Eugene’s Story

Collaboration between Ukrainian and American Health Professional Volunteers Gives Hope to Residents of De-occupied Regions
By Eugene Onofriichuk, Medical Student

I’ve been a Ukrainian medical team member with Global Care Force (GCF) for over a year, providing monthly visits to villages liberated from occupation. My role began as a “medical translator.” I am responsible for establishing contact between the GCF volunteer doctor or nurse with the patient at the mobile clinic. I want to share my experience with a detailed description of our medical team’s work and my motivation to join the team.

If we consider the full-scale invasion of Russia as a “sudden” event for the entire Ukrainian nation, we should remember the specific levels of suddenness for different regions of the country. A few days after Feb. 24, 2022, residents of central and northwestern regions had to analyze the situation and decide whether to stay or leave. As thousands of drivers were moving toward the western border and falling asleep in massive traffic jams, the claws of the Russian war machine captured the citizens of Mykolaiv, Kharkiv, Kherson, and Zaporizhya regions. The villagers became prisoners with no explanation of why their simple lives turned into torture by the eastern enemy’s laws.

GCF, a nonprofit organization that provides necessary medical care to disaster areas worldwide, responded to the call for help for the recently rescued Ukrainian citizens from Russian occupation. Once I learned that GCF provided services in Ukraine, I asked to join the team. Since that moment, my life became tied with the destroyed destinies of villagers, who we try to bring hope through medical care support every month.

Program coordinator Svetlana Kleschar registers people in the clinic lobby. Mykolaiv region. Oct. 2023

Initiative to Support the Unbreakable Ukrainian Nation: What is Global Care Force?

Global Care Force (GCF) began as COVID Care Force, created during the COVID-19 pandemic to respond to the international tragedy, sending healthcare professionals to the areas hardest hit by the pandemic.

In September 2022, Global Care Force sent volunteer medical teams to Ukraine to provide healthcare in previously occupied villages with the support of local authorities. The monthly teams serve rural areas of the Mykolaiv, Kharkiv region, and Kyiv regions. The clinics are held in the local medical facility (so-called “feldshers spot”), or anywhere the local authority allows. Patients go through the following stages at the clinics:

  • Registration – Patients receive a medical card created for them
  • Triage – includes “vitals” measurement (BP, HR, pulse, saturation, blood sugar, body temperature), discovering chief complaint and past medical history
  • Physician consultation
  • Receiving free medications in the pharmacy

While planning the first clinics, I knew Ukrainian interpreters (a role I performed later) would be needed. Interpreters are crucial for the clinics. They serve as a “communication bridge” between the patient and foreign volunteer, help the physician follow and consider Ukrainian medical care guidelines when prescribing treatment, and ensure a precise understanding of past medical history and important details during the consultation.

The principle for choosing regions for a visit is simple – going to where we are needed most. Many patients required help and their condition was becoming worse after each day with no access to medical care. It was predicted that many patients might be in a critical condition and require immediate hospitalization.

Every medical team is very well organized and coordinated and considers even the smallest aspects for the maximum efficiency of the mission. Roxanne Jones, Vice President of Global Programs at GCF, uses a multi-step approach to interview and choose the most experienced and competent volunteers to send to Ukraine. Jones tries to engage physicians of different specialties (emergency care, family medicine, internal medicine, etc.) to create multidisciplinary teams. Therefore, patients can receive the maximum volume of primary care.

Medical teams are equipped with the necessary tools to assess the function of practically every organ and system, enabling them to make informed decisions about the possibility of treating the disease conservatively or recommending urgent hospitalization. Furthermore, specific equipment such as the ECG machine and wireless ultrasound device is used to obtain a complete diagnostic picture of the disease. Patients receive maximum recommendations within the limits of their compliance, which is essential in terms of the problem of access in rural areas to primary care.

Global Care Force paramedic volunteer Chance Shaffner measures the body temperature during triage with the help of Andriy’s interpretation. Kharkiv region, Sept. 2023

Contributing to the Victory: My Motivation to Participate

From the beginning of the war, all Ukrainian citizens faced the critical issue of “personal contribution to the victory.” Moreover, often many Ukrainians got lost in the process of evaluating their knowledge and skills, never finding a vector of their application. Meanwhile, the number of social problems caused by the war increased every day, and the need for an instant solution grew before our eyes.

