NATO Grant Enables MCW Physicians to Share Their Knowledge in Ukraine

When Oksana Sayko, MD, MPH, associate professor of physical medicine and rehabilitation (PM&R) at the Medical College of Wisconsin, first immigrated to the United States in the mid 1990s from Ukraine, she did not know a single person, had difficulty speaking English and was caring for a young child.

"People in my new community saw our family struggling and reached out to us to lend a helping hand," recalls Dr. Sayko. "When I asked why they were willing to help a stranger, they told me that the opportunity to truly help doesn’t come along very often in life. This has stuck with me ever since, and made me want to do the same for others." Dr. Sayko recently was presented with that opportunity.

In November 2014, some 5,000 miles away from her Wisconsin home, the Russian military crossed the border into Ukraine, setting off years of fighting between the two sovereign nations.

Additionally, the subsequent annexation of the Crimea region, along with demonstrations by pro-Russian groups within Ukraine, escalated into an armed conflict between the Ukrainian government and separatist forces.

To date, Ukraine has experienced thousands of fatalities and more than 9,000 wounded.

"The casualties were astounding. I couldn't just sit and watch. I knew I needed to use my skills as a physician to help," says Dr. Sayko.

Her first call was to her PM&R colleague, professor David Del Toro, MD, GME '92, to enlist his help for a medical mission. Although Dr. Del Toro had no connection to Ukraine, he did not hesitate to join. "She came to me and I immediately signed up to help," Dr. Del Toro remarks. "I didn’t see this as a responsibility for those connected to the conflict. Rather, I saw it as my duty as a health professional to help where I am needed the most."

Drs. Sayko and Del Toro quickly assembled a team to travel to Ukraine's capital city, Kiev ("Kyiv" in Ukrainian), in summer 2015.

Map of Ukraine

This initial mission was purely clinical – aimed at helping as many of the wounded as possible. Although the team provided a vital and much needed service for many injured patients, Dr. Sayko knew that they were not doing enough. "I recognized that there was a better way that we could be serving the Ukrainian people, more than just treating on an individual level. To enact change in a big-picture capacity, we needed to alter our approach,” Dr. Sayko shares.

To that end, after returning to Milwaukee, Drs. Sayko and Del Toro solicited help from MCW's Office of Global Health to devise a more productive plan for a return mission in 2016.

"The new approach we came up with boiled down to the old proverb: 'You give a poor man a fish and you feed him for a day. You teach him to fish and you give him an occupation that will feed him for a lifetime,'" says Dr. Del Toro. "We wanted to teach the teachers, in a sense, and provide sustainable medical care for those in need."

Oksana Sayko, MD, MPH
Oksana Sayko, MD, MPH

David Del Toro, MD
David Del Toro, MD

Specifically, the team devised a plan to host an intensive six-day workshop focused on teaching healthcare instructors all of the skills needed to adequately care for wounded patients. To accomplish this successfully, the team would need necessary funding and connections to local teaching hospitals. Knowing about strong US support in this difficult Ukraine political and economic situation, Dr. Sayko contacted the US embassy there; she was connected to the North Atlantic Treaty Organization (NATO) Trust Fund and NATO Support and Procurement Agency, and submitted a grant proposal. NATO Trust Funds are voluntary, nationally led and funded projects established under the framework of NATO to focus on security and defense-related projects.

On the other end, contact was made with the local teaching hospital in Kiev. NATO sponsored the funds for their trip due to overwhelming need and the mission's viability. The team also included Paul Sanford, MD (MCW); occupational therapists, Alexandra Graber and Cecilia Devine; physical therapists, Tina Soeckmann and Kim Dechant; and two interpreters.

The workshop's curriculum encompassed the principles of basic rehabilitation practices. Core rehabilitation skills were taught, such as early rehabilitation, approach to patient evaluation, mobility practices, application of assisted devices, splinting, casting and the utilization of adaptive equipment in the hospital.

The medical community in Ukraine embraced the opportunity to learn from Dr. Sayko's team. Altogether, more than 100 "students" – comprising professors at local medical education institutions and physical therapists – graduated from the course with certificates in rehabilitation medicine.

"We created a situation where we could help more of the wounded by teaching best practices in rehabilitation medicine," says Dr. Del Toro. “This was our overall intent, and we are well on our way toward that end."

On the trip home, planning began for yet another return trip for Dr. Sayko and her team, which they hope will be financed through the NATO Trust Fund. Regardless of the grant outcome, Dr. Sayko and the team will be back in Ukraine soon to lend a helping hand.

– Alex Krouse
 

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