Canada-Ukraine Foundation



Posted on August 10th, in  News

From May 2020 to July 2020 HelpAge International in Ukraine implemented the project aimed to reducing the risks of coronavirus infection among older women and men living along the contact line (0- 5) in government-controlled areas (GCA) in Donetsk and Luhansk regions with financial support from HelpAge Canada.

The project covered 20 settlements in the Donbass area, Governmental-controlled area (GCA).

Donetsk region – settlements: Marinka, Krasnogorivka, Taramchuk, Stepne, Novomykhailivka, Novobakhmutivka, Zalizne, Opytne, Vodiane, Pervomaiske.

Lugansk region – settlements: Novotoshkivske, Nyzhnie, Orikhove, Troitske, Komyshuvakha, Zolote, Stanitsa Luhanska, Makarove, Petropavlivka, Valuiske.

 For implement the project HAI recruited one project officer (PO) in each region, one project assistant (PA) and 10 community volunteers (CVs). All these people were employees of HAI in a previous project funded by ECHO, so they are aware of the policies of HAI, humanitarian principles and rules of personal safety and protection of the older people. Before the start of the project implementation the POs conducted a short update training on the rules of working in a pandemic, the using of Personal Protective Equipment (PPE) and understanding the project’s objectives for volunteers and PAs. Also, when choosing volunteers for the project, we took into account the factor that each of the 20 settlements should be covered by one of our volunteers in order to ensure better access to the beneficiaries and the delivery of non-food items (NFI). The major focus was on provision of COVID-19 adapted hygiene kits, personal protective equipment, COVID-19 prevention through information sharing and guidance on steps needed if one has symptoms and also provide remote psychosocial support via regular check-in mobile phone calls and a HelpAge ‘telephone hotline’ provide accurate and update information on COVID-19.

Additionally, volunteers provided the First Psychological Aid during the visit and provided information about the available services for the older people in specific localities. Since the project is aimed at quick response, it was decided to focus on the beneficiaries of the previous project “ACCESSIII” funded by ECHO. This decision made it possible to save time on additional needs assessment as it relied on its own database of older people. Considering that the ECHO project ended in April and we distributed only sanitizers at that time we have had evidence on high need of hygiene products. Also, according to WHO recommendations, adherence to personal hygiene rules and social distancing are the main factors in curbing the spread of coronavirus infection.

Key achievements

HAI project assistants with the support of volunteers conducted previous database verification. HAI Finance/Log Department selected suppliers in accordance with the HAI procurement procedures and policies. 1000 hygiene kits were purchased (around 16 tons). 1000 stickers with HelpAge Canada and HelpAge International logos were printed for ensure visibility. When forming the set, HAI also guided by the recommendations of the WASH Cluster developed as part of the response to COVID-19. The quantitative composition of the kit is designed for use within three months. Please see Annex 1 for hygiene kits composition. Since the start of the pandemic, we have experienced significant price fluctuations. But since the purchasing power of the population fell, suppliers began to reduce prices for wholesale buyers. Consequently, HAI was able to procure a hygienic kit for three months at the cost of the kit budgeted for one month. Considering that all beneficiaries have chronic diseases and serious health problems, the assistance provided will help significantly reduce the risk of contracting coronavirus infection, improve the quality of life of the beneficiaries and help them adhere to the self-isolation regime.

As at the end of July 2020 the distribution process is coming to an end. A total of 917 sets were distributed. The remaining 51 packs will be delivery to the older people during last week of July 2020. HAI also continued collecting photos and video stories. Unfortunately, during the implementation of the project 32 beneficiaries died, so the hygienic kits will be kept in HAI warehouse and will be delivered to the new beneficiaries as soon as they will be identified in August 2020.

HAI continues providing advocacy through Age and Disability Technical Working Group (ADTWG) on amplifying older people’s voices for ensuring that they are involved in decision-making and that their dignity and autonomy are respected in pandemic. HelpAge chairs the Technical Working group on Age and Disability (ADTWG) formed under the UNOCHA Protection Cluster. The ADTWG aims to strengthen the coordination and capacity of the humanitarian actors to develop and implement age and disability-friendly humanitarian response.

Key numbers

Summary information on beneficiaries included in the 041 project as of 24.07.2020

Photos from the distribution


Hygiene Kits composition.

# Description Remarks
1 Toothbrush 2 pcs
2 Toothpaste 300 ml
3 Soap bars 13 x 75 g soap \(900 g total)
4 Shampoo (hypoallergenic if possible) 750 ml
5 Washing powder for clothes, universal and hypoallergenic 4.5 kg
6 Liquid Bleach 6 of 1-liter containers
7 Dishwashing gel / Washing-up liquid 1,5 liters
8 Toilet Paper 6 rolls
9 Garbage bags (35 Litres) 2 rolls of 30 pcs
10 Rubber gloves for cleaning 3 pairs

Posted on May 20th, in Covid19UCC Communiques & NewsNewsFeatured

May 20, 2020. The COVID-19 Children’s Relief Initiative was launched today as an online appeal to provide support to children in Ukraine in need of basic supplies during the COVID-19 pandemic.

