In the video, a concentrated surgeon gently removes a bullet from a patient’s chest. Except that the patient in question is a plastic mannequin, and that the operating room is a simulation center at McGill University in Montreal. As reported by the Canadian press, this video is part of a program of tutorials, developed since the beginning of March by a group of Canadian doctors to train Ukrainians to operate in times of war. Thousands of kilometers from the battlefields, Quebec practitioners try to help their colleagues to practice war medicine.
Shortly after the start of the Russian invasion, Ukrainian doctors contacted the Steinberg Center for Simulation and Interactive Learning at McGill University by email. They want to get help from this pioneering center in the creation of telemedicine training. The goal ? To be trained quickly in medical operations on wounds typical of armed conflicts. Within the Canadian centre, doctor Dan Deckelbaum, traumatologist surgeon, takes the lead of the project. “If you’re a cardiologist or a dermatologist, you’re a very good doctor, but you don’t know how to treat an injury because it’s not in our area of expertise. These videos can play a vital role in ensuring that procedures are followed as best as possible according to each person’s abilities,” explains Dr. Deckelbaum in The Globe and Mail. With a team of specialist colleagues, he then filmed a series of around ten video tutorials, depicting operations on war wounds that were relatively simple to redo and requiring the minimum amount of equipment.
“Doctors don’t have time to refer to a book”
“In these situations where multiple patients are at risk, doctors don’t have time to refer to a book. Our videos show how the procedures should be done exactly, with visual and auditory support,” points out her colleague Junko Tokuno to Radio-Canada. The videos last from a few minutes to around twenty depending on the complexity of the medical procedures and the severity of the injuries. Only a few video sequences, but enough to allow Ukrainian doctors without training in surgery to know the basic techniques. Through the tutorials, healthcare teams in Ukraine learn to handle a multitude of situations, from people injured by gunshots, shrapnel, and even building collapses. “There are massive numbers of casualties and injuries every day, every moment. Resources are limited, the number of doctors who are experienced in treating seriously injured patients is limited», adds Junko Tokuno.
War does not have the luxury of time. It only took a few days for the Canadian medical team to send their Ukrainian colleagues video tutorials, accompanied by written instructions. To produce the content, Canadian doctors relied in particular on content already produced by the Center for isolated communities in Canada. After being translated by Ukrainian students at McGill University, the new tutorials were sent electronically to Ukrainian doctors in different parts of the country. The files sent are voluntarily light so that the download is not too complex, since part of the electricity infrastructure of Ukraine has been destroyed, especially in the cities most affected by the bombardments such as Mariupol.
Underinvestment and understaffing
If, in any country, a healthcare system is never fully prepared for the effects of a military invasion, this is even more the case for that of Ukraine. Inherited from the Soviet system, it suffers from under-investment and a lack of personnel, in particular due to very low salaries for many years. Dr. Deckelbaum, who has worked with healthcare professionals in Ukraine since 2011, believes in Montreal Gazette that the caregivers on site were now operating under unimaginable tension: “Unfortunately, the hospitals have not been protected and they are victims of bombardments. They use their basements as treatment areas. These are extremely difficult working conditions.”