1. The author has been running anaesthesia projects in Ukraine for 10 years, where hospital infrastructure is often dilapidated and equipment, drugs, and resources are in short supply. 2. He provides training to anaesthetists, nurses, and ambulance crews ("feldshers") on airway management techniques and new equipment. Training sessions are held in hospitals and medical schools. 3. The author expresses gratitude to Intersurgical for supporting his work in Ukraine through the donation of equipment and supplies for training. Without this support, the projects would be difficult to facilitate.

1. Article for Intersurgical UK John M Allwood West Middlesex University Hospital
For the past 10 years I have been running local level , with acute shortages of
several anaesthesia related projects in equipment ,drugs and resources to
Ukraine . My previous form includes a very upgrade and repair buildings .When I
lengthy spell at MSAVLC (medical and first arrived back in 2002 it was
scientific aid to Vietnam , Laos and commonplace to see IV cannulaes re-
Cambodia .By way of an introduction the sterilized between patient use , however a
state of most of the hospitals and health reassuring glance into the peroxide
care institutions is inversely proportional to sterilizing tank confirms that this practice
the modern , state of the art stadium , has been confined to history . and
currently being showcased nightly on our toothpaste employed as a fixative for ecg
tv screens during Euro 2012 .Dilapidated electrodes as they journeyed from patient
run down infrastructure often walks hand to patient. Neccesity is the mother of
in hand with obsolete equipment , and invention and adapting old lemonade
the average monthly salary of a senior bottles for redivac drain substitution is just
clinician is roughly £250 . one example of local ingenuity and
invention from many that come to mind.
Illustration 1: One of the main operating rooms Illustration 2: getting ready for the next
ternopil regional Hospital operation , auoclave in trauma theatre
Ternopil Regional Hospital 2011
The BBC was saying that back in 2010 that
Equipment generally is used carefully and
hospitals budgets in ukraine , nosedived
sparingly to prolong their lives , Single use is
after a 75% reduction in state financing
not in the medical lexicography in this
,the effects are noticable and impact
part of the world .The clinicians are well
heavily on the delivery of healthcare at a
trained and educated and very well up to

2. Article for Intersurgical UK John M Allwood West Middlesex University Hospital
date with our techniques and approaches
to the delivery of “western” healthcare
due to the advance in social media sites
and availability of information which is
avidly digested ,and any visit is always
well anticipated and attended
On a practical level, most of my on the
gound time is in western ukraine ,in the
Illustration 4: Putting the knowldege into
cities of Ternopil and Chortkiv about practice
400km southwest from the capital kyiv.
and normally reached by an overnight The medium of communication is English,
train journey. My purpose is spent my first 1 hour lecture back in 2002 took 3
organizing airway orientated workshops hours with “ lost in translation issues “
and talks in conjunction with the local restricting the flow of the topic's ,
medical universities and departments of however now both the content and
anaesthesia . delivery has been streamlined and we
have a well seasoned pool of English
speaking anaesthetists on hand to assist .
As interns , junior anaesthetists spend 2
years on their basic anaesthesia training ,
so there is always a fairly quick turnaround
and new mouths to drink at the fountain of
Illustration 3: a well attended resuscitation and knowledge The benefits are immense and
airway management study morning at chortkiv
medical college not only allow local practitioners the
tactile pleasure of using contemporary
airway devices , but learning their
significance in our airway algorythm's
and which is my basic template for the
delivery of learning. Depending on the

3. Article for Intersurgical UK John M Allwood West Middlesex University Hospital
location and learning group complexion reliance instead placed on the spoken
and level of expertise numbers can vary word and the showing of instructional
between from 3 to 6 product CD roms , for more advanced
sessions we use real time operating lists ,
though this is normally for senior
practitioners and university faculty
members ,the rationale is that they can
then cascade the learning to the the
more junior / inexperienced team
members in their native ukrainian
language , and besides it keeps numbers
Illustration 5: senior clinicians study session on to a minimum during busy operating
airway devices Chortkiv Hospital
sessions.
senior clinicians or up to 150 when we do
a general airway management study
session for nurses. Locations are usually in
the hospitals themselves or in a dedicated
lecture theatre ,and have even been set
up in hotel rooms when circumstances
Illustration 6: completion of airway management
study morning ternopil regional Hospital
have dictated this option .The learning is
delivered on a practical hands on basis illustration 7: Dr Olexiy Kuybida at regional Hospital
Powerpoint is used sparingly with a ternopil during iGel Study session

4. Article for Intersurgical UK John M Allwood West Middlesex University Hospital
In addition to anaesthestists and nurses we Ternopil later in the year .In finishing this
also offer teaching to a group of short article ,it has to be said that without
professionals called Feldshers , they crew intersurgicals help and assistance these
the local ambulances , assist at births and projects would be difficult to facilitate and
a whole lot more besides . through this article I would like to express
my immense gratitude to the company
and to Andy Masterman ,for all the kind
help over the years if anyone would like
any further information I have had several
feature articles published and would be
happy to provide copies upon request.
I would also like to thank mr Carl
Hollinshead and Dr Ali Rahmaty in ably
Illustration 8: front enterence Local hospital in assisting me in my ventures and to Dr
Bukachivtsi
Tetyana Potupalova Dr Maxsym
It might be of interest to say that in places
Doroschenko ,Prof Alexander Olenyiuk
like the small hospital in Bukachivtsi , which
and Dr Olexiy Kuybida or all their help and
is reliant on Feldshers , in winter time , the
assistance .
temperatures here plummet to -35
celcius , the roads become impassable ,
so they use the horse and cart as the
John Allwood june 2012
rescue ambulance.
As a follow on to local teaching and
this article has been written exclusively for
learning I have set up and successfully run
intersurgical UK , all images copyright john
a programme whereby ukrainian
allwood
anaesthetists come to london for further
training. To date 4 have arrived and we
have a waiting list of future participants For
the future I have new projects in the city of
Zaphorizhe in eastern Ukraine coming up ,
which I am excited about , and a return to