新闻集（含内容及图片）
2023 年 4 月 7 日 第 445 空运联队飞行员参加全力创伤护理训练
2023 年 6 月 1 日 第934空运联队组织联合部队训练演习
2023 年 7 月 7 日 KC-135 作为在德国和荷兰执行多项任务的平台
2023 年 7 月 7 日 飞行员参加联合CCATT训练
2023 年 7 月 19 日 空军预备役 AE 技术人员与秘鲁合作伙伴参加场景训练
2023 年 7 月 13 日 飞行员、盟国和合作伙伴在 2023 年“机动卫士”期间进行医疗准备培训
2023 年 7 月 20 日 当时间紧迫时，AE 团队会及时赶到
2023 年 8 月 1 日 C-STARS 获得了用于传染病准备训练的新设备
2023 年 8 月 1 日 横田医疗队在 2023 年移动卫士期间与盟友测试应急响应
2023 年 8 月 14 日 医务人员在应急响应制定过程中接受培训
美国陆军第 82 空降师和乌克兰第 80 空中机动师的伞兵从 C-17 环球霸王 III 上降落伞
12-乌克兰医务人员在前线俄罗斯乌克兰战争乌克兰医务人员的故事英语新闻
士兵们：医务人员是如何撤离的
2023年3月23日 乌克兰军事护理人员撤离一名受伤的军人 巴赫穆特附近的前线。
2023年7月18日乌克兰的军队：如何拯救他们 更多的士兵
乌克兰东部前线的战斗医务人员
乌克兰正在建造一支先进的无人机军队
康涅狄格州陆军卫队医护人员在大规模伤亡训练中证明了他们的能力
来自“森林中的革命医院”-前线医生的日记-缅甸边境
来自巴克穆特北部前线的报道——更多的战争爆发——《旗帜报》
德国为乌克兰士兵提供免费医疗的承诺遇到了官僚主义障碍
在前线附近的乌克兰临时医院里-独立报
军事医学正在为下一场冲突做准备
在乌克兰南部前线附近，医护人员冒着火箭为士兵治疗
在他们自己的前线——自反攻开始以来，乌克兰外科医生治疗了一波又一波的士兵——科罗拉多哨兵
乌克兰外科医生在他们自己的前线-俄乌战争-半岛电视台
乌克兰医务人员在前线的最新消息
对一线医护人员施加的压力 乌克兰反击
乌克兰战争的教训及其在未来与近邻对手冲突中的应用——PMC
纪念33岁的皮特·里德，一名在乌克兰牺牲的前线人道主义医务人员
“第二次俄乌战争”——政策报告——RAS_NSA
国家元首访问了巴克穆特地区受伤的守军正在接受治疗的稳定点
作为一名战斗医务人员的潜在危险-创伤后应激障碍-前线反应服务
今天的D简报-更多的导弹击中乌克兰-巴赫穆特前后的照片
乌克兰医务人员在波兰的培训进入新阶段-
美国医务人员必须从乌克兰战争中学习-报告说- JEMS- EMS-紧急医疗服务-培训-护理人员- EMT新闻
乌克兰首次在战场上用大型无人机疏散受伤士兵
乌克兰军队在英国接受战斗医疗训练——面临战场医疗人员严重短缺的国家——日本新闻
乌克兰使用无人机疏散受伤士兵-报告
乌克兰战争-认识一下被炸弹和子弹打伤的医生和护士
乌克兰女医务人员和机枪手人数创历史新高——《华盛顿邮报》
乌克兰——在巴赫穆特附近的一家前线医院里——开放民主
乌克兰的医务人员发动了他们自己的战争，因为进攻方的推进给他们带来了更多的伤员
乌克兰的志愿医生用医院营的大巴从东部前线疏散士兵-
乌克兰一线医护人员每天都面临生死抉择
乌克兰军医在前线奋力抢救生命-俄乌战争新闻-半岛电视台
乌克兰军医在前线附近奋力拯救生命——福克斯新闻
乌克兰军队医务人员在前线拯救生命
乌克兰军队医务人员在前线拯救生命
乌克兰战地医生透露她在乌克兰顿巴斯工作的细节_乌克兰新之声
乌克兰外科医生获得军事医学速成班-或管理新闻
本科生与北约的合作伙伴 减少战斗伤亡
-乌克兰战争-无国界医生组织(msf)
乌克兰血腥的战场教给医护人员的是什么
双子城的康复工作帮助乌克兰人从战争中恢复过来 - 乌克兰 - 新闻中心 救济网
陆军预备役战斗医务人员初级创伤护理经验是一种新途径吗_
外科医生看到一波受伤反进攻后的士兵
一线医务人员的自白
乌克兰的战争——从医生和医疗志愿者的角度看——The Week
俄乌的可转移军事医学经验
乌克兰的血腥战场是教医务人员
乌克兰的军事医学是一个关键的优势
乌克兰军事医学是对抗俄罗斯的关键优势
乌克兰血腥的战场教给医护人员的是什么
乌克兰战争中，俄罗斯在最近的导弹袭击中摧毁了一家医院
在俄罗斯炮火下——一名乌克兰士兵撤离伤员——
我所做的就是治疗伤员”-认识一下为与俄罗斯作战的士兵做手术的乌克兰外科医生
第138战斗机联队医疗飞行员前往伤员救护中心
1000名乌克兰病人被转移到欧洲医院
-俄罗斯-乌克兰战争直播：“判断乌克兰夏季攻势是否失败还为时过早” 乌克兰 _ 守护者
将把饱受战争蹂躏的乌克兰病人运送到挪威医院
乌克兰的火车是连接首都和前线的生命线
乌克兰前线维持医疗保健并完成贫困努力
乌克兰前线志愿救护人员阿富汗士兵
隐藏俄罗斯伤亡人员的医院内部
美国志愿医务人员在摩苏尔战斗中救治伤员
在乌克兰战争中，夫妻医生团队经营前线医院
深入了解乌克兰士兵在艰苦的反攻前线的情况
医生在医院治疗受伤的乌克兰军人
乌克兰无国界医生组织报道了俄罗斯的所作所为
欧盟和世卫组织联手进一步加强乌克兰的医疗后送行动
将远程医疗的好处扩展到乌克兰的战争中
乌克兰武装部队的医生
来自前线“我和所有这些士兵都很亲近”
乌克兰一线医护人员面临迫在眉睫的心理健康危机
在俄罗斯各地区开设医疗保健中心
乌克兰前线诊所内，据称俄罗斯集束炸弹袭击造成大屠杀
拯救乌克兰的生命
为乌克兰战争伤员提供物理治疗
数百万人逃离乌克兰战争
俄罗斯医院“简化”战斗伤害以将士兵送回战场
超级细菌在乌克兰战争的战壕中站稳了脚跟
以从俄罗斯手中夺回被俘的巴赫穆特——野蛮的入侵仍在继续
女性志愿者治疗乌克兰前线部队
德国美军医院治疗在乌克兰战斗中受伤的美国人
乌克兰和波兰建立军事医疗中心
乌克兰军医依靠信仰和天性治愈战争创伤
乌克兰外科医生整天给士兵做手术
乌克兰战争和抗菌素耐药性
乌克兰军医在前线奋力抢救生命
乌克兰军医在前线拯救生命
乌克兰医院加班加点，创伤列车疏散战争伤员
乌克兰士兵在前线附近学习急救
乌克兰兽医学会用尸体战争导航世界
志愿医护人员从乌克兰前线疏散受伤士兵
在乌克兰南部前线附近，医护人员冒着火箭的危险治疗士兵
俄罗斯一入侵，我们就开始看到伤员”
乌克兰武装部队的战斗药物：如何拯救更多的士兵
乌克兰的苏格兰医生在俄罗斯入侵中拯救生命
改造后的美国陆军药房准备训练课程增强了未来作战行动的部队保障
美国国防部 MHS GENESIS 部署完成
美军如何让部队适应高空作战
新的“医疗模拟和生物技能中心”在勒琼营海军医疗中心开业
虚拟教育中心为患者提供健康信息
叙利亚称其挫败了以色列黎明前对大马士革乡村的袭击
新闻集 视频类
12-乌克兰医务人员在前线俄罗斯乌克兰战争乌克兰医务人员的故事英语新闻
13-乌克兰战争在一所戒备森严的医院里，满是受伤的士兵
14-在乌克兰的绞肉机城市巴赫穆特，医务人员总是很可怕
15-在顿涅茨克地区，军医如何在前线救治受伤士兵
16-在乌克兰战地医院的一天
17-乌克兰的军事医院遭受战争的影响
19-在乌克兰前线医院的边缘
20-顿巴斯前线医护人员一天的生活
21-在乌克兰战地医院的一天
22-“22号计划”帮助乌克兰医院应对大规模伤亡事件
23-乌克兰一线医护人员的一天
24-一名乌克兰医务人员在战争前线的故事
26-在乌克兰前线的医院里
27-乌克兰前线医护人员如何治疗伤员
28-我只做战争期间的乌克兰外科医生
29-前线医院——西方坦克不能很快赶到
18-乌克兰军队摧毁了俄罗斯军队和武装分子
30-怎样才能成为军队中最好的医生
31-在乌克兰境内，一支旅正在“穿越地狱”，夺回通往巴克穆特的一个村庄
32-俄罗斯士兵在穿越铁路后被乌克兰军队伏击
33-法国空军飞行员在军事演习中分享经验
34-治疗被控袭击战地医院的俄罗斯士兵
35-乌克兰外科医生面对一波又一波的伤兵
36-乌克兰医护人员的随身摄像头显示了战争的恐怖
37-乌克兰战争前线医院治疗乌克兰士兵
38-乌克兰战争在一所戒备森严的医院里，满是受伤的士兵
39-乌克兰战争中的瑞典312医疗部队
40-在乌克兰稳定点前线拯救生命
42-在线考试-前线服务乌克兰医务战争
43-在战争前线运营的乌克兰野战医院
13-乌克兰战争在一所戒备森严的医院里，满是受伤的士兵
14-在乌克兰的绞肉机城市巴赫穆特，医务人员总是很可怕
15-在顿涅茨克地区，军医如何在前线救治受伤士兵
16-在乌克兰战地医院的一天
17-乌克兰的军事医院遭受战争的影响
18-乌克兰军队摧毁了俄罗斯军队和武装分子
19-在乌克兰前线医院的边缘
-
+
首页
乌克兰的战争——从医生和医疗志愿者的角度看——The Week
