January 9, 2023
Dr. Abraham and team performed a nasal reconstruction. (From left: Drs. Nebor, Abraham, a local resident surgeon, and Dr. Komashko)
Editor's Note: In early 2022, a team of American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) members gathered to discuss how, as specialists, they could provide aid to injured Ukrainians. The discussion led to a 9-day medical mission trip in September through an AAFPRS humanitarian and educational surgical exchange program called FACE TO FACE, which provides complimentary care to those who suffer from facial deformities caused by birth or trauma.
The following personal account was adapted from an article in the AAFPRS newsletter.
See more about the trip to Ukraine and hear from Dr. Abraham, Dr. Nebor, and others in a brief documentary video by Razom.
This medical mission to Ukraine was a collaborative effort, which I led as chair of FACE TO FACE. We partnered with Razom, the third-largest Ukrainian aid organization based in the US; one of its founders, Mariya Soroka, accompanied us on the trip. The organization INgenious, set up by Ivanka Nebor, MD, who is originally from Ukraine, also helped us provide aid to physicians in the war-torn country. Dr. Nebor played a critical role in arranging the trip. Finally, we collaborated with Healing the Children Northeast (HTCNE). I have led many medical missions with HTCNE and sit on the board. We had 10 surgeons on this trip, all from the New York or New Jersey area, as well as ancillary staff such as nurses, a surgical technician, and administrators to help with logistics.
Because of the active war, it was not possible to fly directly into Ukraine. The team first met in Kraków, Poland, and then took a bus across the border. This was a nearly 12-hour journey, including several hours to cross security at the Ukraine border. We traveled along a special, expedited “green corridor” arranged for our team, and we could see other trucks stuck at the border, which would need to wait for days to cross.
We traveled to Ivano-Frankivsk, a city near the Western border of Ukraine, where we were stationed due to safety reasons in the event that we needed to evacuate our team quickly. There, the team worked at the Ivano-Frankivsk Regional Clinical Hospital with an official invitation from the Ministry of Health of Ukraine and the hospital.
The AAFPRS team gathers with Ukrainian colleagues and dignitaries on the mission’s final day.
Our main partner at the hospital was Natalia Komashko, MD, who organized the effort to help train Ukrainian medical staff through her head and neck society. More than 130 individuals who had traveled from all over the county were in attendance. The surgical procedures were livestreamed to a conference room, and the surgeons were equipped with microphones in the operating room so that we could describe in detail each step we were doing. We operated on a total of 34 patients, with many very complex cases that took 10 to 12 hours each, including microvascular free tissue transfer and 3-D custom patient-specific implants. The surgeries were performed in collaboration with local Ukrainian surgeons.
The team worked incredibly long days, getting up at 5:00 or 6:00 am and not returning to the hotel until 11:00 pm, often just prior to the mandatory curfew when everything was shut down. We worked with our Ukrainian colleagues on all the cases, educating and training as we operated.
At the end of the week, there was a farewell ceremony with the hospital heads, regional governor’s office, and parliamentarians (similar to US congresspersons) who were very appreciative and thanked us for our efforts. We estimated that we provided more than $1 million of donated medical supplies and services on this trip.
Despite the security concerns—sandbags and metal anti-tank barriers set up at street intersections and around important buildings, frequent emergency alerts, and air raid sirens—we were able to successfully conduct this mission in partnership with our Ukrainian colleagues. Together, we took care of many patients with severe facial injuries from the war, providing state-of-the-art care that would have otherwise not been available to them. Our team was incredibly impressed by the resiliency of the Ukrainian people, with many patients intent on returning to the war effort despite their severe injuries. It was an exhausting but incredibly gratifying experience.
Since our trip, the situation in Ukraine has deteriorated further, but we hope to send additional teams soon. We are currently working on bringing Ukrainian surgeons to the US to provide training on microvascular reconstruction and other advanced reconstructive techniques. In this way, when the surgeons return to Ukraine, they will have an exponential impact by taking care of the large number of patients with devastating injuries from the war.
Dr. Manoj Abraham is a facial plastic surgeon in Poughkeepsie, NY, and a clinical associate professor in the Department of Otolaryngology at New York Medical College in Valhalla, NY. He also is a Specialty Society Governor for the ACS Advisory Council for Otolaryngology-Head & Neck Surgery.