Canadian medical team helps injured in Ukraine

A team of medical professionals from across Canada recently returned from a one-week volunteer mission to Ukraine, having treated 30 patients and performing 37 post-traumatic reconstructive surgical procedures otherwise unavailable to the people there.

On the weekend of arrival, the team initially met with the local Ukraine health care team, receiving a formal tour of the facility, the main military hospital in Kiev. One wing of hospital operating room suites were emptied for them, as were three recovery rooms, three hospital patient rooms, one minor dressing room, change rooms, a lunch room and clinic space for new patients, and access to an Intensive Care Unit above the area that they had access to.

“It was a little hospital provided for us within a larger operating 1,000-bed hospital,” says Dr. Oleh Antonyshyn, head of the mission, and head of the Adult Craniofacial Program at Sunnybrook.

That same weekend, the team began their first clinic and consultations with patients, and the anesthetists, anesthetist assistant and nursing staff set up the operating room, sorting and preparing tools and equipment.

On the Monday, they started operating. “The cases were enormous and very complex technically,” says Dr. Antonyshyn. “We tried to get through as many as we could.”

The initial mandate was to provide specialized post-traumatic reconstructive surgical procedures for civilians who were injured in demonstrations from last year. However, due to ongoing conflict in the region, more than half of the patient cases seen were from more recent trauma.

“Following Euromaidan demonstrations, 1,200 were hospitalized with major injuries, and some had already been operated on,” says Antonyshyn. “Those remaining were students who couldn’t afford to go out of country for treatment and those whose cases were too complex.

Since then, the United Nations Office for the Coordination of Humanitarian Affairs documented an additional 9336 wounded in anti-terrorist conflicts in Eastern Ukraine (UN SITREP, Oct 31,2014). This comprised our patient population.”

We focused on the reconstruction of post-traumatic deformities, including isolated skull defects, eyelid orbital defects, scars, gunshot, shrapnel, missile and sniper wounds. “These were young otherwise healthy individuals with wounds healing. One patient had a post-explosion jaw defect and a vulsive lip injury. We had to cut his lips to open his mouth sufficiently to intubate and then performed a complex jaw reconstruction. On the very next operating table, in the same room, a second team was completing an orbital reconstruction.”

Highly organized, the team met at 8 am each morning to determine who would be in each OR and with which case. When not operating, the teams went to other hospitals to provide medical opinions on cases; for Dr. Antonyshyn, he consulted on maxillofacial cases and for Sunnybrook neurosurgeon Dr. Todd Mainprize, he consulted on neurosurgical patient cases.

Before leaving, the team arranged to leave behind their supplies and equipment to help local medical staff continue their work. They conducted one last outpatient clinic to check in on patients to minimize the incident of follow-up complications.

“We tried to select patients with large deformities which had not been previously attended that we knew we could address in a single, albeit sometimes long operation,” adds Dr. Antonyshyn.

Although the team is now back on Canadian soil, patients can continue to follow up with the medical residents if they have any questions about their recovery.