在乌克兰的战争，正如由 医生和医疗志愿者 在乌克兰工作的医护人员冒着生命危险去提供治疗和帮助 受伤的  混乱中的护理：医疗医生在前线治疗一名受伤的乌克兰人 | Bhanu普拉卡什钱德拉 西弗斯基 ·多内茨河分为两个交战的国家 俄罗斯西南部 ，来自乌克兰东部 。它蜿蜒曲折地从 位于别尔哥罗德北部的俄罗斯中部高地，流经乌克兰境内 卢甘斯克和顿涅茨克抨击了俄罗斯最初的特别 目标 从2022年2月24日开始的军事行动 原产国。在战争的最初几个月里 ，俄罗斯士兵们都做到了 他几次试图过河，但被乌克兰人阻止了 力因此，这条河继续作为一个自然的边界。 也许 ，这就是为什么四个孩子在普里维拉 ，一个小镇的岸边 卢甘斯克州利西尚斯克市的河流 就在俄罗斯进攻的威胁迫近之际 。可悲的是，河流 没有堵上墙，孩子们就被随后的炮弹击中了 当俄罗斯军队在去年6月28日至6月30日之间过河时 年 Pirogov第一志愿移动医院（PFVMH ），一个乌克兰人 非营利组织的民间卫生保健专业人员 ，立即得到了通知 还有一支疏散小组被派往普里维拉运送物资 孩子们，两个男孩和两个女孩。但是当团队到达的时候， 男孩们已因伤势过重而死亡 。这两个女孩中大一点的那个， 12岁时 ，表现出非凡的勇气，带领她的妹妹去了a 地窖但在这个过程中，女孩们受了重伤。 PFVMH小组迅速采取行动 ，将这些女孩们转移到了一家野战医院 巴克穆特 ，距离莱西坎斯克55公里 。那个大一点的女孩被宣布死亡了 到达货物相抵后净额与此同时，小女孩的情况使病情迅速好转 病情恶化 ，野战医院设备无法提供 她迫切需要先进的创伤护理 。所以，PFVMH做了一个 大胆决定将她转到德尼普罗的梅奇尼科夫医院 著名的医疗机构可以追溯到1798年。这意味着 穿越了200公里的战争灾区。 “我们看到许多救护车和救援车辆被枪击 并被俄罗斯的反坦克导弹、自动枪炮和步枪摧毁。” PFVMH的联合创始人詹纳迪 ·德鲁佐科告诉《世界周刊》。这个 俄罗斯人不遵守日内瓦公约所规定的规则 其他保护医疗人员的国际协议。所以车辆 带着医护人员去前线必须避免打红十字会， 这是战场或战区保护的典型象征。 相反 ，我们不得不用绿色的颜色来伪装我们的车辆 他们不那么明显。” 尽管存在风险 ，PFVMH还是把女孩转移到了Dnipro 没有出现明显的拖延，这个女孩就奇迹般地活了下来。他们 他告诉我们，我们已经实现了不可能的事情，” 德鲁琴科骄傲地说 用他的声音表现出来。“女孩的生存成为最重要的 我们整个团队都取得了重大的情感胜利。”  拯救生命：在Pirogov的志愿者 移动医院救护车|提供： PFVMH PFVMH成立于2014年，当时是在美国内战爆发后 乌克兰东部的东巴斯地区，在此期间俄罗斯武装了俄罗斯的支持 分裂分子占领了乌克兰政府大楼并宣布成立 独立PFVMH在冲突地区提供了医疗援助， 在顿涅茨克和卢甘斯克的49个地点运营其流动医院 治疗和治疗超过56000名患者。它吸引了近500名技术人员 来自不同背景的医务人员、护理人员和支持人员。当 大流行爆发后 ，PFVMH缩小了其在冲突中的活动 志愿者以新冠状病毒的形式返回各自的医院 战士 。但它仍已做好了应对紧急情况的准备。与 在俄罗斯入侵开始后，PFVMH恢复了其关键行动。 PFVMH可以说是最有效的民用倡议 站在前线 ，确保对战斗人员和平民的医疗护理 在“黄金时刻 ” 内，关键的60分钟窗口从这个时间开始 让病人接受明确的治疗 。其疏散小组 包括急诊医生或麻醉师 、护士 还有一名司机 ，在高风险地区有额外的安全人员。这个 在过去的一个半年的时间里 ，这个团队已经治疗了超过2.3万人 年  根纳迪 ·德鲁佐科（左二），PFVMH |的联合创始人： PFVMH PFVMH在院前的不同阶段提供服务 关心“ 我们在战场附近有过境点，我们在那里提取 然后把受伤的士兵转移到稳定点 ，” 他说 他曾是一名宪法律师，在成为一名 志愿者一线医生。“在这些稳定点 ，我们有一个 前手术组 ，处理重伤手术病例。在……之后 我们把伤员运送到后方的医院，我们也在工作 和军人一起在稳定点。我们的一线团队 包括大约40到50名医务人员，以及技术人员 ，包括 司机 、技术人员、保镖 、厨师和清洁工。” 虽然它缺乏社会保障和保障 政府 ，战斗人员接收，PFVMH确保彻底 在将医护人员部署到前线之前，先对他们进行培训 每月定期在基辅进行培训课程。医生自愿与 PFVMH接受战术战斗伤亡护理训练 ，即教学 基于证据的，挽救生命的创伤护理技术 战场 。他们配备了防弹衣、头盔和个人装备 急救包。  桑托什库马尔博士 “乌克兰军队委托我们解救伤员 士兵们，知道我们的专业医生有最好的机会 将它们安全送往医院，” 德鲁琴科说。他回忆起保存了一个 顿涅茨克地区斯洛维扬斯克在一场激烈的战斗中受伤。 “他的心停住了四次 ，”他说 。“每一次，我们都设法做到了 这使他苏醒过来，他就恢复了知觉。后来 ，我们意识到那是他的 那天的生日。所以 ，这就像是他的两岁生日一样 生日 ” 战斗人员伤亡的确切人数 俄罗斯方面和乌克兰方面仍不清楚。但它是 据估计，双方至少有十万名士兵丧生 或者到目前为止受伤。平民伤亡的人数也不确定，但是 联合国人权事务高级专员办公室的文件记录 在2022年2月24日至2023年7月30日期间，有26,015名平民伤亡， 其中有9369人死亡，16646人受伤。然而 ，OHCHR 他承认实际的平民伤亡数字可能会更高， 由于一些报告仍在俄罗斯等地有待证实 占领了顿涅茨克和里西昌斯克，波帕斯纳和 卢汉斯卡的西维埃罗多涅茨克。顿涅茨克 、哈尔基夫斯卡和卢汉斯卡 乌克兰东部的爆炸事件 ，乌克兰中北部的基辅和 乌克兰南部的赫尔森斯卡人的平民人数最多 伤亡人数在2022年3月和4月达到顶峰。 然而 ，当考虑到战争引起的发病率和死亡率时 ，就会有一个问题 必须超越在前线发生的事情。 **逃离战争时你会带什么？** “在战争的初期阶段 ，创伤的发生率更高 在平民地区，但随着时间的推移 ，这一数字有所下降 桑托什 ·库马尔，一名印度战争外科医生 ，曾任医学主任 乌克兰应急响应项 目的希望 ，持续一年。“ 大多数 现在的发病率来自于非传染性和非传染性疾病 疾病“这种转变归因于重要的内部因素 自战争开始以来在乌克兰发生的流离失所事件 。它是 据估计，至少有600万乌克兰人在国内流离失所， 超过800万乌克兰难民已经登记 欧洲自战争开始以来。“ 随着人们的迁移，那些与 更多的资源往往会搬到城市 ，然后租一些地方居住 。然而 随着战争的继续，许多人失去了资源 ，最终来到了郊区， 村庄和最终不适合居住的地方，”库马尔说 。他们 失去了获得医疗保健、电力和 水这种缺乏获得卫生保健的机会造成了严重的后果 。为了 例如 ，患有高血压或 心血管疾病可能无法到达保健中心或 由于运输困难 ，诊所获得药物。 因此 ，他们停止服药，从而导致健康 并发症甚至死亡。“这种情况尤其令人担忧 对于孕妇来说 ，因为她们可能无法获得适当的设施 分娩 ，导致母婴死亡率增加 。”  不朽的精神 在顿涅茨克的救援行动|法新社 库马尔曾在超过45个国家的冲突地区工作过 发现俄乌战争是一次独特的经历 。他所看到的 在乌克兰 ，这让他悲痛欲绝 ，是的，但也是深深的反思 。他 叙述了一个涉及一名国内流离失所的妇女的例子 乌克兰南部的赫尔森。在从赫尔森撤离期间，a 桥是那些逃离的人登船的最后一个点 库马尔和他的团队对他们进行了体检 情不自禁的就在那里，他遇到了这位拿着一个包的老妇人 玩具他很感兴趣，询问了这件事 。她告诉他她有了 当她的女儿和孙女离开这个城市时，她犹豫着是否离开这个城市 三个月前离开 。然而，随着战争的升级，她决定这样做 离开  在离开赫尔森之前 ，老太太问她的孙子她是什么 想从房子里拿走，而这个小家伙选择了她的洋娃娃和 库马尔说 。“所以 ，这位祖母只带来了那些 和她的玩具，留下她所有其他的东西 ，包括 贵重物品和衣服。那种互动让库马尔想知道他是什么 他会选择在类似的情况下带走。 库马尔强调，国内流离失所者的人数比例很高 容易受到伤寒和霍乱等疾病的爆发。当他们移动时 从村庄到森林地区 ，水资源变得稀缺 随着这些地方人口的增加，水源可以得到 把…弄脏例如 ，在米科莱夫州的一个城市里，他就看到了 由水源的粪便污染引起的疫情 因为缺少合适的厕所。  遭到攻击：赫尔森儿童医院 ，它被破坏了 俄罗斯今年6月炮击。 此外 ，轰炸或导弹攻击影响严重 发电站和水净化中心等基础设施， 导致了长期的水资源短缺，持续时间长达4天。这个 迫使人们寻找替代的，但受污染的水 来源恶劣的冬季条件也使水难以烧开 没有电力 ，这加剧了获得清洁水的挑战。 乌克兰医疗设施的破坏使情况恶化 许多地方的情况。由人类医生协会发表的一份报告 今年2月，在战争的头几周， 乌克兰的医疗保健系统每天都受到攻击。 “35天来 ，乌克兰的医疗保健系统一直受到破坏 “ 每一天，”上面写道 。“2月和3月的袭击特别强烈。 在入侵的头两周，平均有4到5个星期 医院和诊所每天都受到袭击 。持续不断的攻击 今年3月份 ，共有235起医疗保健袭击事件 从2022年4月到12月，平均每个月发生47起袭击事件。”  帮助之手：乌克兰神经学家奥莱克桑德拉 ·什切贝特曾在美国工作 一个接收 、分类和重新分配食品和药品的仓库 前线。 自2005年以来，库马尔已经去过几乎所有的主要冲突地区， 注意到他目睹了这种针对医院的模式 各种各样的战区。他解释说 ，在很多地方 ，医院都是这样的 被视为敌人修复和加强他们的宝贵资产 战斗员因此，针对医院变得有利 ，如 它阻碍了敌人修复和派遣他们的战士返回的能力 字段。 解决平民获得医疗保健的机会有限的问题 医院的破坏，人道主义 像希望项 目这样的项目采用了几种方法 乌克兰库马尔强调了移动医疗单位（MMUs）的使用 配备了医生、护士 、基本药品和一些实验室 设备这些单位前往偏远地区 ，为人们提供医疗服务 急需的医疗保健和基本药物 。“对于怀孕， 定期进行检查和超声波检查 ，以确保 全面的孕产妇保健 ，”他说。  自2022年3月以来，希望项目的mmu已经提供了超过 2,54,000次医疗咨询，支持350多项现有保健服务 护理设施 。