Care and surgery
Training and skills transfer
Ukraine: at the heart of a surgical mission in Lviv
In Lviv, a city in western Ukraine, La Chaîne de l'Espoir organizes regular one-week missions with French volunteer surgeons and nurses. Their mission: to train their Ukrainian counterparts in the specific techniques of war surgery and infection prevention. Report.
In the corridors of St Panteleimon Hospital in Lviv, Ukraine, French orthopedic surgeon and La Chaîne de l’Espoir volunteer Dr Stéphane Romano carefully examines the X-rays of Arthur Dron, a 24-year-old Ukrainian. The images reveal a complex injury caused by a mine explosion: shrapnel has passed through his forearm, fracturing and rupturing the median nerve. An injury typical of war trauma, requiring specific surgical expertise.
“Before my injury, I was studying journalism and working as an events manager for a publishing house”Arthur confides. “I joined the 125th Territorial Defense Brigade in March 2022. Now, after this mine explosion, I have to relearn how to use my hand.” Following theoperation performed by Dr Romano in collaboration with his Ukrainian counterparts, Arthur remains hopeful: “Part of my nerve was torn off, I lost sensation in several fingers and part of my palm. Thanks to this operation, I’ll be able to recover much faster, regain sensitivity and mobility in my fingers.”
Crucial expertise for complex injuries
Since the start of the Russian invasion, the St. Panteleimon Orthopedics and Traumatology Department has become one ofthe main centers for the care of war-wounded in western Ukraine. “War has brought its own challenges“, explains Dr Vasyl Rokyta, head of the department. “Mine injuries are particularly complex because the nature of the trauma and damage is diverse. Even a delay of a day or a few hours can change the approach to treatment.”
To meet these challenges, La Chaîne de l’Espoir, with financial support from the Crisis and Support Center of the French Ministry of Europe and Foreign Affairs, organizes surgical missions to Lviv several times a year.
“The Ukrainian surgeons are very competent”, says Rory Peters, head of La Chaîne de Espoir’s mission in Ukraine.stresses Rory Peters, Head of Mission for La Chaîne de l’Espoir in Ukraine. “But our specialists bring a unique expertise in war surgery and the treatment of blast injuries, which makes their contribution particularly valuable.”
Dr Romano, who has 35 years’ experience in war surgery, trains local teams in specific techniques: “We mainly teach nerve repair and reconstruction after nerve injury, as well as bone reconstruction with very specific grafts, called induced membrane techniques, which they didn’t practice before.” This collaboration is very useful for the Ukrainian team.
“Together, we carry out consultations for complex cases and perform surgeries. We’ve learned a lot from Dr. Romano, as he has a wealth of experience. Recently, for the first time, we performed surgery on a soldier suffering from a severe brachial plexus injury. It was a first for our facility, and a very exciting and special moment. Emotions ran high “
Dr Vasyl Rokyta, Head of the Orthopedics and Traumatology Department
at St Panteleimon Hospital, Lviv
Infection prevention, a vital issue
But successful surgery depends on more than just the surgical procedure. For the first time, two French nurses are accompanying Dr Romano on this mission to train their Ukrainian counterparts in infection prevention protocols.
“Surgical site infections are a major source of post-operative complications and mortality”, explains Batoul Lyakoute, a nurse and volunteer with La Chaîne L’Espoir.explains Batoul Lyakoute, a nurse and volunteer with La Chaîne de L’Espoir. “It’s particularly critical here because the wounds have often been inflicted in extreme conditions.” Emma Pertusa, also a nurse and La Chaîne de L’Espoir volunteer, adds: “We share specific protocols for pre-operative preparation: transporting the patient to the OR, setting him up, preparing the incision site…”
Ukrainian nurses welcome this sharing of expertise. “It’s an enriching experience to observe how other countries work. On the surface, we do the same things, but their approach is different”, explains Liza Goi, an operating theatre nurse.explains Liza Goi, an operating theatre nurse. “What’s remarkable is thatthey adapt to our way of working rather than the other way around, which makes collaboration much easier.”
The challenge is all the more crucial as medical teams face growing resistance to antibiotics. “Many patients receive initial treatment in hospitals near the front before being transferred here”, explains Rory Peters.explains Rory Peters. “When they arrive in Lviv for further operations, they are often faced with infectious complications. Some lose limbs that could have been saved.”
A chain of solidarity that transforms lives
This expertise is vital for patients like Andrii Sydorenko, a soldier who lost his sight, had his leg amputated and suffered a fractured little finger on his right hand following a mine explosion in the Donetsk region. “Thanks to the doctors, I’m alive today”, he confides.he confides. “With the operation, my finger will now be straight. It may not move, but it won’t get in my way or make me bump into things. It’s a huge improvement.”
For Lesia, wife of Andrii Sydorenko, medical support goes far beyond surgery. “These men aren’t just wounded physically, they’re wounded mentally. At first, Andrii didn’t talk much, he was withdrawn. But little by little, we learned to communicate. Step by step, we’re making progress. We live, we go on, we dream.”
She adds: “Being by his side, I’ve seen how strong he is. He’s taught me to be strong too. Each new operation doesn’t scare us anymore. We’re ready, and that makes us stronger. The support we receive helps Andrii understand that he’s not alone.”
A lasting impact on the Ukrainian healthcare system
“During a mission, we can operate on around twenty patients. But when I come back three months later, I discover that 300 or 400 patients have been treated in the meantime, using these techniques, by the surgeons we trained.”
For Dr Romano, the greatest satisfaction comes from the long-term results.
Through these regular missions, La Chaîne de l’Espoir contributes to the long-term reinforcement of Ukrainian surgical expertise, enabling local teams to cope with the constant influx of wounded. This is essential at a time when the conflict continues to put a strain on the country’s healthcare system, makinghumanitarian aid in Ukraine indispensable.
Photo credits: La Chaîne de l’Espoir / Iva Sidash
