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Interview with Ohmatdyt Children’s Hospital - Kyiv, Ukraine, reveals realities of cancer care in war

The Global Coalition for Radiotherapy has been conducting interviews with hospitals and oncology centers in Ukraine since the start of the war to address the needs for our colleagues and cancer patients.


On 12 August 2022 GCR’s Director of Communications, Darien Laird, interviewed members of the Ohmatdyt Children’s Hospital administration and medical staff to get a glimpse of how the war is affecting their day to day operations.


The interview panelists included:

  • Zhovnir Volodymyr Apollinariovych, General Director, Ohmatdyt Children’s Hospital

  • Anastasia Magerramova, Press Secretary, Ohmatdyt Children’s Hospital

  • Bohdana Bachynska, Senior Radiation Treatment Therapist, Ohmatdyt Children’s Hospital

  • Lyudmyla Vintsevych, Head of Radiation Therapy Department, Ohmatdyt Children’s Hospital

  • Stanislav Rebenkov, Head of Radiology Center, Ohmatdyt Children’s Hospital

Ohmatdyt is the largest children's hospital in Ukraine, whose department of pediatrics radiation therapy is the first and only one in Ukraine, treating an average of 150 patients annually.

“The main and most important challenge in our work is that the country is in a state of war and that we have at least five to ten air alarms every day and we don't know if a missile will hit us, or if there will be an explosion, if children will die or not. This is the main difficulty.” - Zhovnir Volodymyr Apollinariovych, Ohmatdyt General Director

During the interview, the panelists addressed how they have managed challenges, how their patient demographics and care have evolved, and what the global community can do to lend support.


ohmadtyt children's hospital interview


GCR

Please help us understand the landscape of the hospital right now. How have things changed from before the war to directly after the war broke out to things now in terms of workforce, the patients you're treating and just the camaraderie in your hospital?


Apollinariovych, General Director

The war really made adjustments to the work of the hospital. Especially the first month of the war. Because on the first day of the war near our city, near Kyiv, there was fighting, and there were constant explosions and constant shooting. And this affected the treatment process.


In the first days of the war, we discharged all planned patients from the hospital, and 180 patients with oncological problems, hemodialysis, and other chronic diseases were evacuated. They were evacuated either to the western regions or to Europe. At the end of March, our hospital was occupied by approximately 30 percent. We only provided assistance in emergency cases and military injuries. Well, after the liberation of the regions near Kyiv, Chernihiv and the Sumy, we seem to have started working as a regular children's hospital again.


The work of the hospital was also affected by the fact that many children and mothers were evacuated in the first months of the war, and now the children population in Ukraine has decreased sharply, but due to the fact that we are a leading hospital in Ukraine and that we have an expert level of healthcare, we are full and working on full power.


Magerramova, Press Secretary

I would also like to add that Ohmatdyt is the largest children's hospital in Ukraine, but since the beginning of the war we have accepted adults as well, because there were often entire families among the wounded, and we did not separate patients. Often, it was a wounded mother with a child or a mother and father with a child. And that our youngest patient among the victims of the war was one month old, and the oldest was 83 years old.


Vintsevych, Head of Radiation Therapy Department

The department of pediatric radiation therapy is the first and only one in Ukraine. We started work in 2018. We treat 150 patients annually. At the time of the beginning of the war, on February 24, we had seventeen patients. All patients came for treatment that day. Not all the staff could get to work, but all the patients came.


We understand that it is impossible to interrupt the personal treatment of such cancer patients. And our treatment was not interrupted, not for a single day. The linear accelerator worked six days a week. We had remote support and were fully providing the services to all patients who needed them. And in addition, many oncology institutions were closed in Kyiv, and only three were working, including us, and adult patients were also coming to us for treatment. We started the course of treatment for some, and for others, we continued their course.