Almost 100,000 children in Ukraine were living in government-run residential institutions or rehabilitation centres prior to the quarantine announced on March 11, 2020. In an effort to contain the spread of the COVID-19 virus approximately 50,000 children were sent home to their biological families, many of whom are unable to provide or care for them.

“These families are in dire need right now because tens of thousands of children were sent back from government-run institutions to family residences for isolation purposes,” said Mykola Kuleba, the Ombudsman for Children with the President of Ukraine.

“Currently thousands of families are unable to provide basic food and hygiene supplies to their children,” said Mr. Kuleba. “With your support, these vulnerable children can remain where they belong, at home, with their families.  Information gathered during this time will guide the creation of a long-term strategy”.

Donations are now being accepted to support the purchase of food packages and hygiene kits for these children and their families in Ukraine. These materials will be distributed by social workers as they visit the families to assess the health and well-being of the children.

This initiative is being led by Help Us Help and the Canada-Ukraine Foundation. It is supported by Meest Corporation and the Ukrainian Canadian Congress, in partnership with the Ombudsman for Children with the President of Ukraine.

Donations to purchase these kits can be made to either Help Us Help or Canada-Ukraine Foundation and are eligible for tax receipts.  The project website can be found at

The Canada-Ukraine Foundation was established to coordinate, develop, organize, and deliver assistance projects generated by Canadians and directed to Ukraine.  Help Us Help is a member of the Canada-Ukraine Foundation and since 1993, has distributed over $25 million in charitable aid to projects and organizations engaged in education, literacy, arts and culture, social work, civil society, and humanitarian aid.

All food packages and hygiene kits are curated by Meest in partnership with Ukrainian retailers and distributed throughout Ukraine by Meest Express directly to social workers. Packages and kits can also be purchased directly through Meest’s eCommerce website is a new online service, powered by Meest, that allows users to purchase goods and gifts online for their relatives and friends back home in Ukraine. Meest Corporation Inc. was founded in Toronto in 1989 with the main goal of uniting the Ukrainian diaspora abroad, in Canada, with the homeland, in Ukraine. True to its goal of strengthening ties between Ukraine and the Diaspora in Canada, Meest has long been a sponsor of humanitarian aid shipments from Canada to Ukraine and has a long-standing partnership with Help Us Help and Canada-Ukraine Foundation in delivering aid all across Ukraine.


Ukraine has among the highest numbers of institutionalized children in Europe. The majority of these children have families that are unable to provide or care for them. 

Just under 100,000 children were living in residential institutions or rehabilitation centres prior to the quarantine announced on March 11, 2020. In an effort to contain the spread of the COVID-19 virus approximately 50,000 children were sent home to their biological families.  There is great concern that, due to a lack of support from social services in place, these children and families will endure additional hardships during the pandemic.   

Mr. Kuleba has long been an advocate for Ukraine to take steps in transitioning from a society that puts parentless or neglected children in institutions, to one with an extensive Social-Care network that allows children to safely remain in their homes or to enter into foster care.

The pandemic has brought about an opportunity for Ukraine to begin this transition by better understanding the needs of the families of children that have been sent home. 

About Deinstitutionalization (DI) Reforms

In 2017, the Ukrainian government adopted the National Deinstitutionalization (DI) Reform Strategy and Action Plan, which involves supporting families and creating favourable conditions for the upbringing of children. While a pilot DI reform project was launched in the Zhytomyr region that same year, the full dismantling of the orphanage system is planned for 2026. 

For more information:

Krystina Waler, Interim Executive Director Help Us Help

Tel: 1-416-627-9941 Email:


CUF’s marathon in helping Ukraine continues

By New Pathway -Dec 24, 2019

Dr. Oleh Antonyshyn operates during CUF’s medical mission in Ukraine

Yuri Bilinsky, New Pathway – Ukrainian News.

The Berlin wall came down 30 years ago but psychologically it still shapes the economic and political lives of the people in Eastern Germany. Canada-Ukraine Foundation’s President Victor Hetmanczuk provided this example of how long societal change can take under the best of circumstances, at the UCC’s XXVI Congress in Ottawa in November.

The war in Ukraine has gone for six years and we do not know how long this war will continue, Victor Hetmanczuk said. When the war does end, how long is it going to take us to come up with a meaningful plan to help the people in Luhansk and Donetsk oblast? Are Ukrainians willing to pay a 5.5% solidarity tax that the Germans still pay to subsidize the construction of an equal society in Eastern Germany? Will the Ukrainian diaspora agree to pay a 5.5% tax to help rebuild the Donbas? Who is going to invest an amount comparable to $3 trillion that has been invested into Eastern Germany since late 1980s?

