is very limited for many people. That is, doctors on the spot simply clean and close the wounds, and then without the necessary materials, in some cases without implants, these patients cannot be cured,” - the surgeon complains.

He shows photos and x-rays of patients: here a wounded soldier actually has no shoulder, but here is a huge scar from a burn that prevents him from moving his arm. He admits that even with their resources, restoring people after such injuries is not an easy task. Therefore, it is important not only to train Ukrainian doctors to perform such operations, but also to try to provide them with the necessary materials as much as possible.

At the same time, doctors say, we must not forget that they are guests. And always remember that medical schools and protocols between Ukrainian and American doctors may differ.

Susan Ketigian has been a nurse for over 40 years and has spent 15 of those years traveling around the world on charitable missions. During this time, Susan made 29 trips to Asia, Africa, South America and Europe. But in Ukraine they were still able to surprise her.

“On our first trip to Ukraine, a Ukrainian nurse carried instruments into the operating room with her bare hands. The surgeon took them as if nothing had happened. And then I said: wait! I just wanted to understand what's going on here. And they explained to me that she had sterilized her hands. I've never seen anything like this anywhere! But they are the masters here, this is their way, so we just continued the operation.”, she notes.

When you lose face, people can't look at you

However, most of all, Ukrainians surprise doctors with their resilience. Americans remember one of the patients who, after his face was restored, sent doctors a photo in a tailcoat with a bow tie.

“For me, this kind of became a symbol of the endurance of Ukrainians, says Dr. Manoj Abraham. – NDespite such terrible injuries, they strive to, you know, continue to live their lives. For many of the soldiers we operated on, the first question was: how soon can I return to the front line, to my comrades? I think this is a true reflection of the fighting spirit of Ukrainians! After all, they are defending their country and their freedom.”

That is why it is so important for doctors to help the wounded recover as much as possible and regain the opportunity to live a full life.

“You see, when people see a soldier without a leg or an arm, they treat him like a hero. But if you lose your face, people can't look at you, explains Susan. – Therefore, our main goal is to restore their face! I will never forget the young guy we operated on. He had a serious eye injury. And when he lay down on the operating table, he said: “I really want you to fix this. So that my little daughter won’t be afraid of me.”

I can't forget their eyes

The patient from Bucha is most often remembered here. Polina Chervakova tried to get out of the occupied city with her stepson. Russian soldiers stopped their car and started shooting.

“First she was wounded in the shoulder, and the guy in the leg. She stopped to help him. Then she was shot in the face. After that, they took her stepson, and she herself, periodically losing consciousness, continued to wander through the forest for six days. Then people found her and took her to the hospital, recalls Susan. – Six months later she became our patient and part of her jaw was missing. We restored it using microvascular surgery and implants. And her stepson is still in captivity of the Russians.”.

Doctors are not particularly emotional people. They don’t cry when talking about wounds and injuries. They talk quite calmly about the peculiarities of treating people during the war. They are not frightened by blood, screams, scars and improperly fused bones. But in war there is something that penetrates even such professionals.

"One day I was walking down a long corridor in a rehabilitation center.“,” Ben Berenfeld shares his experience, “ there on the walls were hung various photographs of patients who had suffered from the war - adults and children. I walked through the corridor and looked at the faces, especially the faces of the children. Do you know what amazed me? They all have adult eyes. I can't forget it"

Razom Co-Pilot Project volunteers are planning their next mission for the spring. This means that now I need to assemble a team, start looking for new patients to operate on, and negotiate with sponsors on the supply of materials. If you also want to help the project participants - here You can make a donation or contact the team