GCR

At the start of the war, what were the main barriers that you were facing? And now that, as you have said, there is a slow return to normalcy, what are the new barriers you're facing? Including the responsibility to take on new patients as they are transferred to your hospital?


Apollinariovych, General Director

The main and most important challenge in our work is that the country is in a state of war and that we have at least five to ten air alarms every day and we don't know if a missile will hit us, or if there will be an explosion, if children will die or not. This is the main difficulty.


GCR

What is it that you're doing to try to keep that morale among the workforce and among the children when there are these daily, moment-by-moment reminders that there is a war going on around you?


Apollinariovych, General Director

Our hospital has a psychological department. We have psychologists who work both with parents, their children and medical personnel. In addition, the hospital administration conducts many different activities that support doctors psychologically and motivate them for further, fruitful work.


GCR

Is there something that you think the global community, especially the global radiotherapy community, can do to help boost morale?


Rebenkov, Head of Radiology Center

From the first days, the war became a huge shock for everyone and some people were forced to evacuate, there were problems with getting to work, and many employees simply could not get in the hospital or found themselves under occupation. And in these conditions, all the equipment of our hospital worked 24/7 thanks to those people who were staying in the hospital around the clock for more than three or four months.


We practically lived in the hospital and helped all patients, all the services were provided in a full range, and sometimes even more thanks to the selfless work of laboratory assistants, technical specialists, physicists, and, of course, doctors.


Last year, thanks to the administration of the hospital, Ukraine’s Health Ministry, and active doctors from other departments, we achieved an agreement to update our linear accelerator so that we could perform all radiation therapy techniques at the world level. The documents for that were signed at the end of the year, and the process of the renewal of our equipment began. It continued despite the war throughout the entire winter and spring. The updating of the linear accelerator was completed in June, but during this process, the linear accelerator was temporarily stopped for only three weeks.


In the meantime, we continued treating our patients, regardless of any difficulties, war, or the lack of personnel. I think that our radiotherapy community would be interested to know more about our equipment and what has changed in our work, so I invite our head of the radiation therapy department to tell more about our capabilities. I also would like our radiation therapy laboratory assistant to share her work experience during the time when she performed the full work of a laboratory assistant and sometimes a physicist herself for more than three months.


Vintsevych, Head of Radiation Therapy Department

This year started very well for our department, our team went to Jordan for an internship. And we used this knowledge in order to implement another new technique that is absolutely necessary at the stages of conditioning during bone marrow transplantation. This technique is ​​Total Body Irradiation (TBI). On the third of March, the first child in Ukraine was supposed to receive TBI. We did part of the work, we had everything planned out, but unfortunately, all our plans were disrupted by the war. This girl was evacuated and continued treatment in Poland. But despite the war, we still were able to perform Total Body Irradiation again by the 8th of June. This is the beginning of the TBI era in Ohmatdyt. Our first patient was an adult woman, and in a month, June and part of July, we performed four TBIs with adults.


Also, from the end of May, we were accepting children who came from the Mykolaiv region, Chernihiv, and Kharkiv region, Vinnytsia, where the atmosphere was very tense and hot. These were mainly children with brain tumors, who were not even diagnosed with these diseases during the war because our colleagues in the local hospitals regarded the symptoms as stress.


GCR

Is there a concern that there are several patients in the area that because of the war continuing, maybe the fear, maybe the stress that they won't come in to get diagnosis. And so you'll be dealing with some late stage diagnosis treatments in the future?


Rebenkov, Head of Radiology Center

Unfortunately, this situation is already happening and we are seeing a large number of neglected cases that should have been diagnosed two to four months ago. But people, being in the occupied territories, or territories where there was a complete lack of medical support, did not have the opportunity to take their son or daughter to a doctor and get a timely diagnosis.


There is a large number of surgical pathologies that require much more treatment, and a large number of tumors that we observe, both solid and tumors of the central nervous system in difficult cases. And this is already happening, children are admitted in fairly late stages of cancer.