All these questions, which Victor Hetmanczuk posed in his speech at the Humanitarian Aid for Ukraine workshop during the Congress, demonstrate the magnitude of the problems facing Ukraine. These problems won’t be solved with band-aids, it’s going to be a marathon, he said.

This marathon for the Canada-Ukraine Foundation started in 1995 when CUF was established as a National Charitable Public Foundation. Between 2014-2018, CUF conducted 114 projects in Canada and Ukraine. Over these five years, CUF collected more than CAD 9.6 million ($4.9 million were provided by federal and provincial governments). This kind of financing puts CUF among the biggest charitable donors of Ukraine-related projects globally.

Medical supplies provided by CUF

The Foundation is also active in Canada. In 2018, it was successful in obtaining new grants for the Holodomor Bus: $1.5 million from the Federal Government and $750,000 from the Ontario Trillium Foundation. Since the start of the Bus Tour in 2015, around 53 thousand people visited the Bus.

The Canadian Holodomor Bus project has had its repercussions even for Ukraine. During the Toronto Reform Conference in July 2019, President Zelenskyy and his wife visited the Bus at the Holodomor Monument in the CNE grounds. It made an impact on them to the point of further meetings were held in Kyiv recently that could lead to a draft Memorandum of Understanding about CUF’s participation in the building and programming of a similar bus for Ukraine.

The Holodomor Tour Bus in Ottawa

CUF has as its charitable objectives relief of poverty, advancement of education, health care and religion, assisting in observation of elections and other purposes beneficial to the community.

In Ukraine, CUF’s medical mission has consisted of the following: surgical missions, upgrading of medical skills, assistance for the Dzherelo Rehabilitation Centre, dental program for orphans and PTSD support for veterans.

Dzherelo Rehabilitation Centre

CUF’s Ukrainian medical missions have just seen a significant extension. The Foundation has signed a three-year agreement with the Sunnybrook Health Science Centre to participate in the Sunnybrook Ukraine Surgery Education Partnership located in Lviv. Within the partnership, there will be master classes for surgeons, a symposium and an observership in Toronto. In October 2019, on the first mission, 26 patients had operations done in three operation rooms simultaneously, while 138 doctors attended the one-day symposium.

Within CUF’s Ukrainian dental program, 427 orphaned children were examined and received 448 dental appointments where they had 720 dental fillings and numerous other treatments. 47 professionals and volunteers from Ukraine were involved in this program.

CUF’s Ukrainian dental program

The Defenders of Ukraine projects in 2018 were funded by the Ukrainian Canadian Congress National from the proceeds of the Invictus Games event in Toronto in 2018. These projects included Ukrainian Social Academy for “Boots to Business” entrepreneurship training program for veterans and funding for the Donbas ATO Veterans Union and Centre Poruch for psychological support of veterans and their families. The Defenders of Ukraine projects also funded the Veterans House for ATO veterans providing temporary shelter and rehabilitation programs. Pobratymy and Dopomoha Ukraini organizations funded the training in overcoming combat shock trauma and preventing PTSD for veterans.

CUF expects that its revenue in 2019 will amount to $2.3M. These funds will help the Foundation remain the focal point of the Ukrainian Canadian community’s assistance to Ukraine. One of the UCC Congress’ resolutions reads that the UCC will continue to support and augment Canadian humanitarian assistance to Ukraine through the existing mandate of the Canada-Ukraine Foundation. CUF will collaborate with UCC to coordinate, promote, help prioritize and maximize the effectiveness of aid to Ukraine. UCC’s provincial councils are encouraged to communicate to their membership CUF’s mission and objectives. Member organizations of UCC are also encouraged to access the CUF advisory groups for information, guidance and assistance.

The Foundation’s marathon in helping Ukraine overcome its hardships is continuing.

Presentation of Shevchenko Award to CUF
2019 Shevchenko Medal award for community development

At the XXVI Triennial Congress of Ukrainian Canadians, Alexandra Chyczij, the National President of the Ukrainian Canadian Congress presented the Shevchenko Medal award to Victor Hetmanczuk, the president, and Roman Petryshyn, a founder of the Canada-Ukraine Foundation.

By New Pathway -Mar 6, 2018

UCPBA Calgary President Bohdan Romaniuk, Dr. Ihor Zastavnyy, Dr. Vadym Vus, Dr. Orest Kulenych, CUF President Victor Hetmanczuk, in the board room of the Assumption of the BVM Ukrainian Catholic Church. Halya Lypska-Wilson, Acting President, Ukrainian Canadian Congress, Calgary Branch

The Calgary Branch of UCC organized a “Meet and Greet” fellowship on January 22, 2018 for three visiting medical doctors from Ukraine. The meeting was held in the board room of the Assumption of the BVM Ukrainian Catholic Church, who support cultural events. The University of Calgary had just held a 3-day course “Emergency Medicine for Rural Hospitals.” This was the 34th Annual Conference and was held at the Banff Park Lodge. The vision of this course was to provide clinical topics relevant to physicians, nurses and other healthcare professionals who practice in rural communities The Ukrainian Canadian Professional and Business Association (UCPBA) of Calgary co-sponsored this community event.