它还采用了“激增能力提高 ” 的策略， 库马尔解释说 ，这包括提供更多的医生 医院和分中心 ，加强设施，建立 妇科客房 ，并确保基本药物的稳定供应。它 还提供培训机会，以提高卫生保健的技能 供应者 战区的创伤护理与和平地区的创伤护理明显不同。 而在和平地区 ，约95%的创伤病例与 交通事故 ，战争中的伤害是由子弹、屏障造成的 棍棒 、尖锐的物体 、爆炸和与烧伤有关的东西 。库马尔指出 卫生界经常错误地试图治疗与战争相关的疾病 使用与道路事故相同的伤害 ，但它需要 不同的培训、设备 、设施和管理系统。 库马尔现在在乌克兰领导了一个创伤培训项目 哈佛大学人道主义倡议（HHI）。最初 ，这个项 目 直接培训了医生，但人们对其可持续性产生了担忧 HHI离开后。为了解决这个问题 ，我们有了培训的想法 并在大学内部建立专门的培训中心 提出了。这样 ，知识和技能就可以继续被传递了 即使是在球队离开之后。 据库马尔说，世界上只有少数专门的教学机构 专注于处理战争中的创伤。“考虑到大量的资金 投资于破坏和战争 ，资源分配给解决 这些医疗挑战似乎相对微不足道 。”我们 设想这些机构能够迎合不同的观众，从平民到平民 医生 ，由大学作为培训中心 。这个 课程包括高级创伤生命支持（ATLS），血管治疗 外科手术 ，骨科外固定手术 ，牙科手术， 腹部手术和超声引导下的神经阻滞专门为 医生也有创伤护理基础等课程 护士和止血剂 ，这是对外行人开放的。 “例如 ，一个医生可能不一定需要专业知识 做一个完整的搭桥手术 ，但这对他们来说是至关重要的 在血管外科的某些方面的专业知识，”解释道 库马尔。“ 同样地，在骨科手术中 ，他们可能不需要 熟练进行骨盆内固定或全内固定等手术 更换 ，但熟悉外部固定器和夹板是 基本的“培训计划还包括组织mmu，增兵 能力管理 ，药物运输，快速评估 ，创伤护理 系统的建立和野战医院的设置。“这些都是小说 即使是成熟的社会也觉得难以掌握的概念 ，”他补充道。  在治疗方面的培训：在一家医院进行的血管外科培训 佐波里齐亚。 毫无疑问 ，这是一个管理战时的专门训练计划 这些情况将在提供服务方面产生不同的优势。此外， 有许多例子表明奉献 乌克兰的卫生保健专业人员 ，他们自愿担任这个角色 这超出了他们的常规责任。 **你能给我开一剂温柔关爱的药吗** **请给我药吗？** 奥莱克桑德拉 ·什切贝特医生 ，一位年轻的乌克兰神经学家，他患有一个 在基辅的私人诊所就是一个例子 。她就是其中之一 最初 ，他们并不相信乌克兰和俄罗斯之间的紧张局势会升级 变成一场全面的战争。然而 ，当战争来袭时，她开始寻找 她在她的家乡卢茨克避难，在那里她有亲戚。 在一段艰苦的旅程中，她和她的亲戚 ，包括她在一起 祖母和一个三岁的侄子 ，开了将近24个小时的车 无法入睡 ，才能到达靠近波兰和捷克人的卢茨克 共和国一到那里，这家人就找到了一套正在出租的公寓 ，但是 施切贝特拒绝继续闲着 。她在仓库工作了几个小时， 接收 、分类和重新分配食品和医疗用品 乌克兰前线地区。在最初的阶段 ，乌克兰人面临着一个 由于恐慌性的购买和交付，药物严重短缺 限制什切贝特作为关键联系人 来自乌克兰不同地区的医生 ，安排特定的药物 从波兰或捷克共和国来解决这一紧急需要 。在 卢茨克，我们的仓库，能够容纳超过500个托盘，成为了一个中心 在将物资运送到有需要的地区之前的分拣点。” 她说 。“由于邮政服务无法运作 ，我们的志愿者接受了工作 用汽车向不同地区运送物资的危险任务。”  艺术治愈：奥莱娜 ·卢森科，基辅的一名心理学家，从事一种艺术活动 治疗国内流离失所的儿童的治疗班。  孩子们的绘画  孩子们的绘画  孩子们的绘画 在来自邻国的医疗用品中，什切贝特 发现了充满了快速康复愿望的情感信件 乌克兰人民身体健康。在来自波兰的一个包裹里 其中含有预防大出血的药物 ，有一种发自内心的想法 信中写道： “我希望你不需要这个。” 回家吧，还活着吧 。” 她被这种感情所感动，同时也回报了同样的精神 给那些遭受战争打击的地区的病人送药。 “ 同时向国内流离失所者运送药物和食品供应 来自国家东部的人 ，现在住在 避难所，我提供了详细的个性化处方如何服用 她回忆道 。令我惊讶的是，人们表达了他们的观点 衷心的感谢不是对这些食物或医疗用品，而是对这些东西 操作指南他们感到有一种强烈的联系 ，尽管我们从来没有 相遇一位女士甚至联系我说要看我的处方 让她在个人层面上感到被关心和被理解。这个 这次经历深深打动了我 ，因为它能让我向人们展示 即使是在充满挑战的情况下 ，我也真的很在乎 。”  新奇的学习 一个训练年轻人的教育容器教室 护士 ，助产士和医疗助理，由健康技术公司建立的没有 与极客无国界和其他运营合作伙伴|接壤 礼貌： HTWB 从战争初期开始，施切贝特就一直在网上提供网络服务 协商 。在缺乏国家数字健康服务的情况下 短信和视频咨询平台，大多数人到达 通过脸书来寻求帮助。她回应了他们 需要协助提供短信 、语音信息和视频咨询。 什切贝特回忆说，她当时处理过许多令人心碎的案件。 “有一次，一个女孩给我发短信说 ，她90多岁的奶奶病了。” 她说 。“那个女孩告诉我，‘我们现在就在一个避难所，这是爆炸 外面奶奶的无意识 。我该怎么办 ’ ” 她已经出局了 基辅 ，靠近东部的某个地方；紧急服务机构无法到达 她因为爆炸而在那里。  班级里的学生在|上提供： HTWB 所以，施切贝特问了她关于她祖母的症状。"I 我意识到这是一种急性中风，”她说 。“这是毁灭性的，因为 我不能在身体上帮助她。所以，我所做的是给予 对这个女孩的心理支持。我一直在和她打电话， 让她相信她的奶奶没有感到任何痛苦，她只是 在深度睡眠中。不幸的是，老太太走过去了 但那个女孩后来写信给我 感谢我，尽管心理支持是我唯一的东西 当时可以给她吗。” 施贝特还接受过格式塔治疗师的训练(看整体 想象的不仅仅是各部分的总和)和心理治疗师。结束 在她15年的实践中，她寻求了额外的治疗教育 经历急性应激障碍和创伤后应激障碍的患者 （PTSD），特别是在2014年乌克兰战争爆发后 使大批国内流离失所者涌入基辅 。尽管 她没有心理治疗执照，没有专门的培训 为她具备了有效沟通的基本技能 这些人。 有趣的是，在去年战争开始前的那个晚上，她确实是这样的 参加新冠病毒爆发后的心理健康会议，而不是 知道她很快就会处理战争的影响 心理健康起初，她遇到了焦虑和急性的情况 压力让人们感到不安，不知道该怎么办 。随着时间的流逝 她开始看到抑郁症病例的增加。创伤后应激障碍开始 稍后出现，因为它经常随着时间的推移而发展。 目前驻美国担任临床研究协调员 在佛罗里达的诺瓦东南大学，施切贝特继续提供这些服务 在线服务，解决心理健康和神经系统方面的挑战 这是由乌克兰战争引起的 。她指出，现在有很多人来了 抱怨频繁的空袭导致的睡眠障碍 主要是在晚上。 “人们白天会做噩梦，缺乏能量， 导致注意力和记忆力的困难。” 孩子们也会遭受痛苦，提到户外玩耍的能量减少 安全问题。他们显示他们经历了头痛和背痛， 因为他们大部分时间都必须呆在室内。此外，高 焦虑和抑郁的程度会导致头痛。有趣的是， 我观察到慢性头痛的增加，超过了战前 水平许多以前从未头痛过的人现在都声称会头痛 几乎每天都体验它们。解决这个问题已经成为一个 优先考虑我们的努力。” 奥尔加 ·格尔舒尼，荷兰的乌克兰公共卫生科学家 以及美国医院护理和心理健康倡议的方案主任 乌克兰的非营利组织“非国界健康技术公司（HTWB）强调道 这些心理健康问题涉及的范围很广，而且经常出现 被忽视，直到它们显现出来并变得压倒性 人她强调了人们应对压力的不同方式 和创伤性的环境中 。“例如，那些亲眼目睹的人 没有受到身体攻击的创伤性事件可能会面临不同的情况 心理健康问题与那些直接参与战斗或 回到家，发现他们的家人都不见了。” “截肢创伤也会对个人产生深刻的影响 流离失所和脱离家庭的儿童面临着独特的一面 挑战 **一个被战争房屋摧毁的国家能成为一个“安全的地方** **”吗？** 来自基辅的心理学家和艺术治疗师奥莱娜 ·卢森科， 主要关注与妇女、儿童和青少年合作的工作。 “女性发现自己处于一个需要承担所有责任的境地 抚养孩子的孩子落在她们的肩上，因为她们的丈夫去 前线，”她说 。“长时间的压力和心理-情绪上的过度紧张 导致身体疲惫，睡眠障碍，缺乏自信， 自尊心降低，攻击性增加和发展 有罪“与此同时，儿童和青少年也没有个人关系 她有许多成年人解决问题的资源和经验 讲解“ 因为战争，他们变得更加依赖他们的国家 父母，他们不得不过度照顾他们，并真正地拯救他们 生活，”她说 。“对于青少年来说尤其如此，他们，因为 不断的危险威胁，几乎失去了自由行动的能力 和战前一样，花时间和同龄人在一起。当然， 这些限制恶化了他们的情绪状态，阻碍了他们的情绪状态 发展他们的沟通能力。” 艺术治疗技术，其中包括提供心理治疗 通过创造性的媒介提供支持，如绘画，绘画， 视觉，舞蹈，表达性写作，戏剧和音乐，通常是 被认为有最小的禁忌症。然而，根据 卢森科，这一领域的专家已经遇到了一些挑战 在他们自全面战争爆发以来的工作中。 “我们在使用熟悉的方法和练习方面遇到了障碍，比如 那些活动都围绕着创造一个‘安全的地方 ’，”她回忆道。“在乌克兰， 由于冲突，安全的概念被抹去了， 这使得建立一种新的安全感极其困难 在很短的时间内。另一个问题是与 闭上眼睛进行视觉化练习，因为它可能会导致一个 对治疗过程失去控制和管理。