GCR

And as a follow up to that question, what is it that will be essential for your hospital, also for the global community to help with so that you can rebuild? And to get to the point where you're not dealing with this care gap?


Apollinariovych, General Director

It’s true that in Ukraine there’s a humanitarian catastrophe caused by the Russian invasion of Ukraine. And we have problems not only with patients with tumors or oncology problems, we see different types of problems. From normal nutrition of small babies to this difficult problem like oncology. Every type of medicine now is a big problem. In many directions of health care, we have many questions. Not only oncology.


And I said that there are really many cases of advanced oncological diseases, endocrinological diseases, and other diseases in Ukraine. And all this is connected with the war started by Russia. And the problems arise not only for oncological patients but even for feeding babies who sometimes need the formula and cannot get it in places of hostilities.


I also want to say that in addition to such a humanitarian disaster, our radiologists have gained a lot of experience in the treatment of wounded children. Our doctors now have, unfortunately, many experiences in diagnosing children with various injuries from military weapons. In addition, the war disrupted our plans to develop the radiology department. Before the war, we dreamed that our machines would be upgraded and restored, and we would receive the machine to diagnose tumors.


Our dream is to receive one more machine for MRI because now we have a very big queue of our patients, and some patients wait for MRI observation, and examination for more than two months. It’s so long, so long. So this war destroyed many of our dreams.


Rebenkov, Head of Radiology Center

Thank you to the entire international community for the enormous support it has already provided during these months. We have received a lot of help from different departments, not just radiology, and it is very supportive and helps us a lot. And we feel this support. I especially wanted to thank the company Elekta, which helped us carry out this upgrade and gave us a large number of parts as humanitarian aid.


GCR

We thank you so much for all of your time. I just want to end and give each of you an opportunity to share if there's anything else that you think is important to share, whether it's a personal experience or some sort of a call to the global community to aid, to support, to just understand the challenges that you are facing in your hospital.


Bachynska, Senior Radiation Treatment Therapist

I will add that the war made great adjustments to our department in terms of staffing, because as a result of Russia's attack on Ukraine, one of my colleagues had to evacuate with her children, and the other colleague is now at the frontlines. Likewise, our department has undergone major changes in terms of diagnostics. Our CT simulator had to master the diagnostic function as well, because there were many wounded, and the emergency department was located directly above us, and therefore we had to provide assistance in the diagnostic field as well. And we did not stop from the first day both in the treatment of patients and in the same way we provided assistance in diagnostics.


Also, from the experience of our department, we have personal stories due to the fact that when there was an all-day curfew, our patients stayed in our department, they lived there. Apart from that, our department, since it is located on the minus first floor, hosted everyone during the air raid. For the doctors who could go down and the patients. Therefore, we were like bomb shelters, and our patients lived and there, and were treated there. The process did not stop.


There are also personal stories like how our patients cheered us up and themselves. We had patients who would come for procedures and bring us flowers saying, "I haven't had time to buy bread yet, but I brought you flowers." It was really very big support. So it's people like this who create warm stories and warm memories for us despite this global catastrophe that happened and is still happening.


GCR

We know the global community will be inspired by all that you've sacrificed and that you continue to sacrifice as you treat your patients, take care of them, and provide the necessities that they've needed. It's very inspiring. Thank you for sharing.


Magerramova, Press Secretary

We just want to say thank you for your support and for your attention. We want to teach you how to say in the Ukrainian language “Thank you”: “Dyakuyu.”


We are grateful for this interview because we want the world to know the truth about Ukraine, about the war in Ukraine, and about our hospital’s work during the war times. What we see is children with bullets in their hands, in their ribs, legs, children without fingers or legs or with shrapnels in their bodies and so on. It's difficult to understand that this is happening right now in the middle of Europe, and really, we need support in different ways. We are grateful for your time and for your attention.


complete interview transcript
Ohmatdyt Children's Hospital Interview Transcript 12 Aug 2022
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