Bohdan Romaniuk, President of the UCPBA Calgary opened the meeting by welcoming the doctors and shared information about the Canada-Ukraine Foundation (CUF) and its President Victor Hetmanczuk and the phenomenal work that he and the organization is doing with help in Ukraine. The three doctors — Orest Kulenych from Ternopil, Vadym Vus from Rivne and Ihor Zastavnyy from Lviv region, had come to Alberta. Travelling and morally supporting the visitors was Victor Hetmanczuk. CUF has raised millions of dollars in funding for emergency medical assistance to Ukraine, especially to those affected by the war in the Donbas. Both Bohdan Romaniuk, and Victor explained the function of the Canada Ukraine Foundation and how it has been supporting medical help and doctors going to Ukraine to take care of the needs of patients and their families hurt in the war ongoing in Ukraine

Having visited our hospitals in Calgary, the three visiting doctors with amazement in their voices told those present how impressed they were with our Canadian system of healthcare. The availability of buses fitted with medical equipment and supplies that go to rural areas here in Alberta with help to those in need, including our STARS ambulance helicopter service. The sharing of ideas and support of medical staff was another important realization for them. Ukraine’s medical system differs from the Canadian one. The young doctors, and medical students present shared information. For example, the doctors who work in the villages are not allowed to do sutures, they send their patients to hospitals in the nearby cities, yet Danylo a first year medical student at U of C, learned to do them his first day in medical school.

Dr. Semkuley, who with his wife Elaine of Medical Mercy have been going to Ukraine for over 30 years with humanitarian help, compared experiences they had during their visits every May to villages in Western Ukraine and teaching the villagers to help themselves by building and renovating in their villages. Learning how they could improve their facilities on their own, not waiting for the government to help them. It has changed very slowly over the years and sometimes not. Dr. Ihor Zastavnyy mentioned that Ukrainians are starting to understand volunteerism, especially since the Revolution of Dignity and making positive changes by volunteering and organizing volunteer groups.

One of the doctors shared an experience of how it hasn’t changed. While attending to a patient when volunteering for ATO in Eastern Ukraine, a woman from the village learned he was from Western Ukraine and referred to him as Bandera “Banderivets”. She was apprehensive about him caring for her. He, in turn, said let me examine you and then you can judge me. She ended up telling him that she is immediately going to call her friends in Russia and Crimea and tell them that he was normal.

Most rewarding for those of us attending that evening was that we shared our love for Ukraine and wanting Ukraine to have the same level of healthcare that we in Canada are blessed with. In fact, within days Dr. Vadym Vus wrote the following: “Thank you very much for your warm meeting! We are already in our Motherland and it is pleasant to realize that your hearts are open to Ukraine. We will already extend the knowledge, experience and contacts that you have discovered for us. Blessing to your community and waiting to meet with you in Ukraine!” Vadym Vus.

Regarding Donations and Bequests for the Dzherelo Children’s Rehabilitation Centre

With the winding down of the Children of Chornobyl Canadian Fund (CCCF), the Druzi of Dzherelo are continuing their charitable work under the umbrella of the Canada-Ukraine Foundation (CUF). 

Please make your future donations to the Centre payable to the Canada-Ukraine Foundation and in the memo line write: DZHERELO.

Mail to: Canada-Ukraine Foundation (for Dzherelo Centre), Suite 200, 620 Spadina Ave., Toronto, ON, M5S 2H4.

If there are questions, please send an email to

Board of Directors
Canada-Ukraine Foundation

                    Charitable Number 898992151RR0001

By New Pathway -May 15, 2019 – Victor Hetmanczuk

Photo from the CUF medical mission in Ukraine

From May 18 – 27, 2018, Canada-Ukraine Foundation held its 6th medical mission in Ukraine. The mission worked in Odesa and had as its goal to treat individuals injured in the ongoing war in Eastern Ukraine and conduct surgical master classes which would contribute to capacity building within Ukraine’s Ministry of Defense medical system. The mission was located at the Military Hospital Clinic Centre of the Southern Region.

Specifically, this project aimed to:

  1. Provide soldiers and civilians with devastating injuries an opportunity for the most complex surgical reconstructions, to restore function, minimize disfigurement, and enable them to return to assume productive lives.
  2. Save lives and radically reduce the number of casualties succumbing to their injuries due to inadequate primary trauma care.
  3. Provide training to local surgeons, anesthetists, and nurses, and provide them with the requisite resources to achieve and maintain a global standard of primary trauma care and post-traumatic deformity reconstruction.

