One strategy for the development of sustainable care for burned children from Ukraine

In March 2005, a young girl came to Shriners Hospital from Ukraine for treatment of injuries she sustained in a fire while saving her younger sister. Because of her heroic story, the girl had come to the attention of Ukraine’s government, which arranged and financed her transport for treatment to Shriners Hospital in Boston. The tragedy turned to opportunity when the Ukrainian physician that accompanied the girl to Shriners from Ukraine asked for assistance in bringing another patient from Ukraine. The second child suffered a serious injury in e Ukraine in June of 2005 when he was returning home from fishing and the tip of his fishing rod touched a low-hanging electrical power line. He suffered a 4th degree high voltage electrical injury. He had a 25% total body surface area burn, requiring 3 weeks of intensive care and resulting in a right below-elbow amputation.

Dr. Gennadiy Fuzaylov and Ukrainian doctors collaborated on the transportation of the second patient to the US. Dr. Fuzaylov is a pediatric anesthesiologist at Massachusetts General Hospital and works closely with the physicians and surgeons at Shriners Burns Institute in Boston. The second child’s treatment required attention to a number of logistical issues including: (1) completing the Shriners Hospital approval process; (2) obtaining funds for the child and his guardian’s transportation, housing, food and expenses; (3) creating a support network for the patient and his mother to assist them on a day-to-day basis in a foreign country. Dr. Fuzaylov contacted multiple charities who agreed to assist with the necessities for this patient. They have also continued to support efforts on behalf of additional patients.

In the past 5 years, 10 other children from different parts of Ukraine have been brought to the Shriners Hospital in Boston for treatment. The network established for the first and second child proved to be a valuable tool for arranging care and funding for the subsequent 10 children. Dr. Fuzaylov realized that his fluency in Russian, his connections within MGH and Shriners, and his empathy for these families newly arrived in Boston made him perfect for the job as coordinator of care. “If not, then who will help” was his only thought. He soon realized that there were many more unable to make the trip to Boston. How could care be improved for these children in Ukraine?

Through connections made at the European Conference for Burn Care, Dr. Fuzaylov began developing a plan to improve care in Ukraine. He felt collaborating with a surgeon would help his case. He asked Dr. Daniel Driscoll, a plastic surgeon at Shriners and a member of the MGH Department of Surgery, if he would be interested in visiting Ukraine to assess the current system with a long-term goal of improving care. In September 2010, the two left for Kiev for a week. They toured 4 hospitals, saw and evaluated dozens of patients and gave lectures about burn care. They learned a great deal about how burn care is delivered and the impediments to its improvement. They made a follow up trip in June 2011 when Shriners Hospital Outreach Clinic was held, seeing dozens of children and assisting in the surgical care of five. The trip strengthened ties with the Burn Center in Lviv in Western Ukraine Dr. Fuzaylov and Dr. Driscoll imparted some of their knowledge of surgery and anesthesia to a medical staff thirsty for further input and knowledge of the American means of treating patients.

After evaluating the country’s need on 2 visits, an initial multifaceted program of improvement was designed. These doctors felt that small improvements on multiple fronts can improve the care of burn patients in this population.

Dr. Fuzaylov and Dr. Driscoll have been collaborating with the local and national government in Ukraine to arrange improvement in the care at these facilities. The collaborative effort can extend to educating both American doctors about Ukrainian techniques and needs as well as educating Ukrainian physicians both in the US and in Ukraine for further improvement of care. Combined with the government’s burn prevention campaign, the efforts will reduce the mortality and morbidity associated with devastating burn injuries.

Dan Driscoll, M.D.