UKRAINE. The trauma care available in Ukraine is of a high standard, but how care is organized has significant problems. Corruption and an inability to use care resources the best way hurt the country’s crisis preparedness from the outset, according to Amir Khorram-Manesh, docent at the University of Gothenburg.
Amir Khorram-Manesh is a docent in surgery with a focus on disaster medicine and trauma at the University of Gothenburg, as well as chief physician at Sahlgrenska University Hospital. After the European Union negotiated a fragile cease-fire, in 2015 he joined an international group of experts tasked by the EU to support Ukraine’s crisis preparedness. At that time, the group visited the capital city of Kyiv and the country’s second largest city, Kharkiv, to establish training programs in crisis and disaster management.
Run-up to the crisis
Even at that time, while the lead up to the current crisis in Ukraine was occurring, and Amir Khorram-Manesh recalls that he suspected where it was headed.
“We had a positive reception in Kyiv, where we met with key individuals in healthcare administration and doctors. Then, once we established contact with the university in Kharkiv, we saw a clear desire to be updated on disaster medicine, and it was evident that the city was much closer to the Russian border.
We offered training in the form of lectures and practical exercises that work very well here at home and that have also worked well elsewhere in the world, such as Thailand. But I fear it has not been well maintained in Ukraine. Today there are several private companies in Ukraine that use the equipment and materials we brought, and it is unclear whether the government agencies or hospitals have oversight over the training we established.”
Fundamental societal problems
He concludes that trauma care at hospitals in Ukraine is relatively high quality and that medical staff are more than capable of handling the injuries that can happen in a war. However, proper governance and organization are lacking, particularly with everything related to emergency medical services. At the same time, he is concerned that the country’s Soviet legacy may be an obstacle if the crisis culminates in war. The country’s crisis preparedness would benefit from a comprehensive change in society.
“There were and still are problems with corruption. It was common for key people asked what they could benefit personally from new programs and organizational changes. Important material is not delivered or perhaps isn’t used as it should be, and there is no ability to optimize the use of healthcare resources. The country’s ability to offer emergency care before patients reach hospitals, known as pre-hospital care, is also very poorly organized.”
Amir Khorram-Manesh is editor and co-author of the international Handbook of Disaster and Emergency Management, a revised edition of which was published last year. The book can be downloaded free of charge online at: https://www.researchgate.net/publication/355107219_Handbook_of_Disaster_and_Emergency_Management_2nd_Edition_2021
BY: ELIN LINDSTRÖM