Thankfully, instability in the country and war in Eastern Ukraine didn’t overwhelm treatment capacity in Odesa, the medical mission was carried out as planned. Instability in the country and ongoing war did not directly threaten the safety of the teams during the mission. All postoperative complications have been minimal.

Emails were exchanged between CUF lead surgeon, Dr. Oleh Antonyshyn and Ukrainian surgeons Dr. Fedirko and Dr. Mazur who have both conducted follow-up procedures and continue to offer their services to all of our patients.

The mission achieved:

  • Rapid intraoperative education of sophisticated health professionals (local Ukrainian plastic, ENT, maxillofacial and neurosurgeons, anesthetists, operating room staff), providing enhanced beneficiary skill to treat complex trauma and post-traumatic deformity.
  • Enhanced beneficiary access to resources required to perform complex trauma and post-trauma reconstruction and in implementing primary trauma life support.

Direct Beneficiaries:

  • Total # of direct beneficiaries (people directly trained, impacted, or influenced by the project): 139
  • Total # of direct beneficiaries who were women and girls: 33
  • Total # of direct beneficiaries who were men and boys: 106
  • Total # of indirect beneficiaries: An estimate of 700 people were indirect beneficiaries.

Indirect beneficiaries:

  • Medical professionals of the MOD of Ukraine and their patients and their families.
  • Families of wounded soldiers and civilians.
  • Medical students who attended lectures given by Dr. Oleh Antonyshyn and Dr. Todd Mainprize.

Gender Equality:

Gender considerations were taken into consideration as much as possible.

  • The surgical team travelling from Canada was comprised of both men and women. All professions were represented by both genders, demonstrating that both genders are capable of being great nurses and doctors. We worked closely with both male and female colleagues based on their specialties. We tried to and believe that we did empower women to take on leadership roles in the hospital and within the medical department in the Ministry of Defense of Ukraine. One way this was done was through one-on-one training between our operating room nurses and their Ukrainian counterparts. Jodi Clements mentored a young Ukrainian nurse teaching her the more advanced responsibilities that she has in the O.R. with the permission of the Ukrainian head nurse.
  • Patient recruitment did not differentiate between genders. Soldiers and volunteers injured as a result of the war, requiring the type of medical treatment our team is providing, were considered without preference for one gender over the other. There were very few females.
  • Efforts were made to report how many female and male members were part of the training audience. Reporting has been segregated by gender.

While every effort was made to be as inclusive as possible, the reality remains that there are not as many women as men enlisted in the Ukrainian armed forces. Very few women are serving in active duty on the front lines and therefore are not injured as often. Ukraine still has a male dominated military culture where women are not looked upon as equals in many cases. CUF made every effort to empower the women with whom we did come in contact. By taking male nurses and female surgeons with us on our medical missions we wanted to show our Ukrainian colleagues that the stereotype of women being nurses and men being doctors, which is so prevalent in Ukrainian culture, could be successfully altered.

One of our female patients was a volunteer and the other was in her home when it was bombed in Luhansk. The patient whose home was destroyed lost one of her legs and had severe burns on her body. Her hands were affected to the point where it is very difficult.

This was CUF’s first medical mission to Odesa. A lot of preparation work was done including two advance visits to help prepare the hospital and make them understand CUF’s requirements for the mission. Many supplies were collected and purchased in Canada in advance of the mission. Unfortunately, our shipment of 25 large boxes filled with supplies did not arrive on time. Thankfully the team had enough supplies with them and were able to purchase other necessary supplies to make up for this shortage. We were fortunate that we did not have to turn away any surgery thanks to the flexibility of Dr. Antonyshyn and his team and the willingness of the Ukrainian team to help us find and share whatever we needed.

The mission began on a very positive note with the Ambassador of Canada to Ukraine, Mr. Roman Waschuk hosting a kick-off reception along with members of the Operation Unifier team. Over 150 attended the reception. This included various stakeholders in Odesa and many of our counterparts from the Odesa Military Hospital.

Operations took place from Monday to Friday with 3 operating tables running full-out for the 5 days straight. Both teams worked very well together and the mission was deemed a success by both teams. The head of the hospital has invited CUF back again for the same sort of “master class medical mission” whenever we are willing.

By New Pathway -May 3, 2019 – Victor Hetmanczuk,

The meeting between President Petro Poroshenko and the Canadian team at the Kyiv Military Hospital

Activity 4: Surgical observerships in Ukraine and Canada

Our previous missions made it abundantly clear that Ukrainian health professionals required a rapid introduction to global standards of trauma care. Involvement in international organizations which focus on surgical education and research is critical, and we therefore pursued Arbeitsgemeinschaft für Osteosynthesefragen Craniomaxillofacial (AOCMF) membership and training for two key surgeons.