第三个 问题围绕着再次受创伤的潜在危险 通过使用可能不成功的隐喻和 在战争时期令人痛苦。” 所以，像卢森科这样的艺术治疗师创新性地研究了这些技术 为了使它们对当代的乌克兰更有效。“在每个 在实验阶段，我们采用了呼吸练习来稳定情绪状态 卢森科说。“而不是一个无法实现的‘保险箱 ’ ‘地方 ’，我们创造了‘力量和复苏 ’的地方。” 在成立面向儿童和国内流离失所者的支持小组之前 个人，全乌克兰艺术治疗协会，由艺术领导 治疗师奥琳娜 ·沃兹内森斯卡，发起了一个公开的情感支持 成人组。这项努力于2022年3月初开始 延长了近一个月，看到了教育工作者的参与， 心理学家和艺术治疗师。这次会议被证明是关键的，在 开发新的艺术治疗技术 受到战争的影响。“我们发现自己同时也是两者的 参与者和研究人员，”卢森科说。 卢森科强调了这些创新方法的极大帮助 个人在表达他们的内在经验时，即使没有依赖性 在文字。她回忆起与青少年的一次聚会，她要求他们参加会议 用橡皮泥来塑造一个景观 。“在练习的过程中，a 一个14岁的女孩精心制作了两座相邻的山和一个山 第三座山，之后眼泪在她的眼睛里涌出，”她说 说“为了恢复她的情绪平衡，我们采用了一种技巧 被称为“蝴蝶拥抱 ”。随后，该女孩透露了她的身份 情绪她表达了她对她的父亲的担忧和渴望 他在前线驻扎了一年。通过这个隐喻 表达，她能够表达她的斗争和处理她 情感 卢森科还回忆了工作中发生的许多重大事件 与孩子。她讲述了一件涉及一个女孩逃离a 她的母亲和俄罗斯占领地区。“尽管她有 她上课上了一个半月，就沉默了，”她说 卢森科。“然而，在一次艺术治疗会议中进行的 与美国艺术家兼摄影师布莱恩 ·麦卡蒂合作 她以与来自战争地区的孩子们打交道而闻名，她开始 说话她表达了她对自己的家的渴望和她的强烈的渴望 尽快返回那里。她甚至说，‘记录下我的故事和故事 让全世界都听到吧 。’” 所获得的经验和实际技术的磨练 卢森科和她记录了冲突的第一年 最终，来自全乌克兰艺术治疗协会的同事们 最终出版了名为《时代儿童的艺术疗法》 *的战争”。* 格尔舒尼强调，乌克兰正在经历一个阶段 治疗师，特别是心理健康专业人员，也需要支持 应对职业倦怠和疲惫的症状。所以，HTWB推出了 “帮助治疗者治愈 ”或3H计划 。“与众多的 暴行发生在乌克兰，有大量的医疗保健服务 服务提供者已经离开，造成了心理健康支持方面的差距，”他解释说 格尔舒尼人 。“为了解决这个问题，我们邀请了心理学家和专家 从美国的精神病学来进行网络研讨会，专注于解决这个问题 由战争引起的心理健康问题。我们的主要重点是指导 乌克兰心理学家和心理健康提供者在治疗他们的 客户和处理他们所面临的挑战。然而，它很快 很明显，这些专业人员需要自己， 引导我们特别启动一项心理健康支持计划 为他们。” 格尔舒尼与非政府组织“无国界极客 ”的团队发挥了重要作用 通过提供全面的设备来解决医务人员短缺的问题 培训年轻护士、助产士和医疗助理的容器。 这些容器作为教室，配备有笔记本电脑，桌子， 椅子和一个为不间断的学习会议使用的发电机 。这个简单的 关键的倡议允许学生继续他们的教育和 为该国急需的医疗保健劳动力做出贡献 在战争期间。 格尔舒尼和什切贝特也在一个 由HTWB发布的医疗聊天机器人。“我们创建了这个聊天机器人来帮助我们 教前线战斗的医务人员，临床医生和 急救人员在治疗和运送战争伤亡人员时，”他说 HTWB创始人Jarone李。 库马尔强调，除了创伤护理的专业知识，医务人员 在一线野战医院工作必须有一定的了解 战争机制，包括炮弹和火炮的运动轨迹。 “他们需要知道子弹能到达多远，以及哪种类型的子弹 在不同的情况下，保护措施更为有效。”知识 关于扫雷也是必要的，因为这些地区经常有 必须安全导航的雷区。在这样的操作 环境需要纪律严明，以避免跨越危险的危险线 。 要确保有效和安全，有很多东西需要学习和理解 在这些具有挑战性的情况下采取行动。” **治疗师应该在战争中偏袒任何一方吗？** 全球人道主义项目，如希望项目和志愿医疗人员 比如库马尔坚持严格的政策，不偏袒任何一方 在战区提供援助。因此，他们的服务是独家的 献给平民，而不是战斗人员。 然而，PFVMH的价值观是不同的，因为该组织有一个明确的观点 效忠乌克兰 。在战争的早期，一种超民族主义的民族 德鲁琴科在乌克兰-24频道的爆发引起了一场重大事件 争论他说，他已经指示他的医生“ 阉割 ” 俄罗斯战俘 。该声明收到了国际声明 德鲁琴科在同一天道歉。“它是在下面的 我发表了一句令人遗憾的声明，我的情绪非常紧张 告诉《周刊 。“我对俄国士兵的暴行感到震惊 我们的郊区，救护车面临不断 挑战，我们几乎没有得到一两个小时的睡眠 一天那时，我的妻子[斯维特拉娜 ·德鲁佐科，一名儿科医生 他领导着我们的医疗团队在前线，还有我 收到了极其残忍的信件、电子邮件和信息。我做了一个 情感爆发我从未命令我的团队进行任何这样的工作 我的说法不真的。” 然而，这一有争议的事件促使德鲁佐科发表了平衡 更强调他的医生在遇到事故时的行为 俄罗斯的战俘。“我们进行了一次检查，我确实是 自豪地说，我们的医生治疗他们坚持国际治疗 处理战俘的标准，尽管俄罗斯人很可怕 已经带来了我们的土地，”他说 。他提到了他的团队 两个月前，他还在顿涅茨克附近治疗了一名俄罗斯战俘。 有一种说法是，危机是一个伟大的老师 。专业人士喜欢 格尔舒尼和德鲁琴科证明，战争造成了乌克兰人的死亡 医学领域的适应、创新和发展。“五月，我参加了一个 在乌克兰西部举行的护理会议 战争期间的临床医学，以及心理和生理方面的医学 格尔舒尼回忆道。“一个惊人的观察结果是如何做到的 训练有素的乌克兰保健专业人员。 他们处理极端创伤的经验使他们的高度 在训练他人方面很有价值 。许多人都有工作的经验 野战医院或帐篷，在充满挑战的条件下 。” 战争也教会了他们如何创新和合作。“战争 ” 环境为医生提供了更广泛的操作范围 德鲁赞科说 。“我们学会了利用复杂的东西 创造性的设备，如移动CLC(闭环 通信)恢复单位，最初为北约特别设计 力，我们在稳定点上有效地使用 给制造商留下深刻印象。这种水平的创新和 合作让我想起了医学的繁荣 乌克兰著名医生如亚历山大 ·沙利莫夫之后 第二次世界大战我相信，战后，乌克兰的医疗领域将会如此 在正确的法律框架的前提下，如果没有，我们将有数百个 成千上万的医生，拥有独特经验和专业知识的医生。”  The war in Ukraine, as seen by doctors and medical volunteers Medics working in Ukraine risk their life to provide healing and succour to injured  Care in chaos: Medics attending to an injured Ukranian on the frontline | Bhanu Prakash Chandra The Siversky Donets River divides two warring nations, separating southwestern Russia from eastern Ukraine. It meanders its way from the Central Russian Upland, north of Belgorod, flows through Ukraine’s Luhansk and Donetsk Oblasts―Russia’s initial targets in its ‘special military operation’ that began on February 24, 2022―and returns to its origin country. In the early months of the war, Russian soldiers had tried to cross the river several times but were stopped by Ukrainian forces. And so,the river continued to act as a natural boundary. Perhaps, that is why four children in Pryvilla, a town on the banks of the river in the Lysychansk municipality of Luhansk Oblast, were out playing even as the threat of a Russian attack loomed. Sadly, rivers do not wall up, and the children got caught in the shell firing that ensued when Russian forces crossed the river between June 28 and June 30 last year. The Pirogov First Volunteer Mobile Hospital (PFVMH), a Ukrainian nonprofit of civilian health care professionals, was immediately notified and