The national surgical institute in Kharkiv, Ukraine’s second city, grapples with the same problems as countless other hospitals across the country and the entire former Soviet Union.
A chronic lack of money, equipment and supplies puts a huge strain on vital services, prevents wards and operating theatres being renovated and modernised and tempts overworked and underpaid staff to move abroad.
In Kharkiv, pressure on health services has been intensified by the recent influx of at least 145,000 people, who fled fighting between Ukraine’s government forces and Russian-backed militants just three hours’ drive to the south.
But to Ukrainians long used to drab and dilapidated hospitals and to having to provide everything from their own food to essential medicines while being treated, the sixth floor of the Kharkiv institute comes as something of a shock.
It is brightly decorated and lit, it beeps and buzzes with modern western equipment, and its surgeons, doctors and nurses discuss their patients in a mix of Russian and English.
This is perhaps Ukraine's finest clinic for child heart surgery, thanks largely to money raised by Adi Roche's Cork-based charity Chernobyl Children International (CCI).
Since its first mission here in 2008, CCI has pumped €1.75 million into a unit that provides emergency heart surgery for the region’s children and now offers a lifeline for infants from a conflict zone where the medical system is collapsing.
The charity's latest fundraising drive in Ireland collected more than €200,000, which is being used to support several visits to Kharkiv this year by international "flying doctors" who will operate on more than 20 children during each stay.
Best chance
On the team’s latest visit last month, their patients included Vika Doronina, who received life-saving surgery on a major heart defect on the eve of her first birthday.
“She has great care and equipment here. It gives her the best chance to recover and be healthy,” says Vika’s mother, Tatyana, who travels one hour by bus each day to the hospital from her hometown, where she cares for Vika’s twin sister.
“Vika’s grandmother stays here with her all the time. It’s amazing what the doctors are doing for Vika, and that it is paid for by Irish people, by their kindness.”
The unit's lead surgeon, Igor Polivenok, says its work would be dramatically reduced without Irish donations, with grave results for sick children in the region.
“These international missions and life-saving procedures could not be done without donations from Ireland,” Dr Polivenok says, as visiting colleagues from the United States, Argentina and Britain examine patients alongside local staff.
“Without treatment, 30 per cent of children with congenital heart disease die before their first birthday, so early diagnosis and treatment are essential. If this unit didn’t exist, the children would have to go to Kiev, and travel is very tough on them. And now we’re also taking children from the conflict zone, where no one is performing these operations.”
Sri Rao, a heart specialist based in Alaska, says it would cost about €150,000 to take one child to the US for surgery; the same amount covers three visits by a team of experts to Ukraine, allowing them to operate on more than 60 children, train local staff and bring in crucial medical supplies.
“When we started coming here in 2008, the clinic could only treat older children with relatively simple heart problems,” says Dr Rao.
Upskilling
“Now it can treat much smaller children with much more complex issues, and with far better outcomes. I would say the clinic can now treat 98 per cent of paediatric heart problems.
“And while we used to come with a full team of 15-20 medics, the teams have got smaller and smaller as staff here have acquired skills.”
Dr Rao and the other medical volunteers come from the Cardiac Alliance, which was created in 1993 by US heart specialist William Novick.
It has worked in 32 countries and, according to Dr Rao, aims ultimately to “make itself obsolete” by training local doctors and nurses in every stage of treatment, from diagnosis, through surgery to post-operative care.
The foundation also “tops up” the often meagre salaries of heart specialists in developing countries. This is to encourage them to stay at home, rather than taking their skills abroad for a better wage.
It could make a big difference to staff in Kharkiv, who now include medics who fled fighting in the rebel-held city of Donetsk.
On a bright winter morning in Kharkiv, British-born cardiac nurse Frank Molloy speaks quietly in Russian with his Ukrainian colleagues as they move from bed to bed, examining tiny children with fresh, livid wounds running the length of their chests.
One of the smallest is six-month-old Gleb Vatutin, whose mother Ira anxiously watches over him.
“Gleb might need another operation at some point, but his treatment here gives us great hope,” she says. “It’s wonderful that Ireland helps us.”
Roche founded her charity in 1991 to help people affected by the Chernobyl nuclear disaster five years earlier.
Having initially provided recuperation breaks in Ireland for children from radiation-contaminated areas, CCI has since raised €98.5 million for projects ranging from foster homes in Belarus to heart surgery clinics.
Anonymous donation
Last week, Roche announced plans to fund a high-tech diagnostics laboratory at the Kharkiv hospital, thanks in part to a gift of €60,000 from an anonymous donor in Derry. The equipment is expected to come from
Damien Kenny
, a heart specialist who distributes apparatus donated by US hospitals.
"This is a fantastic example of how the concern and the generosity of a single person living in Northern Ireland, when combined with the work of a Dublin-born cardiologist now based in the United States . . . will help save hundreds of lives in the years ahead," Roche says.
“Our next flying doctors’ cardiac mission will take place in May and we will try to have the . . . lab operating by then.”