The Arbeitsgemeinschaft für Osteosynthesefragen Foundation (AO Foundation) is an organization led by an international group of surgeons specialized in the treatment of trauma and disorders of the musculoskeletal system. Founded in 1958, AO fosters one of the most extensive networks of currently more than 16,000 surgeons, operating room personnel, and scientists in over 100 countries. Their mission is to foster and expand the network of health care professionals in education, research, development and clinical investigation to achieve more effective patient care worldwide. The AOCMF is the division of this organization which focuses on Craniomaxillofacial surgery (

Observerships for 2 Ukrainian surgeons were carried out in Switzerland.

Two lead Ukrainian surgeons attended the AOCMF Principles of Facial Fracture Repair Course in Davos, Switzerland in December 2015 – Drs Igor Fedirko, and Dr. Ivan Pavliuk. Dr. Fedirko is the Head of the Maxillofacial Surgery Department at the Central Military Hospital Clinic in Kyiv where we carry out our surgical missions. Dr. Pavliuk is an associate and full time consultant in the same department. The contribution supports their registration, travel, accommodation and food expenses.

  • Both surgeons were supported in their applications to the AOCMF European Faculty.
  • Admission to faculty impacts future educational development in trauma surgery in Ukraine:
  1. The 2 surgeons can sponsor other Ukrainian surgeons for membership to AO and participation in AO courses;
  2. This greatly facilitates the possibility of organizing and hosting regional AOCMF courses in Kyiv through local faculty (Drs Fedirko and Pavliuk) to educate other Ukrainian trainees.

Activity 5: Ukrainian Trauma Life Support Courses

UTLS is an intensive five-day course consisting of seminars, workshops, practical stations and simulations run in real time. There are 25 students at each course, allocated to five groups of four students and one group of five students. Students receive a manual, already translated into Ukrainian, 4 weeks prior to the start of the course and they are advised to study the manual carefully before attending the course.

Four separate courses were taught by six physicians and licensed paramedics as senior instructors and six Patriot Defence instructor assistants/translators. A total of 97 doctors completed the four course cycles. A total of 100 doctors were registered, however three doctors were forced to leave the courses early due to an unforeseen event (illness, deployment into the ATO). All 97 doctors received certificates of completion that are good for four years.

The goal of this project was to support those that are most severely and profoundly affected by the war in Ukraine, and to provide the requisite skills and resources to those who care for them. Specifically this project aimed to:

  • Provide soldiers with devastating injuries an opportunity for the most complex surgical reconstructions, to restore function, minimize disfigurement, and enable them to return to assume productive lives
  • Save lives and radically reduce the number of casualties succumbing to their injuries due to inadequate primary trauma care
  • Provide training to local surgeons, anesthetists, and nurses, and provide them with the requisite resources to achieve and maintain a global standard of primary trauma care and post-traumatic deformity reconstruction.

All three objectives were achieved with unprecedented success. There is no other country or organization that has been able to implement a surgical mission of this magnitude in Ukraine, or that has had a similar impact on the future development of trauma management in Ukraine. Direct intervention by Canadian health care professionals in mitigating the devastation of war in Ukraine highlights Canada’s foreign policy and humanitarian efforts, and sends a powerful message to Russian aggressors. The unanticipated benefit is the regard that Ukrainian injured, medical professionals, and the population in general have for Canada. The Canadian surgical missions were reported in 148 news broadcasts, videos and publications within Ukraine, and the reception received by Canadian team members was exceptionally cordial and enthusiastic.

The degree to which the Canadian Surgery Mission influenced public opinion within Ukraine was highlighted by a surprise visit by the President of Ukraine and his delegation to the Kyiv Military Hospital while the Canadian Team was operating. President Petro Poroshenko awarded Medals of Merit to three Canadian team members who provided treatment for the wounded ATO warriors in the Main Military Clinical Hospital in the framework of the Ukrainian- Canadian joint initiative. They were as follows: Dr. Oleh Antonyshyn, Dr. Carolyn Levis and Krystina Waler.

In the course of the meeting, the Head of State noted: “Thank you for your care. It is very easy to stay at home and say that you do not care. Your arrival symbolizes that we are not alone in our struggle against the aggressor. You are a symbol of global support for Ukraine”.

The president expressed special gratitude to the people of Canada for helping Ukraine.

The second unanticipated outcome was the recognition of Canadian expertise in organizing and implementing trauma surgery missions by the international medical community. Launching a self-contained multidisciplinary surgical mission to perform surgery of this complexity in a foreign country is distinctly uncommon and has rarely been accomplished with any degree of success. Canadian Mission Team members have been asked to discuss and describe details of the development, organization, management and execution of international surgical missions in various forums: Department of Surgery assemblies in University of Alberta, Edmonton, University of Calgary, Dalhousie University, the University of Toronto Global Surgery Program.

