An NHS Lothian plastic surgeon has opened up on providing life-saving treatment in Ukraine during the ongoing conflict with Russia.
Patrick Addison, Clinical Director for Plastic Surgery, recently flew out to the war-torn country to offer his clinical expertise and to support the development of ortho-plastic services in the country.
Patrick, 54, was based in the Lviv Emergency Hospital in Western Ukraine where attempts were underway to establish the country's first plastic surgery department. Prior to the war, no services were available and only limited scope for reconstructing limbs or other parts of the body destroyed by cancer or accidents were available.
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Patrick recalled his time in Ukraine and painted a stark picture of the stresses hospitals were and currently are faced with, including very few nurses, limited PPE and conducting procedures during frequent power cuts and air raid sirens.
Patrick, who treats patients across the Lothian area, said: "There were just four nurses with very limited experience and clinical skills, managing well over 100 patients There were no alcohol dispensers to be found, gloves were a rare commodity and I quickly learnt not to expect a plastic apron.
"Throw in frequent power failures, regular air raid sirens and the occasional cruise missile strikes to create a really challenging environment."
While Patrick is used to treating patients back home who have not long since sustained an injury, patients in Ukraine have more than likely travelled to various different hospitals with multiple injuries.
Patients are often malnourished and have badly infected wounds that are extremely difficult to manage. Case histories are difficult to capture accurately with surgeons often having to rely on experience and judgement to determine what treatments the patient may have had previously and how they sustained their injuries.
Patrick added: “The hospital in Lviv is undergoing renovations but the trauma patients are mainly restricted to decaying 1950s operating theatres with outdated equipment. Drugs including antibiotics, anaesthetics and analgesics are in very short supply, as are wound dressings.
“In theatres, much of the ordinarily disposable equipment is re-used indefinitely. Scalpel blades, burrs and needles are blunt and fracture fixation metalwork is used until it breaks.
"The junior doctors perform all the tasks of their western counterparts but are also the porters, translators, and ‘fixers’ who deftly manage all the logistical problems that arise throughout the day, source the materials required for each operation, and bring them to theatre in a plastic shopping bag.
“Despite everything they are going through, the Ukrainians I met are incredibly friendly, resourceful, adaptable, determined, enthusiastic and highly motivated. The invasion has only strengthened their determination.
"As respecting the resilience of Ukrainian healthcare staff, my experience in Ukraine reminded me not to take for granted all that we have here in terms of access to cutting-edge equipment, medical supplies and drugs.
"The NHS may be facing some of the most challenging times in its history, but we must not lose sight of how special and important an organisation it is. It is humbling to have been able to help just a little but so much more help is needed."
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