A patient lies unconscious in the intensive care unit of the Bergmannsheil University Hospital in Bochum. Her facial features are difficult to discern due to large wounds. Various tubes and sensors are connected to her body. The woman struggles with death.
Tetjana Burjak and Dmytro Sadyraka are not upset by the sight. They stand quietly at the bedside, listen to their German colleagues and ask questions.
Burjak and Sadyraka are anesthesiologists. Tetjana comes from the city of Dnipro and Dmytro from the capital Kyiv. Both treat patients with severe burns, including many soldiers and civilians who have been victims of the war in Ukraine.
The two doctors are the third Ukrainian doctor couple at the Bochum Clinic to come to Germany as part of the internship program launched by Health Minister Karl Lauterbach after his visit to Ukraine last year. The aim of the measure is to share German know-how with doctors who are treating seriously injured people in Ukraine.
By the end of 2022, 30 Ukrainian medical professionals were participating in the program, with ten more joining in January. Bochum is not the only city where you can do internships. The trade association clinics in Ludwigshafen, Duisburg, Halle, Hamburg, Murnau and Tübingen also take part in the program.
However, the Ukrainian doctors are not allowed to treat German patients alone, explains Marcus Lehnhardt, director of the “University Clinic for Plastic Surgery and Hand Surgery, Center for Severe Burns and Sarcoma Center” in Bochum. He is responsible for the doctors from Ukraine.
“They go along with the ward rounds in the morning, they go with us to the operating room, to the intensive care unit and are then trained in the areas that they particularly ask about. For example, they are present in the OR the whole time during anesthesia. You ask and then things are explained and you can also help,” says Lehnhardt, adding: “Ukraine is a fully developed country, so the know-how of the guests we have here is very, very high. Nevertheless, there are always things that you can learn from, where you can see that we might be doing things differently and supposedly better when it comes to the details.”
Tetjana Burjak has acquired a lot of practical knowledge in two weeks: how doctors communicate with each other during operations, how patients are washed and shaved, how medication is administered and which wound dressings are used. The medic says her hospital in Dnipro receives a lot of help from abroad, including medicines and consumables. “But sometimes we look at it and don’t know what it is. When I came here I took photos and sent them to my nurses and explained to them what is for what. All these little things improve the overall help,” says the head of the physiology and intensive care unit of a hospital in Dnipro.
Her colleagues from surgery, who are already applying their new knowledge in practice, were trained in Germany before her, says the doctor. According to Burjak, her hospital has even been able to compare treatment results. For example, five miners came to the clinic with burns. Three of them, who were treated with German know-how, recovered faster than the other two, who were treated with the previous methods, according to the medic.
She points to another innovation that is now being used in her clinic: the team time-out. Marcus Lehnhardt says: “Before an operation starts, we always have a so-called team time-out, where we stop and see: Is this the right patient? Is the indication correct? Is the page correct? Do we have all the instruments? Have we thought of everything? This is one last check-up before the operation starts.” After talking to some Ukrainian trainees, Lehnhardt came to the following conclusion: In the Ukraine there is no lack of knowledge or skills, but above all of material support, for example wound dressings.
The burns center of Kiev City Hospital No. 2 has already sent several doctors to Bochum to observe them. They all agree on the differences between German and Ukrainian clinics. The Germans, in their opinion, have more equipment and consumables, but above all more staff. Ukrainian doctors say that the war has significantly increased the workload on medical staff in Ukraine. At the same time, there are not more, but often fewer doctors than before the war, because some are deployed at the front, others have left the country.
“It has become more difficult because the cases have become more difficult. There are more soldiers, fewer children because many of them are abroad. It is also more difficult because electricity and water are switched off at home,” says Andriy Schernov about the situation in his Kiev hospital. In November of last year, he was in Germany for an internship.
His colleague, anesthetist Dmytro Sadyraka, who was in Bochum in January, says the mine injuries pose a particular challenge for Ukrainian doctors. In addition to visible burns, there are also injuries that are not visible at first glance, such as tears in internal organs. According to him, another challenge is the high risk of infection among the wounded at the front. “Dirt, dirt – someone might have been dragged across the floor somewhere and the wound couldn’t be treated immediately. Maybe someone lay in a tent on the battlefield for a day. Some come from one hospital to another, collecting infections, or the emergency vehicles were not sufficiently disinfected,” says Sadyraka.
Marcus Lehnhardt from the BG Klinikum Bergmannsheil in Bochum is happy that doctors from the Ukraine can visit his hospital. “Of course it’s always nice to exchange ideas with colleagues – to know what are you doing there, what are we doing here? The feeling that you have someone here from a war situation that you can somehow show something to is of course a very positive thing. We all have a certain helplessness and can do relatively little. When you have someone here, you have the feeling that you are giving a little support. That’s a nice thing, of course,” says the doctor.
When asked what they plan to do in the evening after their day at the clinic, Tetjana Burjak and Dmytro Sadyraka say: “Rest and sleep, lead a peaceful life for a while.” Due to the war and the heavy workload, it is not possible to relax in in Ukraine, says Burjak. She recommends that her Ukrainian colleagues do internships in Germany: “As many colleagues as possible should come here, but also nurses.” Now the doctor also knows what materials and equipment are still needed in Ukraine in order to be able to treat the wounded more effectively.
Adaptation from the Ukrainian: Markian Ostapchuk
Autor: Danilo Wrist
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The original of this article “German know-how for the treatment of Ukrainian war victims” comes from Deutsche Welle.