Most notably, the successes of the CUF GPSF supported surgery missions have prompted other groups to explore possibilities for humanitarian projects in Ukraine. Members of the U.S. Army approached CUF to share the knowledge that we have gained. A delegation led by Col. Anne L. Naclerio, Deputy Surgeon General for the U.S. Army Europe, observed the CUF medical mission on Thursday, February 25, 2016 after which a meeting took place to discuss possible collaboration moving forward. Pending approvals, Col. Anne L. Naclerio hopes to run a medical mission to treat orthopedic trauma while training Ukrainian military medical professionals to do so effectively themselves.

By New Pathway -Apr 23, 2019 – Victor Hetmanczuk, Canada-Ukraine Foundation.

CUF’s team operates at the Ukrainian Military Hospital.  Photo: Adriana Luhovy
CUF’s team operates at the Ukrainian Military Hospital.
Photo: Adriana Luhovy

During the missions, we also provided training to military surgeons, surgical trainees and nursing staff at the Central Military Hospital Clinic (CMHCK). These Ukrainian medical personnel are already in the front lines treating war casualties in the country’s foremost trauma centre. All patient consultations and all surgical procedures were performed in collaboration and with the active participation of Ukrainian surgeons and anesthetists. The projected number of people that would be trained and have their surgical skills enhanced was exceeded. There was such a huge thirst for learning and knowledge from our Ukrainian colleagues that people were constantly coming and observing. Operating tables would have up to 20 people surrounding each of them at any given time.

Each of the 2 missions provided direct intensive intraoperative training to the CMHCK staff: 3 anesthetists, 3 anesthesia assistants, 5 surgeons, 3 surgery assistants/trainees, and 2 nurses. In addition to these 16 people, direct intraoperative training and teaching was provided to 65 visiting surgeons, nurses and medical students. Throughout the mission, military neurosurgeons, maxillofacial surgeons, ENT (ear nose and throat), trauma and plastic surgeons and trainees from Kyiv, Odessa, Lviv, Dnipropetrovsk came and went. In total, over the two medical missions, 81 people (many that observed the first mission returned to observe during the second mission) were able to enhance their skills through training obtained during the course of the medical missions.

The training was provided according to standards employed in Canada for Continuing Medical Education (CME) and resident training. Ukrainian health professionals actively participated in:

  1. Patient assessment, physical examination, radiographic examination
  2. Formulation of treatment plan and surgery preparation
  3. Discussion of options, variables, risks, and risk management
  4. Practical demonstration of requisite surgical skills
  5. Instruction in postop management of pain, infection prophylaxis, etc.

Resident teaching and training is vastly different in Canada and Ukraine, with the Canadian system being much more formal and defined in terms of teaching standards, methods, requirements for competence-based learning, availability of educational resources. One of the unexpected outcomes and legacies of these missions was the demonstration of resident training methods employed in Canada, and the enthusiasm with which local Ukrainian trainees responded to these efforts.

In an effort to maintain and develop this ongoing clinical and educational collaboration across borders, a decision was made to develop a Telemedicine Program. Experience previously obtained in developing live surgery demonstrations for International CME programs (Advanced Craniomaxillofacial Forums) and research of current technology and standards for two way videoconferencing through “Sunnybrook telemedicine” and “Ontario Telemedicine Network” facilitated the design of a telemedicine system that would optimally serve the patient care and educational needs at the Kyiv Main Military Hospital.

The Telemedicine system will be used to:

  1. Document relevant surgical cases performed by orthopaedic, craniofacial, hand and microsurgeons, and neurosurgeons at Sunnybrook Hospital
  2. Conduct combined surgical rounds and seminars featuring recorded surgical cases
  3. Perform remote clinical or radiological consultations

The equipment necessary to establish a telemedicine/ telesurgery link between Ukrainian and Canadian Trauma Centres was selected following presentations and quotes by Stryker Endoscopic Systems and Panasonic. Panasonic was chosen based on quality of product and best price. The system comprises 3 hubs:

  1. A portable OR cart with camera and video recorder. This will be available to any Sunnybrook OR performing relevant surgery. The recorder allows documentation of data from multiple sources: overhead camera, head cam, and computer (for CT data, and powerpoints)
  2. Telecommunications Hub at Sunnybrook Hospital
  3. Telecommunications Hub at Kyiv Main Military Hospital

Panasonic professionals came to Sunnybrook to teach Dr. Antonyshyn the most effective way to set-up and use the equipment. Dr. Antonyshyn shared this information with his Ukrainian colleagues.