As a medical student, studying medicine at different social levels was critical. With a deep understanding of the problem of villagers’ access to primary care, my motivation was to help poor villagers who live in terrible conditions. I also wanted to introduce the Global Care Force mission to other medical colleagues and increase the number of Ukrainian doctors engaged in the fight against the aggressor. Therefore, I aimed to reveal the huge social problem by personally contributing to its solution.

The described social problem has been one of the most important in Ukraine. Unfortunately, it’s still unnoticed. The claim that the low medical care level in villages was induced by the war is a mistake. To be clear – the war aggravated it and made it critical. More than half of the villagers didn’t receive any complex health assessment. Furthermore, those who already suffered from chronic diseases when full-scale invasion began had their illness aggravated due to the strict wartime regime and occupation-induced stress. After being admitted to the team as a translator, I started my preparation for my first trip to the recently de-occupied villages of the Mykolaiv region.

From left: Dr. Lev Prystupiuk, Medical Director, Ukraine, Luibov Galisevych, Pharmacy manager, Roxanne Alexander Jones, Director Global Programs

The First Visit is the Toughest – How It Started for Me

The day after the team met in Kyiv, we drove towards Mykolaiv, a big city in the south where we would be based. We stayed for three nights and then drove to different villages every morning. It was hard for me to fall asleep that rainy night because it was the first time I went to an area directly damaged by the war. I had numerous expectations about the following day, and I fell asleep very late after becoming tired of analyzing them.

After breakfast and packing, we left the hotel at 8:30 a.m. We traveled by two vans in which we managed to fit about 20 containers of medical supplies in addition to 16 group members. Through the raindrops that slowly crawled down the car glass, I could see the unhealed explosion gashes, which stained the fields recently covered with the green of the spring sowing.

The moment of crossing the border of de-occupied territories was obvious. Fields fenced off by white and red ribbons, warning signs of “Dangerous! Mines!,” and many roadside “dead villages” where almost every house was partially destroyed by shelling left no doubt we were almost there. One village greeted our team with frightening silence: nobody was seen outside at the entrance and until the arrival point. Only a few curious villagers were viewing our arrival from behind the half-open doors of several houses. After stopping at the local medical facility, we deployed the mobile clinic within 15 minutes and were ready to see the patients.

A crowd started gathering near the registration table, and half an hour after setting up, it was almost impossible to walk through the corridor. Nearly 60 people signed up for an appointment. The majority were elderly women who managed to survive the worst 10 months of their lives. I asked one of the women why females made up most of the patients. She said, “Some of the men were killed, some forcibly taken away, and some managed to escape.” After hearing that simple and terrifying explanation, I realized the price paid for freedom and the opportunity to live.

That October, I worked with Albert, a physician assistant in psychiatry from Philadelphia, who dedicated his life and professional path to treating patients with post-traumatic stress disorder. Albert asked to refer all psychiatric patients to us, considering the unique opportunity for patients to have a complex mental health assessment.

I will remember our first patient forever. She was a middle-aged woman who developed a severe sleep disorder after almost nine months of occupation. After conducting a comprehensive assessment of mental health with the use of patient-reported outcomes scales, we established a preliminary diagnosis: severe anxiety-depressive disorder. After 40 minutes of communication, using several psychological techniques and gaining the patient’s trust, Albert managed to detail the main causes of the mental disorder. Through pain and tears, the woman shared everything that did not leave her thoughts and asked for only understanding. Professional ethics didn’t allow me and Albert to reveal what she said or her emotions, but the story we heard could not leave us indifferent.

After listening to the woman, we proceeded with treatment prescriptions. The most expedient management techniques in such a case are psychotherapy sessions combined with drug therapy. However, limited time and the impossible long-term follow-up by local specialists made it necessary to prescribe treatment “here and now.” Albert applied personal skills in psychotherapy and demonstrated several exercises to teach the patient to find solutions in her subconscious. He recommended that the patient conduct such sessions at home along with taking small doses of medication. At the end, the woman thanked Albert for his time, promised to follow all the recommendations, and left the clinic with hope in her heart and a smile on her face.

