Introduction:
The report aims to provide an overview of the "Growing Humanitarian and Healthcare Crisis in Ukraine" webinar, held on June 21, 2023. The webinar focused on discussing the ongoing health care crisis in Ukraine, the impact of the war on civilian life and the country's health care system, unmet needs, opportunities for international collaboration, and the efforts of various organizations in addressing these challenges.
Participants:
Mark C. Poznansky, MD, PhD: Director, Vaccine and Immunotherapy Center, MGH; HUG Co-Founder; Professor of Medicine, Harvard Medical School.
Nelya Melnitchouk, MD, MsC: Colorectal Surgeon, BWH; Assistant Professor of Surgery, HMS; President and Co-Founder, Global Medical Knowledge Alliance.
Marianna Petrea-Imenokhoeva: Founding member at HTWB (Health Tech Without Borders).
Jeff Hersh, PhD, MD: Board Member at HTWB.
Sofiya Hrechukh, MD: Psychiatry; Lviv; BWH.
Vadym Vus, MD: Family Medicine; Rivne Oblast; MGH.
Arkadii Vodianyk, MD: Infectious Diseases; Kyiv; MGH.
Organizations:
HUG GoFundMe: https://gofund.me/4a5f8781
GMKA: https://gmka.org/
HTWB: https://www.htwb.org/
Full recording is available: https://youtu.be/OZ6532GzLTQ
Dr. Mark Poznansky's speech highlighted the ongoing war in Ukraine and the urgent need for support. He emphasized the severity of the conflict, comparing it to some of the most intense fighting in Europe since World War II. The invasion by Russian forces has resulted in high casualties and humanitarian crises. In his speech, Mark Poznansky mentioned the "kill twice effect" as a Russian military strategy of destruction, targeting healthcare facilities in Ukraine. He highlighted the resilience of Ukraine's healthcare system, stating, "The fact that the healthcare system in Ukraine continues to operate amid such circumstances is a testament to the heroic dedication of healthcare workers."
Poznansky also discussed the Scholars at Risk program, which involves training Ukrainian physicians and surgeons. He stated, "We've trained seven Ukrainian physicians in person here, bringing medical specialties from psychiatry to infectious disease and surgery." He further mentioned the involvement of over eight medical and surgical teams from institutions like Mass General, and Brigham and Women's Hospital, freely giving their time to assist in rebuilding Ukraine's healthcare system.
During the webinar, Dr. Nelya Melnitchouk, a colorectal surgeon at Brigham and Women's Hospital, highlighted the importance of addressing the educational needs of Ukrainian physicians and patients. She emphasized the language barrier and limited access to evidence-based literature as major challenges. To tackle this, she co-founded the Global Medical Knowledge Alliance, providing free evidence-based educational materials in Ukrainian. With the outbreak of the war, they expanded their focus to trauma and mental health education. Dr. Melnitchouk also discussed their partnership with Heal Ukraine Group and Harvard Scholars at Risk, offering hands-on training for Ukrainian physicians in the United States. She stressed the significance of education alongside medical supplies, as proper knowledge and skills are crucial for positive patient outcomes. "Large number of Ukrainian soldiers after they are being treated, they come actually back to the front lines, so we have to do our share and as my husband says, software is as important as hardware and probably even more important. So, we're trying to help Ukraine with that need, focusing on those educational opportunities."
Dr. Sofiya Hrechukh, the head of the Department of Psychiatry in Ukraine, expressed her gratitude for the opportunity to learn in the United States. She highlighted the increasing mental health needs in Ukraine, particularly among civilians and soldiers affected by the war. As well as the importance of training for mental health professionals, citing her own challenges in treating a patient who had experienced torture. She stressed that training alongside with humanitarian aid or drugs, is crucial in addressing the complex needs of individuals who have suffered greatly. As the trauma is expected to escalate even further after the war ends, Dr. Hrechukh urged for trainings to be provided to psychotherapists and psychiatrists in Ukraine.
Dr. Arkadii Vodyianyk highlighted the challenges faced by healthcare facilities in Ukraine due to the ongoing war, with over one thousand attacks on health reported. These attacks create numerous obstacles, including constant shelling and an influx of patients, leading to challenges in providing adequate care. He emphasized the importance of preparedness in healthcare facilities to mitigate the impact of such threats. Dr. Vodyianyk also mentioned recent developments, such as ensuring infection prevention control requirements and enhancing surveillance of antimicrobial resistance. "Just after the return from Mass General Hospital, we initiated the development of cumulative antibiogram in one of the health capacities. Now we finalize it and discussed with the Minister of Health the possibility to roll it out to all Healthcare facilities that have software for data collection, which is one-third of all Healthcare facilities. These days, the results that we obtained showed some very worrisome situations but also some opportunities on how we can improve the treatment of patients." He highlighted the need for training and adaptation of knowledge in the country's context to overcome the unique challenges posed by the war.
