Medical team from U.S. travels to Zaporizhia to perform reconstructive surgery (12/06/98)

Medical team from U.S. travels to Zaporizhia to perform reconstructive surgery

by Askold Mosijczuk

ZAPORIZHIA - A group of nine health workers representing Interplast - a non-profit organization based in California consisting of plastic surgeons and health care providers dedicated to performing reconstructive surgeries on disadvantaged children throughout the world - traveled to Zaporizhia on September 9.

The team was headed by Dr. Richard Casuccio, plastic surgeon and Virginia Chapter president of Interplast, and Dr. Askold Mosijczuk, a pediatric hematologist/oncologist who also represents the Ukrainian Medical Association of North America (UMAN) and the World Federation Ukrainian Medical Associations (WFUMA). Team members were Dr. Lidia Chapelsky, pediatrician; Mary Ann Markus, RN; Dr. Nicholas Marsh, anesthesiologist; William Oscanyan, secretary; Dr. Joseph Pelkofski, oral surgeon; Dr. Chili Robinson, plastic surgeon; and Lori Rodrigo, RN.

The trip, arranged with medical and local government officials from Zaporizhia, had a dual mission: to provide humanitarian aid to children with congenital birth defects, and to exchange medical information, including advances in anesthesia and reconstructive techniques. The mission was personally endorsed and supported by Ukraine's ambassador to the U.S., Dr. Yuri Shcherbak, and Ukraine's minister of health, Dr. Andrii Serdiuk.

The Interplast team was warmly greeted by Ukrainian colleagues at the Zaporizhia train station on the morning of September 12 after an overnight trip from Kyiv. Following a traditional generous sampling of Zaporizhian hospitality and a tour of the city, the team visited with the students of the "internat" (boarding school) for ill children in Novo-Mykolaivka the following morning to examine and select the patients on whom they would operate.

The team was greeted with bread and salt by students clad in traditional Ukrainian dress, and entertained with dancing, singing and recitations of Taras Shevchenko's poetry.

What was not immediately apparent was that most of these children are orphans and all had language and speech problems, usually the current result of cleft lip and cleft palate. Although the school is suffering from the financial hardships present throughout Ukraine, the children were very well cared for, educated and happy.

The team saw a similar situation at the Sonechko orphanage for infants and toddlers in Zaporizhia, from which several patients were selected for corrective surgeries. Most of the children already had undergone at least initial surgical repair, in most cases, however, only the first stage of repair had been done - usually lip repair - with palatal repair to be done at an older age, often after age 7. This contrasts sharply with the younger age at which children in the U.S. undergo complete repair - usually by age 1 because of the better technical support, especially with anesthesia, in the U.S.

Over the next five days the Interplast team, shoulder to shoulder with Dr. Oleksander Moseyko, chief of plastic surgery at No. 5 Maxilofacial/External Medicine Hospital and Dr. M. Makarova, pediatric surgeon, performed corrective surgeries on 23 children. Due to the meticulous nature of plastic surgery, the hours spent in the operating room were long, but informative and productive.

The team's anesthesiologist, Dr. Marsh, spent many hours discussing the latest anesthesia advances with his Ukrainian colleagues. This included hands-on training with the $7,000 gas analyzer machine donated by Interplast to the Zaporizhia Children's Hospital, as well as instruction for the operating room nurses and nurse anesthetists on the use of the two pulse oxymeters donated by the WFUMA (value $1,500).

In addition, there were continuous discussions regarding various techniques used by U.S. surgeons, as well as those used by Dr. Moseyko, some of which were patented by the latter and his chief, Dr. I. Berdiuk.

When all of the day's surgeries had been done, the Americans and Ukrainians as one team combined rounds on all post-op patients, as well as pre-op patients for the next day. The discussions were invigorating, the work and effort rewarding, and the patients adorable.

On Thursday, September 17, a press conference was held at Children's Hospital No. 5. This was attended by all of Zaporizhia's news media, national TV from Kyiv, directors of health agencies and government officials, physicians and health care workers. Dr. Casuccio and other members of the Interplast team, as well as Dr. V. Dmytriakov, Zaporizhia's director of health, and Dr. Moseyko were members of the panel that answered numerous questions presented by the media and audience.

The questions, often dealing with comparisons between surgical care in Ukraine and the U.S., were pointed. The answers, especially by the Ukrainian professionals were honest and direct, reflecting courage and integrity on the part of Zaporizhian doctors, as well as a welcome openness on the part of the Ukrainian media. Although Russian was still commonly heard, the Ukrainian language predominated in the exchanges.

After completing all surgeries, the Interplast team received a warm send-off for the train ride back to Kyiv and departure to the U.S. Many excellent and close personal contacts had been formed; much new and not so new information had been discussed, and the dual mission of humanitarian aid and exchange of medical information was successfully accomplished.

It is anticipated that Interplast will return to Zaporizhia on a yearly basis to follow up on the patients operated on this year, and to offer surgical corrections for future children with birth defects.

Dr. Askold Mosijczuk is the president of the Greater Washington (D.C.) UMANA Chapter.

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