Serving the people through the clinic took approximately five hours. After letting the words of pain and fear pass through our hearts -while also giving hope to many compatriots – we drove back to Mykolaiv leaving the war consequences we faced behind. The successful work at the first clinic marked the beginning of a new story in my life, because since that time I’ve been attending practically each monthly GCF mission.

The warning sign “Dangerous! Mines! at the entrance to a village in the Mykolaiv region. May 2024

Survivor Stories – Forever in My Heart

At this point, I have already participated in more than 10 GCF missions. Due to the improvement of my theoretical and practical knowledge, I was allowed to provide various types of medical assistance on my own, which has significantly helped my professional growth. In each village, hundreds of stories are left behind, and each has found its place in memory. Unfortunately, the number of mental wounds left by the war is much larger, and some can’t be treated even with the strongest medications.

The story of Anna sticks in my memory. A small-caliber shell in a garden exploded when a woman picked it up. Anna barely survived. Her severe elbow injury, accompanied by intense pain,could not be relieved by common painkillers and anti-inflammatory medications. Due to the irreversible damage in the ulnar and radial bones, the only way to relieve the pain was a joint injection of steroids from rural pharmacies. Fortunately, during the last team visit, Anna was examined by highly skilled rheumatologists. In addition to injections that helped to relieve pain for a long time, the woman received wound care recommendations to prolong the pain-relieving effect. It allowed her to return to normal life, and she was very grateful for the support of the GCF medical team.

“I’ve been alone for many months because my son voluntarily went to the frontline. Before your visit, I had nobody to rely on and talk about my pain. I am very grateful for the hope you bring to us.” – Anna said with tears in her eyes.

My heart also treasured the story of Vira, a math teacher forced to move to another village when her native city was occupied. After devoting a big part of her life to teaching children and with the sudden disappearance of the opportunity to continue her work, Vira suffered severe stress. Moreover, hiding from the shelling in a cold basement for an extended period of time caused aggravation of several chronic diseases. Having no possibility of receiving proper treatment, Vira lost hope of getting things better. After the village was rescued from occupation, Dr. Gail Hacker, a family doctor from Oregon, examined Vira. Dr. Hacker quickly determined the severity of Vira’s chronic diseases and chose primary vectors for their medical management. After that, Vira became a permanent attendant of each clinic in her village because it was the only way for her to receive necessary treatment and control the disease flow.

Vira shared her thoughts after her consultation.

“I didn’t think that I could lose the purpose of my life – working with children – or return to a normal life even after the village was rescued. But I believe that it will happen, and you bring this day closer.”

I won’t forget the day when Tetiana, whose son tragically died on the frontline, came to see the medical team. She was under occupation for more than six months. praying to bring her only granddaughter, Lisa, to a safe place. The permanent worries about her granddaughter’s destiny severely worsened Tetiana’s health condition causing the development of severe anxiety disorder. Eileen, a trauma care provider from California, brought the chance for recovery. During her session, Tetiana learned how to make the first step to gain strength for solving her health problem and healing even the scariest mental wounds.

“Everything has become possible with your support because I didn’t receive any comprehensive diagnostics or treatment till now. I’ve worried for a long time that my anxiety could lead to severe consequences. But now I’m convinced I’ll find a way to heal myself. We need you here because you’re the only way to survive.”

From left: Volunteer Albert Bono, Eugene Onofriichuk, and a patient during the consultation. Mykolaiv region. Oct. 2023

Bringing Victory Closer

Since the first time I served with a GCF team I’ve been trying not only to change the consequences of the war’s destructive and violent effect but also help solve an essential social problem. I feel happiness when looking at the growth of health awareness and general medical knowledge of villagers and noticing smiles appearing on the faces recently full of despair. Every “thank you” makes our victory day get closer, which makes me convinced that we came here not in vain.

I want to express a special thanks to all the volunteers I served with and who helped me become a true team member. Thank you to the local authority of Ukrainian regions for supporting and coordinating medical teams before their visits. Thank you to everyone who put efforts to help the Ukrainian nation!

Global Care Force Medical Team, February 2024

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