The bombing of hospitals weakens the possibilities of treating not only those wounded in the war, but also other clients of specialized medical care and basic health care. They will also be moved from the country. In the east, the situation of hospitals near the front is alarming.
Small-looking warts may require extensive and long-term treatment.
In the attacks of modern war, there are several victims at once, all with many injuries
During the Second World War, many wounded in the war had to be cared for in Finland as well. Actual special expertise in the treatment of war injuries is not as widespread anymore. During the long period of peace, the ways of warfare have changed a lot.
Artillery weapons and missiles used in modern indirect warfare cause many victims at once and many different injuries to their victims. Actual war injuries are usually various shrapnel, crushing and limb injuries as well as tissue damage.
For example, those Finns who are doing aid work in countries at war are familiar with the treatment of injuries. Through SPR, doctors and nurses go for training in conflict areas.
Red Cross aid worker Kim Housing is currently in Yemen. He knows what the traces of different types of disasters and conflicts are like. He has worked in various rescue and treatment tasks in the Philippines, Iraq, Syria and Bangladesh, among others. Asunta is a nurse by training.
– If the situation has continued in the crisis area for a long time, the initial situation of the patients can be really bad. It could be that they haven’t eaten or drunk properly for many days, or haven’t been able to wash themselves, says Asunta.
According to him, the most common war injuries could be compared to injuries caused by traffic or factory accidents. At worst, they can have dozens of victims, as in war, for example, in airstrikes.
– War wounded are always dirty. Every time there is an explosion, a huge amount of soil rises up and is carried into the open wounds. If a bullet comes out in a combat situation, fibers from clothing and equipment get into gunshot wounds.
Today, the infection of battle wounds can be prevented with antibiotics, but before antibiotics, most of the deaths of war wounded were due to infections.
A small damage can be big
It may come as a surprise to a patient or their loved ones who received war injuries in first aid that the damage that initially seemed small is actually in a significantly larger area after the first operation. According to Asunna, this is due to the fact that all bad tissue and possible foreign substances must first be removed so that healing can begin.
Corrective, aesthetic surgery is only performed later.
Working in a war zone requires medical professionals to be able to apply and operate with limited resources.
Asunta faced the most challenging moment during her assignment in Iraq, when victims of chemical warfare were brought to the hospital.
According to Asunna, quick decisions often have to be made in urgent situations, especially if there are several victims. In the case of the chlorine attack, it was unclear what had happened or whether it was safe to treat the victims of the chemical attack.
– When we talk about a situation where the whole society is in a state of war, such as Ukraine, Yemen, Iraq and Syria, the resources of the treatment facility are already so overloaded that the assessment of the patient’s situation is turned on its head.
– In other words, those patients who under normal circumstances could be saved with, for example, intensive care, their treatment may have to be stopped in order to save more less injured ones, says Asunta.
“It is important to help a country at war”
Among the arrivals have been patients with injuries from the war.
The operation is coordinated by the Helsinki and Uusimaa hospital district together with other hospital districts and the Ministry of Social Affairs and Health. HUS’s responsible senior physician Antti Vento says that those who have arrived in Finland have not needed immediate hospital treatment, but further treatment has been planned for them.
– The load is so low at this stage that it does not affect the treatment of our own patients. It is important to help a country at war in such a situation, says Vento.
STM’s special expert Krista Lyra says that the arrivals can be civilians or soldiers. It is not always a case of someone wounded in the war, but there may be a need, for example, for the continuation of cancer treatments that were interrupted due to the war, or for rehabilitation treatment.
– Patients coming through the EU are all in need of very different types of help.
Comprehensive basic information about the new arrivals is obtained in advance, so their treatment can be planned well in advance, Lyyra says.
Around 880 patients have been transferred from Ukraine to other parts of Europe through the EU rescue service mechanism. Of these, Germany has received approximately 330 patients, Spain approximately 180 patients and Italy approximately 110 patients. Relative to the population, the most patients have gone to Norway and Lithuania.
Requests are added to the common system of all states covered by the mechanism, where states can then offer treatment places according to their own resources. If more than one country offers treatment, it is up to the patient to decide which offer he accepts.
Patients on the eastern front of Ukraine are also treated on the medical train
The Doctors Without Borders organization transports patients from eastern Ukraine to western Ukraine for treatment. One round-trip train journey from Lviv to Dnipro and close to the fighting in the Donbass region takes two days. The train can transport around 40 patients at a time, depending on their needs.
Ukrainian Albina Zharkova has been working on the medical train coordinated by Doctors Without Borders (MSF) since the end of March, starting from the train’s first trip.
In February, after the war started, Zharkova left her job as an assistant professor of medicine at Sumy State University and joined MSF’s lists. Sumy is located in the northeastern part of Ukraine near the Russian border.
Zharkova tells that most of the people driving the train are civilians. The wounded usually have several injuries in different organs.
– I have never seen so many patients in need of traumatic amputation. People often have multiple tissue injuries that can extend into the muscles.
Patients awaiting transplantation are brought to Dnipro from various parts of eastern Ukraine.
According to Zharkova, every train journey has been different. Antibiotics and painkillers have been needed for the first treatment of many patients. Due to the poor availability of medicines, many may need acute help for their long-term illnesses, for example hypertension or diabetes treatment.
– For someone working in such a situation, the most important thing is to understand how to prevent a bad situation from turning into a catastrophic one. You have to be able to save what can be saved.
– The most important thing is to know how to treat tissue damage and, on the other hand, also work with people who are in a difficult situation mentally, says Zharkova.
Hospitals in western Ukraine are also being helped
Although the medical care system in eastern Ukraine has run into problems, hospitals are functioning in western Ukraine.
Evacuees from the east burden the system on the west side. Disaster relief coordinator of the Finnish Red Cross Johanna Arvo visited the western parts of Ukraine last week to find out the current needs of primary healthcare.
Arvo believes that the load will increase even further in the West.
– The needs are very different in the East and the West. In the East, a big challenge is that there will be many soldiers and civilians injured in the war, and in addition there would be many other people who need special medical care to be treated. Hospitals and equipment on the eastern side have been badly damaged in the bombings, and cannot be used.
The problems of those suffering from long-term illnesses pile up when the usual follow-up cannot be done, which in turn burdens basic and specialized medical care. According to Arvo, 10–30 percent of the treatment capacity in hospitals in Western Ukraine has been reserved for the treatment of war injuries.
The Red Cross is in the process of delivering more mobile units to the region, which will be equipped, for example, with the usual selection of medicines that can treat hypertension and diabetes patients, in order to reduce the burden on primary healthcare in Ukraine. Mobile units resembling an ambulance can be used to move to where help is most needed, for example to internal reception centers in Ukraine.
– You can often reach safety without medicines, prescriptions or your own health information. A long and tiring journey can worsen already existing health problems even more. In this, we aim to be of help to the national health care, says Arvo.
You can discuss the matter on 31.7. until 11 p.m.