an evacuation team was dispatched to Pryvilla to transport the children―two boys and two girls. By the time the team arrived though, the boys had succumbed to their injuries. The older of the two girls, aged 12, showed remarkable bravery in leading her younger sister to a cellar. But in the process, the girls suffered severe injuries. The PFVMH team acted swiftly to transfer the girls to a field hospital in Bakhmut, 55km from Lysychansk. The older girl was proclaimed dead on arrival. The younger girl’s condition, meanwhile, was rapidly deteriorating, and the field hospital was ill-equipped to provide the advanced trauma care she desperately needed. So, the PFVMH made a daring decision to transfer her to Mechnikov Hospital in Dnipro, a renowned medical institution dating back to 1798.That meant traversing 200km of war-hit areas. “We have seen many ambulances and extraction vehicles that were shot and destroyed by Russian anti-tank missiles, automatic guns and rifles,” Gennadiy Druzenko, cofounder of PFVMH, tells THE WEEK. “The Russians do not adhere to the rules set by the Geneva Convention and other international agreements that protect medics. So vehicles carrying medics on the frontline have to avoid putting the red cross, which is typically a symbol of protection in the battlefield or war zone. Instead, we had to camouflage our vehicles using green colours to make them less visible.” Despite the risks involved, the PFVMH transferred the girl to Dnipro without significant delay, and the girl survived, miraculously. “They told us that we had achieved the impossible,” says Druzenko, pride showing in his voice. “The girl's survival became one of the most significant emotional triumphs for our entire team.”  Saving lives: Volunteer medics at work in a Pirogov First Volunteer Mobile Hospital ambulance | Courtesy: PFVMH PFVMH was founded in 2014 after the outbreak of the civil war in the Donbas region of eastern Ukraine, during which armed Russia-backed separatists seized Ukrainian government buildings and declared independence. PFVMH provided medical aid in conflict zones, operating its mobile hospital at 49 locations in Donetsk and Luhansk Oblasts and treating over 56,000 patients. It attracted nearly 500 skilled medics, paramedics and support staff from diverse backgrounds. When the pandemic struck, PFVMH scaled down its activities in the conflict zone, with volunteers returning to theirrespective hospitals as Covid warriors. But it remained prepared to respond to emergencies. With the onset of the Russian invasion, PFVMH resumed its critical operations. PFVMH is arguably the most effective civilian initiative working on the frontline to ensure medical care for both combatants and civilians within the ‘golden hour’―the critical 60-minute window from the time of injury for a patient to receive definitive care. Its evacuation team comprises an emergency care medic or an anaesthesiologist, a nurse and a driver, with additional security personnel in high-risk areas. The team has treated more than 23,000 people in the last one and a half years.  Gennadiy Druzenko (second from left), cofounder of PFVMH | Courtesy: PFVMH The PFVMH delivers its service in the different stages of pre-hospital care. “We have pass-over points near the battlefield, where we extract wounded soldiers and transfer them to stabilisation points,” says Druzenko, who was a constitutional lawyer before becoming a volunteer frontline medic. “At these stabilisation points, we have a forward surgery group, which deals with heavily wounded cases. After that, we transport the wounded to rear hospitals, and we also work alongside military medics at the stabilisation points. Our frontline team consists of around 40 to 50 medics, plus technical personnel, including drivers,technicians, bodyguards, cooks and cleaners.” While it lacks the social protection and guarantees from the government that combatants receive, PFVMH ensures thorough training for its medics before deploying them on the frontline, holding regular monthly training sessions in Kyiv. Doctors volunteering with PFVMH receive Tactical Combat Casualty Care training, which teaches evidence-based, life-saving techniques for trauma care on the battlefield. They are provided with body armour, helmets and individual first-aid kits.  