They were nurses and doctors providing care as it is given everywhere in the West. Then, overnight, they had to heal war wounds. Often without proper training, healthcare workers in Ukraine have had to reinvent themselves and improvise — under stress, urgency and insecurity — to save lives and care for their fellow citizens.
By an unexpected coincidence, her 21-year-old son, who lived in Boutcha, returned to kyiv the day before the Russian invasion. Then when explosions sounded shortly before dawn on February 24, 2022, Oiena Prymak took charge of Kyiv’s Okhmatdyt Hospital, Ukraine’s largest pediatric hospital, where she serves as chief nurse. . “I couldn’t imagine myself leaving and leaving my patients and colleagues behind. »
Several of his colleagues – about half – however made the opposite choice and fled the region. “We don’t judge anyone. It’s a difficult choice when you have a family and children, ”slips the 44-year-old woman.
On the second day of the attack, Oiena asked her husband, son and 14-year-old daughter to accompany her to the hospital. And they didn’t come out for 43 days. “It was dangerous to move to kyiv, so we decided to live there,” she explains. At the hospital, the needs were immense: it was necessary to take care of the young patients already on site as well as to take care of the wounded who were beginning to arrive.
In an emergency, Oiena’s husband and children pitched in to help her reorganize the hospital. Sick children were moved to the basement, safe from the bombardments. Operating theaters were hastily refitted, also underground. Oiena leveraged her networks to find medicine, medical equipment and food to keep the hospital afloat. And the head nurse listened to her nursing colleagues to support them. “They were shocked and lost. »
On the first night, a pregnant woman showed up at the hospital and had to give birth in fear, holed up in the basement of the hospital. “Giving birth must be done in happiness and joy. This woman was so terrified that when I offered to take her baby to rest, she was never able to let go,” Oiena said with tears in her eyes.
To cope with the chaos of the first days, the hospital welcomed patients of all ages, and no longer just children. “A family tried to escape the occupation in Irpin [près de Boutcha, en banlieue de Kiev]. But the Russians fired. Only the husband made it to the hospital alive. We had to amputate his leg,” says Oiena with emotion. This family had previously fled the occupation, this time to Luhansk in 2014, when pro-Russian forces invaded the territory. “She tried once again to escape the war, but horror overtook her. »
Fatigue, psychological and physical, has accompanied Oiena for almost a year and a half now. “But even if it’s very difficult, we will never give in,” she says. Hospital rooms are filled with children — from all over Ukraine — who have had to have amputations or have metal shrapnel in their heads. “We could save more lives and avoid amputations if the children could arrive at the hospital by plane, but the airspace is closed”, and therefore the transport time, by land, is much longer, deplores- she.
“Before, I didn’t know what hating was. But now I know, Oiena mentions through her cell phone screen. Every day I think I can’t hate Russians more, but the next day I hate them even more. »
Mental Health First Aid
For Dr. Maya Bizri, a Lebanese psychiatrist who spent part of her childhood in Montreal, these extreme emotions experienced by healthcare workers in Ukraine must be seen as moral wounds, that is to say traumas that arise “when we are living or practicing our profession in a reality that contradicts our values,” she explains.
In a war zone as in the event of a disaster (COVID-19 pandemic, explosion in the port of Beirut, etc.), resources, human and material, are limited. Healthcare workers are therefore constantly forced to make decisions that are not optimal for their patients. “The moral injury can come from these choices,” says the 36-year-old doctor. Wounds that can turn into shame and guilt. “But we can normalize these emotions by discussing them in a group”, which shows, for example, that other people evolving in the same context share these emotions.
These group discussions are part of the workshops that the psychiatrist led in the spring with 38 health workers working in Lviv, in western Ukraine. Following a request made by the Ukrainian government to the MedGlobal organization, with which the DD Bizri, it offered a corpus of five modules to equip health workers so that they take better care of their mental health, that of their colleagues and that of their patients.
They were taught mental health first aid and given tools to better approach their colleagues. “We should not wait for a person to receive a diagnosis of major depression or post-traumatic stress disorder to intervene. As soon as there are signs, such as anxiety, insomnia, irritability, we can intervene “, without having a training in psychiatry, estimates the DD Bizri.
It also made workers aware of the need to maintain a routine in times of war. Managers, for their part, were made aware of the problem of mental health among their employees. “You can’t have a functioning healthcare system if you don’t have caregivers who can care for patients and be productive,” says the psychiatrist.
Soon, other training should be offered by MedGlobal, but this time, in the form of a transfer of knowledge thanks to which Ukrainians will, in turn, be able to train their colleagues.
The modules will also be adapted based on the feedback received from the first participants. In particular, they asked for tools to deal with the alcoholism of their fellow citizens. A problem that was already present in the country before the war, but whose prevalence is said to be growing since bombs have been raining on it.
Tomorrow: Ukrainian medical technicians trained by Canada before being sent to the battlefield