Taking care of the wounded: Ukraine's own and borrowed experience

Dmytro Afanasiev, head of medical projects at the Kolo Charity Foundation, discusses the foundation's activities, such as equipping evacuation trains, supplying wound vacuum devices, and borrowing experience.

Activities of the Kolo Charity Foundation

Yelyzaveta Tsarehradska: Could you tell us about the Kolo Charity Foundation?

Dmytro Afanasiev: It is a charitable organization that has existed since 2013. Our activities were initially aimed at expanding Ukrainian culture. Still, when the full-scale invasion occurred, it was a situation of "choosing without having a choice": everyone started doing what had to be done in those first days, weeks, and months. Then, we analyzed our activities and arrived at something more precise and systematic, choosing certain fields, particularly medical projects in my area of ​​responsibility.

Evacuating and treating the wounded

Yelyzaveta Tsarehradska: We often talk about the needs of our warriors at the front and raise money for weapons. Meanwhile, according to my observations, tactical medicine and related topics come second at best on the list of priorities. Please tell us about the most important projects you are engaged in.

Dmytro Afanasiev: When the invasion began, everyone was engaged in everything, and then specific areas were singled out. The voice of the military about the need for drones, jamming systems, and trucks is loud; society hears it, and it's important. Even grandmothers now know what drones are and why they are needed, and they contribute to fundraisers for drones. Some veterans need prosthetic devices and rehabilitation; society also hears about these needs. At the same time, there is a layer of people who have no voice but need help because they are in a zone between life and death, and it is often unknown on which side they will end up. This is voiced by doctors, and we try to help out here by providing assistance to those fighting for life.

One of the bright and highly useful projects in Ukraine is evacuation, particularly by trains organized thanks to the cooperation between the Medical Forces Command and the Ukrainian Railways. I am happy that the Kolo Charity Foundation is also involved in this project.

Iryna Soloshenko, who manages this project, is a very talented person. This system currently permits evacuating more than 70% of all wounded from locations where they have received first aid. These are carriages transporting stabilized patients and resuscitation carriages where medical treatment can be provided during transportation. We were involved in equipping these carriages. We can be really proud of this project as it meets the requirements of our time and is unique worldwide.

The project I have been working on since March 2022 is focused on supplying wound vacuum devices to medical institutions that provide free medical care to victims. With vast numbers of our defenders wounded by shrapnel, it was difficult for me to imagine that such a thing could be done with their bodies. The only way to help them was to apply therapy that helps avoid infections and creates special conditions in which cell reproduction increases three to four times.

The volunteer community responded actively, and a fairly large number of these devices were brought to Ukraine, but there were other challenges. The devices came from all over the world, so we received over 180 different models, each requiring different consumables.

Securing them is a difficult task even in peaceful times because consumables are needed constantly, in large quantities, and in every medical facility. Nevertheless, we found an American company that produces universal consumables for all models. We tested them and received positive feedback from medical facilities. So, now our task is to create a fund that would allow us to provide these consumables to our facilities on a monthly basis. We need to draw public attention to this issue in order to provide the necessary assistance, as almost 90% of the wounded need it.

Ukraine's and Israel's experience in caring for the wounded

Yelyzaveta Tsarehradska: How does the process of helping the military develop? We understand that after first aid is provided, medevac transport has to deliver the wounded to a stabilization point, and from there, they are taken to the hospital by evacuation trains. These are multiple stages that society does not necessarily know about.

Dmytro Afanasiev: It's really important to know about all those heroes who do their job at every stage to save the lives of our defenders who make it possible for us to live and communicate calmly. When I met with the Israeli military quite a while ago, I was amazed at how much society and the state were ready to act to provide them with the necessary assistance at every stage in case of need. The military needs to know they have this support and be certain that this system will work properly. Ukraine's situation is special because we have a very long front line, unlike Israel. But if you analyze Israeli experience, you can put together our own Ukrainian puzzle from individual elements.

Yelyzaveta Tsarehradska: From your experience, are the communication processes set up properly? It is crucial for all the systems to be interconnected and for people to communicate clearly and quickly when it comes to transporting our wounded warriors.

Dmytro Afanasiev: You are right, but I cannot speak about the whole picture. We are responsible for supporting people engaged at certain stages. We have supplied and equipped evacuation vehicles and worked on the resuscitation evacuation carriages I've mentioned.

Wound vacuum devices are used at many stages. When the wounded have been stabilized, they can be transferred further, unhooking them from one device and connecting to another. We clearly understand that this significantly reduces the percentage of amputations and subsequent disability.

Any system needs a clear structure with deadlines, responsible personnel, necessary resources, and certain reserves. In Ukraine, various volunteer, public, and charitable organizations have extensive experience in providing assistance. However, I think these actions are more local rather than interlinked into a single whole. Ukraine has excellent examples of well-coordinated systems, such as "Diia" and centers for administrative services. Some managers put together teams, developed plans, and implemented them. We need this in the medical field now; having such a neighbor, we will need it in the future.

Yelyzaveta Tsarehradska: In your opinion and from the experience of communicating with Israeli colleagues, is it possible now to rev up cooperation between Israel and Ukraine in the areas of your involvement?

Dmytro Afanasiev: In March 2022, we simply donated about UAH 70,000 to purchase wound vacuum devices. When it was necessary to provide them with consumables, I realized how big of a logistical challenge it was. I made phone calls to doctors I knew in the USA, Israel, France, and Germany. We received the necessary information and tried to apply it to the Ukrainian situation. I am against blind copying because it does not work. We need to look at how something is done elsewhere and build a model to suit our scale and needs. Volunteering has flourished in Ukraine; we have acquired experience, and this potential now needs to be used.

Financial support

Yelyzaveta Tsarehradska: Many may say that all of this sounds good, but it requires additional money we don't have. Is it a myth or the truth?

Dmytro Afanasiev: Expensive and cheap are relative concepts. How much does a human life cost? A set of consumables for an average seriously injured person costs from $300 to $500. Without them, the wounded will probably not be saved. Ukraine does not have the necessary money for this, so we turn to Europe and America. They often don't want to invest in some military application, while medicine is a different matter. That's why probably 95% of the funds we raised came from the West. For them, a few million dollars is part of the corporate social responsibility line in the budget of one corporation. At the same time, for us, it's an opportunity to enable key medical institutions to provide medical care constantly.

Yelyzaveta Tsarehradska: What are you busying yourself with now besides supplying wound vacuum devices?

Dmytro Afanasiev: In general, we have quite a few projects, but this direction is currently the main one because it is much needed. We are also developing a project to set up a blood bank in a military hospital in Kyiv. It should provide the entire country with the necessary amount of blood and plasma. There is a lot of talk about prosthetics, and the main difficulty here is the number of prosthetists, which has not changed much. Kolo wants to develop this direction and has established an NGO centered around the Kyiv Polytechnic Institute. Personnel is trained, and the most advanced technology, including equipment, is assembled there.

This program is created with the support of Ukrainian Jewish Encounter (UJE), a Canadian charitable non-profit organization. 

Originally appeared in Ukrainian (Hromadske Radio podcast) here.

This transcript has been edited for length and clarity. 

Translated from the Ukrainian by Vasyl Starko.

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