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Notes from Abroad: Neurology on the Frontlines

Kateryna Potapova, MD, MHA Neurologist, Assistant Professor

Bogomolets National Medical University

Kyiv, Ukraine



1)    How it was that you found the opportunity to join us here in Boston briefly

On February 24, 2022, Russia commenced a full-scale invasion of Ukraine, escalating a war that began in 2014 with the annexation of Crimea and parts of eastern Ukraine. In the face of this invasion, every Ukrainian feels the need to contribute to the defense against the aggressor and hasten victory in one way or another.


As a neurologist and teacher at the Neurology Department at Bogomolets National Medical University, one of the best medical schools in Ukraine, my primary goal is to acquire the necessary skills and practical knowledge to improve the quality of medical care for the population in these challenging times of modern warfare. The medical education process, even in the cities further from the warfront, including Kyiv, also suffers from the negative impact of constant air alarms and threats from the air, which necessitates interrupting the educational process. Imagine the numbers: since February 24th, there have been 36,675 alarms across Ukraine, with each one lasting an average of 1 hour and 6 minutes. To continue learning and teaching others, it is necessary to continuously improve knowledge and to plan possible steps for strengthening the capacity of Ukraine's healthcare system.


With this goal in mind, I sought opportunities for training abroad. During my search, I came across information about the possibility of training at the world's top clinics, the teaching hospitals of Harvard Medical School. The opportunity was organized by the Harvard Scholars at Risk Program, Heal Ukraine Group, and Global Medical Knowledge Alliance. Observership programs aim to spread the opportunity to implement acquired knowledge in Ukraine, and I wholeheartedly share this idea. Therefore, besides expressing my desire to participate in the training program, I also applied as a volunteer to contribute as a medical strategy expert for HealUa app and as an author of educational materials for patients through the GMKA platform.


2) Your work developing educational materials in neurology to other doctors in Ukraine

 

          Amidst these challenging circumstances, Ukrainian healthcare professionals are tasked with the critical mission of saving the lives of millions of citizens,

enduring artillery fire, and seeking shelter in bomb shelters, tirelessly serving in military and civilian hospitals, both on the frontlines and in rear areas. However, the widespread displacement of medical personnel has intensified the shortage of primary care physicians and specialized specialists in various regions. In order to contribute to enhancing the quality of medical care and to share my expertise, I joined the HealUA app, developed by GMKA. This platform facilitates peer-to-peer consultations among Ukrainian physicians, as well as with physicians from other countries, on a non-commercial basis. From May 2022 to February 2024, 3,538 physicians joined HealUA, with the majority (95%) from Ukraine. Notably, among the users, 13% were neurologists and neurosurgeons, highlighting the importance of HealUA to neurological care.

This application has become essential for Ukraine, allowing instant access to expertise even in frontline zones like the Luhansk or Donetsk regions. 42.5% of the submitted neurological cases received consultations from international experts.


This underscores the global reach and collaborative nature of HealUA, providing a platform for knowledge exchange and expertise-sharing beyond national borders.

Another important part of my humanitarian work is writing educational materials for patients. Our team at GMKA focuses on combating misinformation prevalent in Ukraine's medical information space. We are raising awareness about modern diagnostic and treatment protocols, oncological screenings, chronic neurological conditions management, and acute emergencies, which have been exacerbated by the war. We translate materials from English, primarily focusing on best practices from around the world, making them accessible to Ukrainian patients who may not understand English. A significant number of professors and doctors from Harvard Medical School have joined in writing materials for patients and for doctors in Ukraine, and we are sincerely grateful for their involvement in this project.


3) And how the current war in Ukraine has changed the state of neurology – as you mentioned, you are a neuroimmunology/MS doc who has now became a general neurologist because of the nature of the needs of the population which are related to war injury.

Since 2022, Russia has attacked and destroyed approximately 1525 medical facilities in Ukraine. Due to the Russian invasion, Ukrainian health care is facing disruptions due to damaged hospitals and logistical problems. Consider these harrowing statistics:

●      More than 1382 attacks have been made on Ukrainian hospitals;

●      717 attacks damaged or destroyed hospitals and clinics;

●      Nearly 210 Ukrainian health workers have been killed, kidnapped, injured, or arrested;

●      Over 13 million Ukrainians have been displaced, with 6.7 million refugees abroad and 6.6 million internally displaced;

●      There have been 30,457 civilian casualties, with 10,582 killed and 19,875 injured. However, OHCHR specified that the real numbers could be higher.



As for the impact of the ongoing war on neurology in Ukraine, it has necessitated a shift in focus from specialized areas like neuroimmunology to more general neurology due to the influx of war-related injuries, such as traumatic brain injury, posttraumatic epilepsy, peripheral neuropathy, etc. Chronic conditions and their management, for example, multiple sclerosis or epilepsy remain prevalent, posing significant challenges to the Ukrainian healthcare system already strained by the demands of wartime.

The war unleashed by Russia against Ukraine is a tragedy not only for the Ukrainian people but also a global challenge. Only by uniting our efforts can we stop the aggressor, and education is one of the tools that can aid in this endeavor. Every life matters, and every life saved counts.


If you are a medical professional interested in participating in humanitarian projects for Ukraine, please contact the Harvard Scholars at Risk Program, Heal Ukraine Group, and Global Medical Knowledge Alliance to clarify details and opportunities. You can download the application for responding to clinical cases from Ukrainian doctors in the HealUa app.

 

 













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