Dr Santhosh Kumar “The Ukrainian army entrusts us with the extraction of its wounded soldiers, knowing that our professional medics have the best chance of delivering them safely to hospitals,” says Druzenko. He recalls saving a wounded soldier in Sloviansk, Donetsk region, during a heavy battle. “His heart stopped four times,” he says. “Each time, we managed to revive him, and he regained consciousness. Later, we realised it was his birthday that day. So, it was like a second birthday for him on his birthday.” The exact number of combatants killed or injured―both from the Russian side and the Ukrainian side―is still unknown. But it is estimated that at least a lakh soldiers from both sides have been killed or injured so far. The number of civilian casualties is also uncertain, but the Office of the UN High Commissioner for Human Rights documented 26,015 civilian casualties between February 24, 2022,and July 30, 2023, including 9,369 killed and 16,646 injured. Nevertheless, the OHCHR acknowledges that the actual civilian casualty figures are likely higher, as some reports are still pending corroboration in locations like Russia- occupied Mariupolin Donetsk and Lysychansk, Popasna and Sievierodonetsk in Luhanska. Donetsk, Kharkivska and Luhanska oblasts in eastern Ukraine, Kyivska in north-central Ukraine and Khersonska in southern Ukraine had the highest number of civilian casualties, with the numberspeaking in March and April 2022. However, when considering morbidity and mortality caused by war, one has to look beyond what happens on the frontline. **What will you take with you while fleeing a war?** “In the initial phase of the war, there was a higher incidence of trauma in the civilian areas, but this has decreased over time,” says Dr Santhosh Kumar, an Indian war surgeon who was medical director of Project HOPE at Ukraine Emergency Response for a year. “The majority of morbidity now arises from non-communicable and communicable diseases.” This shift is attributed to the significant internal displacement that occurred in Ukraine since the war began. It is estimated that at least 6 million Ukrainians are internally displaced, and over 8 million Ukrainian refugees have been registered across Europe since the start of the war. “As people migrate, the ones with more resources tend to move to cities and rent places to live. However, as the war continues, many lose their resources and end up in suburbs, villages and eventually uninhabitable places,” observes Kumar. “They lose access to essential services such as health care, electricity and water. This lack of access to health care has serious consequences.” For example, individuals with chronic conditions like hypertension or cardiovascular diseases may not be able to reach health centres or clinics to obtain their medication owing to transport difficulties. Consequently, they stop taking their medicines, leading to health complications and even death. “The situation is particularly concerning for pregnant women, as they may have no access to proper facilities for delivery, leading to increased maternal and infant mortality,” he adds.  Undying spirit: A rescue operation in Donetsk | AFP Having worked in conflict zones in more than 45 countries, Kumar found the Russia-Ukraine war to be a unique experience. What he saw in Ukraine left him devastated, yes, but also deeply reflective. He recounts an instance involving an internally displaced woman from Kherson in southern Ukraine. During the evacuation from Kherson, a bridge served as the final point of embarkation for those fleeing, where Kumar and his team conducted medical checks for those being transported. That is where he met this elderly lady carrying a bag with toys. Intrigued, he inquired about it. She told him that she had hesitated to leave the city when her daughter and granddaughter had left three months earlier. However, as the war escalated, she decided to leave.  “Before leaving Kherson, the old lady asked her grandchild what she wanted to take from the house, and the little one chose her doll and teddy bear,” says Kumar. “And so,this grandmother brought only those toys with her, leaving behind all her other belongings, including valuables and clothing.” That interaction made Kumar wonder what he would choose to take with him in a similar situation. Kumar emphasises that internally displaced people are highly vulnerable to disease outbreaks like typhoid and cholera. As they move from villages to forested areas, water resources become scarce, and with the increased population in these locations, water sources can get contaminated. For instance, Pervomaisk, a city in Mykolaiv Oblast, saw an outbreak, caused by faecal contamination of the water source owing to the lack of proper toilets.  Under attack: Kherson Children's Hospital, which was damaged by Russian shelling this June. Furthermore, bombing or missile attacks impacted critical infrastructure like power stations and water purification centres, leading to prolonged water shortages lasting up to four days. This compelled people to seek alternative, though contaminated, water sources. The harsh winter conditions also made it difficult to boil water without electricity, exacerbating the challenge of accessing clean water. The destruction of Ukrainian health care facilities worsened the situation in many places. A report published by Physicians for Human Rights this February observed that during the first weeks of the war, there were constant and daily attacks on Ukraine’s health care system. “For 35 days, Ukraine’s health care system was damaged every single day,” it read. “Assaults were particularly intense in February and March. During the first two weeks of the invasion, an average of four to five hospitals and clinics were attacked daily. Attacks continued throughout the year, with 235 attacks on health care overall in March and an average of 47 attacks each month from April through December 2022.”  Helping hand: Oleksandra Shchebet, a Ukrainian neurologist, worked in a warehouse receiving, sorting and redistributing food and medicine to the frontline. Kumar, who has been to almost all major conflict zones since 2005, notes that he witnessed this pattern of hospitals being targeted in various war zones. He explains that in many places, hospitals are viewed as valuable assets for the enemy to repair and reinforce their combatants. As a result, targeting hospitals becomes advantageous, as it hinders the enemy's ability to repair and send their fighters back to the field. To address the issue of limited access to health care for civilians, which was exacerbated by the destruction of hospitals, humanitarian programmes like Project HOPE employed several approaches in Ukraine. Kumar highlights the use of mobile medical units (MMUs) equipped with doctors, nurses, essential medicines and some lab equipment. These units travel to remote areas, providing people with much-needed medical care and essential drugs. “For pregnancies, regular checks and ultrasounds were conducted to ensure comprehensive maternal health care,” he says.  