6. Ukraine:
Current Trauma Status
• United Nations Office for the Coordination of Humanitarian
Affairs (OCHA) , Sept 5th, 2014:
• 2,905 deaths, including 28 children
• 7,640 wounded, including 58 children
7. CUF MEDICAL MISSION:
Objectives
• To assess the needs for further treatment of those
wounded during the events of the mass protests in
Ukraine since Nov. 21, 2014
• Evaluate the capacity and needs of the various medical
facilities and services in Ukraine
• Characterize the range and scope of post-traumatic defects
and deformities
9. CUF MEDICAL MISSION:
Objectives
• To assess the needs for further treatment of those
wounded during the events of the mass protests in
Ukraine since Nov. 21, 2014
• Evaluate the capacity and needs of the various medical
facilities and services in Ukraine
• Characterize the range and scope of post-traumatic defects
and deformities
10. CUF MEDICAL MISSION
• Evaluated Capacity and
needs of:
• Emergency Services
• Medical Technology
• Operating Rooms
• Intensive Care Units
11. CUF MEDICAL MISSION
• Evaluated capacity and
needs of:
• Emergency Services
• Medical Technology
• Operating Rooms
• Intensive Care Units
12. CUF/UCC MEDICAL MISSION
• Evaluated Capacity and
needs of:
• Emergency Services
• Medical Technology
• Operating Rooms
• Intensive Care Units
13. CUF/UCC MEDICAL MISSION
• Evaluated Capacity and
needs of:
• Emergency Services
• Medical Technology
• Operating Rooms
• Intensive Care Units
14. CUF MEDICAL MISSION:
Objectives
• To assess the needs for further treatment of those
wounded during the events of the mass protests in
Ukraine since Nov. 21, 2014
• Evaluate the capacity and needs of the various medical
facilities and services in Ukraine
• Characterize the range and scope of post-traumatic defects
and deformities
15. CUF MEDICAL MISSION
Outpatient Clinics
• Direct patient
assessments in
conjunction with
Ukrainian physicians
and surgeons
16.
17. Maidan
Trauma Etiology and
Characteristics
Sniper injuries
Rubber bullets
Non-lethal and globe
(head) trauma
24. Surgical Initiatives
• Operation Rainbow Canada Surgical Mission
• Kyiv, Nov 2014
• Telesurgery
• Lviv and Kyiv, Summer 2015
• University of Toronto Department of Surgery
Observerships
• Fall 2015
25. Operation Rainbow Canada
- Volunteer non-profit medical services organization which functions
without paid staff and provides free reconstructive surgery for cleft lip
and cleft palate deformities to needy children and young adults in
developing countries.
- 23 international missions since 1998
26. Operation Rainbow Canada
• 100 operations in 1
week
• Treat patients that would
not otherwise be treated
27. Operation Rainbow Canada
Dr Kimit Rai
ORC Surgical Team
- Self-contained surgical team of 20
surgeons, anesthetists, nurses
- All surgical instruments, tools and
supplies
- All medication, dressings and
disposables
28. Operation Rainbow Canada
Kyiv, Nov 6-16,2014
• Objectives
• Provide free reconstructive surgery to those with deformities
and injuries that would otherwise not be addressed
• Promote surgical education to expand the medical
infrastructure and create self-reliance
29. Operation Rainbow Canada
Kyiv, Nov 6-16,2014
Patients
1. Euromaidan victims
with established post-trauma
deformities
2. Casualties from
current conflict with
terrorists in Eastern
Ukraine
30. Rainbow Surgical Team
• 2 plastic surgeons, 1 hand/microsurgeon, 1 neurosurgeon, 1
general surgeon, 1 plastic surgery resident/fellow
• 2 anesthetists, 1 anesthesia fellow
• 1 internist
• 5 OR nurses, 3 PACU nurses, 1 preop nurse
• 1 mission coordinator
• 1 admin support
32. Operation Rainbow Canada
Kyiv, Nov 6-16,2014
• Host facility will be the
Main Military Hospital,
Kyiv
Editor's Notes
Good Evening Honoured Guests. Prime Minister Harper, Reverend Fathers, Rabbi Frydman-Kohl, Ambassador, … and friends.
Thank you for coming tonight to support our humanitarian medical efforts in Ukraine.
I’d like to take this opportunity to describe the current urgent medical needs in Ukraine, our partnership with Operation Rainbow Canada, and how we plan to provide help to those in Ukraine who need it most.
Confrontations between civilian demonstrators and armed Government police, militia and Berkut forces became increasingly violent
Since the end of Euromaidan, Putin has entered Ukraine, annexed Crimea and started a war in Donetsk and Lughansk regions.
As a direct consequence of these actions, the UN reports over 7,000 injuries. These include soldiers, innocent bystanders, and 58 children
The Canadian Ukrainian Foundation organized an urgent Medical Mission to Ukraine in April 2014
Khristia Waler, Dr George Huculak, Dr Ulana Suprun, Andrij Pivtoran, Dr George Luckiw,
Met with first responders and physicians who provided primary care at MedPunkty on the Maidan,
Assessed the resources available locally to deal with acute trauma as well as post-traumatic reconstruction and subsequent rehabilitation
We evaluated over 30 OR’s in Donetsk, Kyiv and Lviv to determine where a Canadian surgical team may be function effectively
And multiple ICU’s and Recovery Rooms to evaluate the facilities available for postop care
Direct patient assessments were undertaken in conjunction with Ukrainian physicians and surgeons, to determine the specific needs of Maidan trauma victims and to characterize the residual post-traumatic issues
Rubber bullets, which are designed to function as a deterrent in crowd control, were employed to inflict maximal damage, resulting in an incredibly high number of globe injuries
Blunt trauma, from punches, kicks and clubs resulted in a disproportionately high incidence of craniofacial trauma
Use of live ammunition in Feb 2014 resulted in a dramatic increase in the severity of injuries
During our outpatient clinics, we had an opportunity to assess a large population of patients with residual post-traumatic deformities that have not been addressed.
The resources and surgical expertise required to deal with these post-traumatic defects and deformities are simply not available in Ukraine. The most prominent deformities are:
The CUF-sponsored Medical Needs assessment resulted in multiple initiatives that we are now acting on. The primary surgical initiative is the Canadian Surgical Mission to Kyiv scheduled for this November.
Our immediate focus is the Surgical Mission to Ukraine
This will be organized through an existing humanitarian organization, Operation Rainbow Canada
Every year, Operation Rainbow send a team to developing countries or remote areas, where cleft children do not normally receive surgical care
Operation Rainbow Canada is partnering with the Canadian Ukrainian Foundation to support a surgical mission to Kyiv, Nov 6 – 16, 2014
The objectives are to:
1. Provide reconstructive surgery to restore the lives of those with deformities and injuries that would otherwise not be addressed
2. Promote surgical education by actively engaging local medical professionals, to expand the surgical infrastructure and create self-reliance
Scope of surgical presentations
Traumatic and post-traumatic deformities that are repairable through a single surgical intervention
Skull
Face
Hand
The team includes approximately 20 individuals. The specialists involved are dictated by the specific needs of the patient population.
All the surgeons are Canadian surgeons who are expert in treating craniofacial and hand trauma.
How do we identify the patients?
We are actively triaging now and will be doing so for the next 2 mos