The use of two-way videoconferencing and advanced information communication technologies to deliver examinations, treatments, clinical, and education services will allow Sunnybrook Health Sciences in Toronto and the CMHCK to collaborate, share knowledge and consult patient cases for years to come. Dr. Antonyshyn has the same implants, instrument sets and pieces of equipment that were purchased for the CMHCK (to create a centre of excellence in Craniofacial surgery) at Sunnybrook Health Sciences. Since our second medical mission, our colleagues have continued to use the new technologies that were purchased for them. Through telemedicine, Dr. Antontyshyn will continue to train his Ukrainian colleagues to use the new equipment, instruments and implants, that were donated to them, as efficiently and effectively as possible by consulting on specific cases and organizing viewings of his complex surgeries. Dr. Antonyshyn in Canada and Dr. Ihor Fedirko in Ukraine are both committed to using this educational tool for years to come.

Further refinement of these initial efforts and wider adaptation of Telemedicine through Ukrainian Medical teaching centres can potentially revolutionize training of health professionals and delivery of health care. This leaves a legacy.

By New Pathway -Apr 18, 2019 – Victor Hetmanczuk
Instrument sets that were donated to CMHCK

Canada Ukraine Foundation’s medical missions, which were held in 2015-2016 at the Central Military Hospital Clinic in Kyiv (CMHCK), provided consultations and surgical reconstructions to patients with complex traumatic defects. The missions also aimed to deliver technology, equipment, surgical tools and supplies to create a centre of excellence at the CMHCK. The specific resource deficiencies that restrict delivery of primary trauma care and sophisticated trauma reconstruction in Ukraine were previously identified during two prior CUF-sponsored missions to the CMHCK and a country-wide needs assessment mission performed in April, 2014. This project’s objective was to provide the technology, surgical equipment and supplies, and the device training that ensure maintenance of global standards of care, during the course of surgical missions and in the future.

List of purchased equipment:

  • Complete sets of surgery instruments: (purchased in Canada)
  • Complete power system for bone cutting and shaping (purchased in Canada)
  • Complete Stryker bone fixation system with sufficient hardware and implants to perform surgery for 2 years (purchased in Canada)
  • 1 tourniquet to allow bloodless extremity surgery (purchased in Canada)
  • 3 reusable cuffs for the tourniquet (purchased in Canada)
  • Orbital implants (purchased in Canada)
  • Titanium meshes for bone defect reconstruction (purchased in Canada)
  • Suction drains (donated in Canada)
  • 3 cautery and haemorrhage control systems (purchased in Ukraine)
  • 8 bipolar cautery forceps (purchased in Ukraine)
  • 2 advanced surgical head-lighting systems (purchased in Ukraine)
  • 1 computer system to allow intraoperative visualization of patient CT and other Xray data (purchased in Ukraine)
  • 1 pantographic X-ray system (purchased in Ukraine)
  • 1 multi-use operating table (purchased in Ukraine)
  • 1 portable autoclave for sterilization (purchased in United States)

The capital equipment purchase made possible by GPSF generated a tremendous impetus for industry, institutional and volunteer donations of medical devices and disposables. Hospitals and medical supply companies contributed in-kind donations towards both missions (this includes but is not limited to Sunnybrook Health Sciences Centre, Trillium Heath Care providers and St. Michael’s Hospital in Toronto). Disposables (sutures, staples, gloves, gowns, drapes, medication, etc worth tens of thousands of dollars) were essential for surgery, and were sent to Ukraine in advance of each of the missions.

Some of the larger donations included:

  • Stryker Canada provided us with a grant for equipment and implants for the first medical mission valued at $152, 544 (as mentioned previously).
  • Calavera Surgical Design donated $37,500 worth of custom, molds, forming tools, and custom implants for skull defect reconstruction.
  • For each mission, Health Partners International Canada provided us with medications to support our mission that valued over $20,000 each.
  • $9,000 McGvath Video Laryngoscope
Calavera molds, forming tools, and custom implants

It is important to note that in addition to the purchase and delivery of the latest surgical technology, specific training in the direct application of this technology was provided during the course of both missions.

For example:

  1. Prior to this mission, CT scan images essential for surgery had to be anticipated and printed on photgraphic transparency sheets as hardcopy to be brought to the Operating Room on the day of Surgery. The Canadian mission installed a computer system with the necessary software in the operating room to allow sophisticated CT data visualization intraoperatively.
  2. Bone fixation systems were grossly deficient and most complications in fracture healing occurred as a direct consequence of inadequate fracture stabilization. The GPSF allowed delivery and implementation of state-of-the-art bone fixation systems which dramatically altered craniofacial fracture repair outcomes.
  3. Calavera Surgical Design system was specifically designed to facilitate rapid, efficient, durable and anatomically accurate reconstruction of skull defects resulting from gunshot and shrapnel wounds. This provided a very practical and readily adaptable solution for the neurosurgical services.
Canada Ukraine Foundation's Medical Missions in Kyiv. Part 1
Canada Ukraine Foundation’s Medical Missions in Kyiv. Part 1
Canada-Ukraine Foundation’s Medical Missions in Kyiv: Part 3

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