THE MEDICAL SYSTEM IN UKRAINE. WHY CHANGES ARE NEEDED
Medicine is the criterion that determines the attitude of the state towards its citizens, especially those who stand up to its defence.
The turning point for Ukrainian medicine was the war with its precursor during the Maidan shootings. But is it ready to admit its mistakes, and moreover correct them?
We met Sergiy Merchuk at a festival in Lutsk in the summer of 2015. We came across him earlier during the crossfires at the Maidan, in a hospital where the casualties were taken. Some of the casualties were Sergiy's friends.
After these events he served in the special regiment "Azov", went through the "Patriot Defence" tactical medicine course, returned to civilian life and is currently working for the Lutsk patrol Police.
During our conversation Sergiy recalls the events of February 2014. One of his friends, Vasily Moysey, was injured: "Seeing Vasily wounded, knowing that type of wound, that was all too present in the east, and now having first aid training, I can say today that he could have been saved."
When Moysey was transferred from the stretcher, which was used to transport him to an ambulance, Sergiy noticed a pool of blood. Only after, in the prosecutor's office, did he learn from a photo that the wound was much larger than he thought: "The bullet passed right through Vasily. I only saw the top hole, which I closed and the blood stopped. Now I know, that in the first aid kit there is a seal that allows me to close up holes from both sides."
Sergiy himself received close to eight light wounds on his body. A rubber bullet made a wound 3 centimetres deep. "When I arrived at the hospital, I said that I work for the "CTO" and hit myself on a pin" Sergiy admits. "The doctor walked out and I could hear him talking on the phone, saying that he had a Maidan protestor on his hands, and that someone should come to take me away." Sergiy left the hospital and went to the Maidan, where he got treatment.
This was the fate of many. "Starshiy Plastun-Skob" and first company commander of the now disbanded "Harpoon" battalion Bohdan Kuharuk also entered the ATO after Maidan. He went through the "Patriot Defence" first aid training course twice.
July 22, 2015 near the checkpoint between the towns Avdiyivka and Yasinovataya, Bohdan together with "Harpoon" and the 74th Reconnaissance Battalion, while performing a mission, got blown up by a mine.
Five out of eight received injuries, two of them serious and one of the casualties was the combat medic of the group, on whom they relied on heavily. As a result, Bohdan had to give first aid and evacuate his fellow soldiers.
"In the first second – what happened wasn't clear. Then screaming, and it became evident that something terrible happened. Only after ten minutes did I start to act consciously" - remembers Bohdan. "14:10 – I remember writing the time that I applied the tourniquets to everyone."
Thirty minutes passed, before the first victim was transported to a car. The heavily injured were taken away in an ambulance, and Bohdan himself transported two other guys, call-sign “Artist” and “Kabul,” to Kostiantynivka.
We caught up with one of the casualties which Bohdan saved, after his release from a Kyiv hospital. Paul Bilous or "Kabul" was the same combat medic that received a crippling injury to the hands, legs, a broken ribcage and injury to his lungs.
Paul remained conscious and helped Bohdan telling him what to do. "It's good that I knew what a pneumothorax was and how much time I had left approximately. I immediately told "Kuku" (Bohdan Kuharuk) , to drive me to this place, and not another place, where we couldn't arrive in time" recollects Paul.
Bohdan brought the wounded to Kostiantynivka. Paul was taken straight to the operating room, the rest were taken to another hospital, since there was only one operating room there. "Artist was rebandanged in the reception, but was given no further care. The doctor said that the operating room was taken by Kabul, and if we were to wait two hours Artist would lose his leg." The surgeon phoned the hospital in Artemivsk, and got an operating room. The leg was saved.
• Read also: Every soldier should be trained in first aid
Paul in Kostiantynivka spent about three hours in bed: "When I came to, some sort of flies were buzzing around abouve me. I try to swat them, ask for someone to do something with them, and I get this reply: ‘Ah. They also annoy us.’ That was their attitude." He was then transferred to a hospital in Dnipropetrovsk, and then to Kyiv.
Kabul started to serve in the east in the 25th battalion. First he was a radio operator, then started helping the chief medic, then retrained to become the medic of the group. When he reached this position, he went through the "Patriot Defence" Ukrainian Long Range Patrol Medic course and then transferred to the "Harpoon" battalion.
Paul says that he made sure that everyone who entered the ATO passed a tactical medicine course and anyone who went on a mission had an individual first aid kit (IFAK).
"There were cases when our boys threw over tourniquets to neighboring trenches, and they were thrown back with the response,‘Guys, give us some normal tourniquets!’ They had not seen these newer tourniquets before", - remembers Paul.
The only critical accident, that affected his battalion, was an explosion on the July 22, 2015, when he had to give first aid to himself and tell his team what to do next.
Time cannot be wound back, because life does not bend to your wishes. This is where the "Plast" slogan "Ready yourself!" is most significant. To avoid losses, you have to be ready to take responsibility for your own life as well as the life of others.
Building a new medical system needs to start right now, and not simply pay lip service to system change, while another round of shocking events shake the country.
The Ukrainian philosopher Gregory Skovoroda wrote about slow consistency a time when advancements become possible through gradual and systematic training. Like other European intellectuals, the core value for Skovoroda is the person and his or her life.
Ukrainian medicine needs to foster a patient centered approach to health care, making care of the individual the goal and not simply a means. These are the changes that will ensure the nation surives.