Support for Ukraine's trauma victims

DOCTORS AND RESEARCHERS at Yale School of Medicine (YSM) with friends and family in Ukraine have organized to raise funds and equipment for overwhelmed hospitals in the embattled country.

The Russian invasion of Ukraine left doctors at YSM who have Ukrainian roots feeling distraught and frustrated. Instead of stewing, they acted, forming an organization to channel desperately needed medical supplies and equipment to their overwhelmed Ukrainian colleagues. Doctors United for Ukraine (DU4U) has so far delivered more than $1 million in medical and mental health aid to the embattled nation, said DU4U’s Vice President Andrey Zinchuk, MD, MHS, assistant professor of medicine.

“We were lucky to find people who shared our worry and shared our hope that we can ameliorate some of the war’s effect on people,” said Zinchuk, who came to the United States as a boy with his family in 1992. “It’s also an action for self-preservation. If you make a difference, you are not hopeless.

What you do matters. The group’s major focus is providing medical supplies and equipment to treat acute war injuries—everything from shattered limbs to severe abdominal and chest wounds. Needs range from basic tools like drainage tubes and fixators to repair broken bones to more sophisticated items, such as wound vacuums and field ventilators, to keep patients alive until they reach a hospital.

“These women and men [Ukrainian health care workers] have done an impressive job with the resources they have,” Zinchuk said. “They are incredibly grateful for the resources from charitable organizations. We are not the only ones.”

DU4U operates differently from some charitable organizations, which typically send pallets of materialstowarehousesmanaged by Ukraine’s Ministry of Health.

Zinchuk and his fellow physicians talk directly with Ukrainian critical care doctors and military hospitals to learn their specific needs. DU4U then buys the equipment and sup-plies in Ukraine or Poland, and ships them directly to where they are needed. The group has also received in-kind donations from manufacturers, he said. Recipients close the loop by sending photos of the items in use.

“It’s sort of like Etsy for medical purposes, a small-scale grassroots effort,” Zinchuk said.

But while the program has been an overall success, the ongoing destruction and violence are never far away. Last September, a Russian missile strike destroyed a mobile hospital and about $100,000 of medical items supplied by the group.

DU4U is also helping Ukrainians cope with the war’s psychological impact. Group Co-president Irina Esterlis, PhD, associate professor of psychiatry, is helping mental health professionals in western Ukraine—a relatively safe region—treat refugees from Eastern Ukraine who are traumatized by the war. One of the most serious challenges is that Ukrainian psychiatrists and therapists aren’t trained to treat post-traumatic stress, Esterlis said.

“A lot of psychologists in Ukraine have psychoanalytical or Gestalt training, which focuses on early-life experiences,” said Esterlis, who was born in Ukraine. “Acute trauma that you experience in war or being raped or seeing your parents killed has nothing to do with how you were raised. A lot of them don’t know how to treat people with acute trauma because they’ve never been in that situation.”

Helping empower Ukrainian mental health professionals with new skills so that they can treat post-traumatic stress is therefore a top priority for the group, Esterlis said.

DU4U’s third focus is women’s health care. The group’s other co-president, Alla Vash-Margita, MD, associate professor of obstetrics and gynecology, is helping her Ukrainian counterparts treat pregnant women and women who have been raped. The needs range from IV solutions given to women in labor to gynecologic instruments like hysteroscopes and laparoscopes, said Vash-Margita, an Ob/Gyn. The stress of war inevitably affects preg- nant women in negative ways, said Vash-Margita, who is from Ukraine and graduated medical school there.

“From the maternity side, there’s a great need because of the stress and poor living conditions,” she said. “Women are lying in basements or traveling, with no connection with loved ones. Many women experience miscarriage or preterm labor. We’ve been asked to provide medication to prevent preterm labor and to prevent postpartum hemorrhage.”

Treating rape victims is challenging because so many choose to keep the attack secret due to shame and stigma, and medical assistance often becomes available only at some time after the assault, Vash-Margitasaid.

The three faculty members agree that the need for help remains enormous. “It’s not like you give 1,000 people services and now there’s 100,” Esterlis said. "That 1,000 keeps growing."

Zinchuk is so far the only one of the three faculty members to travel to Ukraine since the war began; he went last June to help set up a program to replace heart valves for vulnerable patients in the western part of the country. During the trip, he visited Borodyanka, a town near Bucha that also saw Russian atrocities, he said. What he witnessed left a deep impression.

“It’s one thing to hear about it and to read about it, it’s another to experience it,” Zinchuk said. “What we saw there was horrendous. Destroyed buildings. Destroyed lives. The remains of people’s lives like children’s notebooks; toys, clothes in the building’s rubble. A pharmacy that’s destroyed. That’s a meaningful experience for us, and it provides motivation.”

DU4U could not do its work without partners. Dwight Hall at Yale, a center for public service and social justice, has been acting as their fiscal sponsor. “They [Dwight Hall] have been our lifeline, helping us receive donations until we can build up our enterprise,” Zinchuk said. Similarly, William Rosenblatt, MD, professor of anesthesiology, and his REMEDY nonprofit organization have donated surgical supplies to DU4U.

Asked what DU4U needs, the YSM participants are blunt: money. After an initial outpour- ing, donations have slowed. The group, which recently obtained nonprofit status from the IRS, has conducted fundraisers in the past months, including a benefit concert by the New Haven Symphony, Zinchuk said.

"We're hoping to ramp up," he said. "I think the challenge is that in the last few months, people are getting tired. Ukraine is not the top line of the news anymore. Similarly, the donations have petered out. We have to work harder to fund our mission.”

To donate to Doctors United for Ukraine, visit dwighthall.org/doctors-united-ukraine, which is hosted by Dwight Hall at Yale.