Dr. Vadym Vus expressed his gratitude for the invitation to Boston and highlighted the importance of the ongoing training despite the challenges in Ukraine. He mentioned the diverse activities of his FOCUS POCUS ultrasound team and their most recent training in ultrasound methodology and diagnosis at the Azov Family Medicine Conference of Ukraine, and partnership with the Christian Medical Association. They provided several training courses for military doctors and distributed portable ultrasound devices. Dr. Vus also participated in podcasts and conferences, discussing medical education, and exploring disruptive innovation for Ukraine. He emphasized the need for assistance in organizing evacuation systems, effectively using ultrasound, and addressing the issue of post-traumatic limb care. He expressed a desire for collaboration and knowledge-sharing to enhance training and thanked the audience for their support.
Marianna Petrea-Imenokhoeva discussed “Helping Healers Heal”, the peer-to-peer support program, which aims to address the mental health needs of Ukrainian mental health professionals during the war. Marianna acknowledged the complexity of the task and the scarcity of experts in specific areas like child psychiatry and assault victims. Marianna describes the evolution of the program, starting with webinars and realizing the need for peer-to-peer support to assist Ukrainian psychologists dealing with secondary trauma. She expressed the unique and complex nature of the problems in Ukraine, highlighting the potential for Ukrainians to become experts in addressing these challenges. She mentioned the telehealth support provided in collaboration with the Ukrainian platform Doctor Online, where they have delivered more than 170.000 consultations. She introduced the Tactical Medical Chatbot developed by Health Tech Without Borders, which aims to provide support and education in tactical medical response. Additionally, Marianna mentioned Dr. Nelya Melnitchouk's efforts in teaching in-person and online classes, specifically focusing on the "Stop the Bleed" program for citizens.
Destruction of the Kakhovka hydroelectric dam
Jeff Hersh’s speech was focused on water, sanitation, and hygiene (WASH). Jeff highlighted that approximately a quarter of the planet lacks reliable access to clean drinking water, while half the planet faces limited or insufficient sanitation services. He connected these global challenges to the situation in Ukraine, where the recent destruction of a dam caused flooding, disrupted sanitation, and tainted the water supply with chemicals and heavy metals. Jeff mentioned the efforts of Health Tech Without Borders in partnership with other organizations to provide water purification systems and address the WASH needs in Ukraine. He also emphasized the far-reaching ramifications of the water crisis and the necessity of long-term solutions to overcome the challenges caused by the destruction of infrastructure.
Dr. Arkadii Vodyianyk highlighted the impact of the destruction of the Kakhovka hydroelectric dam on both sides of the river. The left side, which the Ukrainian government lacks access to, suffered more severe consequences due to its flat geography. He mentioned that nearly half of the water samples currently do not meet safety standards, leading to communication efforts to educate the population on water usage and preparation. While there hasn't been a significant increase in waterborne diseases or infectious diseases yet, the long-term consequences are expected to affect various sectors beyond drinking water, such as production and farming. The implications on healthcare and the population in affected regions are likely to be more challenging and sensitive in the future.
Dr. Sofiya Hrechukh shared her experience with mental health cases following the Kakhovka disaster. She observed that after the news of the disaster, previously stable patients experienced mental breakdowns, necessitating inpatient care. The impact on mental health, though invisible, became more pronounced due to exposure to news through social media and the internet. Dr. Hrechukh and her colleagues are striving to develop new communication channels, such as YouTube and Telegram chatbots, to provide support to citizens. She emphasized the need for training and resources for mental health workers and discussed efforts at the national level, including the Ministry of Health opening mental health centers, bringing back psychologists and psychotherapists to general hospitals, and providing sponsorships and scholarships for psychiatrists.
In this concluding part of the webinar, a question was raised about preparedness for a potential compromise of the nuclear power plant. The response emphasized that while there are measures in place, it is difficult to be fully prepared for such events given their scale and complexity. The speakers expressed their belief in the future and the importance of unity and international support to rebuild and improve healthcare and mental health services in Ukraine. The need for continued assistance, both in terms of resources and expertise. They highlighted the resilience and determination of the Ukrainian people to create a better future.
The webinar concludes with a reminder of the QR code for donations to the Global Medical Knowledge Alliance, which aims to support educational programs related to the healthcare crisis and reconstruction in Ukraine. The panelists expressed gratitude for the support received thus far.
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