Since March 2022, Project HOPE's MMUs have provided more than 2,54,000 medical consultations, supporting over 350 existing health care facilities. It also employs “surge capacity improvement” strategy, which, explains Kumar, involves providing additional doctors to hospitals and sub-centres, enhancing facilities, setting up gynaecological rooms and ensuring a steady supply of essential drugs. It also offers training opportunities to improve the skills of health care providers. Trauma care in a war zone clearly differs from one in peaceful areas. While about 95 per cent of trauma cases in peaceful areas are related to road accidents, most injuries during a war are caused by bullets, barrier sticks, sharp objects, explosions and related to burns. Kumar points out that the health community often mistakenly tries to treat war-related injuries using the same approach as road accidents, but it requires different training, equipment, facilities and management systems. Kumar now leads a trauma training programme in Ukraine offered by the Harvard Humanitarian Initiative (HHI). Initially, the programme trained the doctors directly, but concerns arose about its sustainability after the HHI’s departure. To address this, the idea of training universities and establishing dedicated training centres within them was proposed. This way, knowledge and skills can continue to be passed on even after the team leaves. According to Kumar, only a few dedicated teaching institutes worldwide focus on handling war trauma. “Considering the significant funds invested in destruction and warfare, the resources allocated to address these medical challenges seem comparatively minuscule,” he says. “We envision these institutes to cater to diverse audiences, from civilians to doctors, with universities serving as centres for the training.” The courses include Advanced Trauma Life Support (ATLS), vascular surgeries, orthopaedics with external fixation, dental surgery, abdominal surgery and ultrasound-guided nerve blocks exclusively for doctors. There are also courses like trauma nursing fundamentals for nurses and Stop the Bleed, which is open to laymen. “For instance, a doctor may not necessarily need expertise in performing a full bypass surgery, but it is crucial for them to possess specialised knowledge in certain aspects of vascular surgery,” explains Kumar. “Similarly, in orthopaedic surgery, they may not require proficiency in procedures like pelvic internal fixation or total replacements, but familiarity with external fixators and splinting is essential.” The training programme also covers organising MMUs, surge capacity management, drug transport, rapid assessments, trauma care system establishment and field hospital setup. “These are novel concepts that even mature societies find challenging to grasp,” he adds.  Training to treat: Vascular surgery training at a hospital in Zaporizhzhia. Undoubtedly, a specialised training programme for managing wartime situations will yield diverse advantages in delivering services. Moreover, there have been numerous instances demonstrating the dedication of Ukrainian health care professionals, who have willingly taken on roles that go beyond theirregular responsibilities. **Could you prescribe a dose of tender loving care with the medicines, please?** Dr Oleksandra Shchebet, a young Ukrainian neurologist who had a private practice in Kyiv, is an example. She was among those who initially did not believe that the Ukraine-Russia tensions would escalate into a full-scale war. However, when war came knocking, she sought refuge in Lutsk, her native town, where she had relatives. In a gruelling journey, she, along with her relatives, including her grandmother and a three-year-old nephew, drove almost 24 hours without sleep to reach Lutsk, which is close to Poland and the Czech Republic. Once there, the family found an apartment on rent, but Shchebet refused to remain idle. She worked in a warehouse for hours, receiving, sorting and redistributing food and medical supplies to frontline areas in Ukraine. During the initial phase, Ukrainians faced a severe shortage of medications due to panic buying and delivery restrictions. Shchebet played a pivotal role as a key contact person for doctors across different parts of Ukraine, arranging specific medicines from Poland or the Czech Republic to address this urgent need. “In Lutsk, our storage, capable of holding over 500 pallets, became a central point for sorting supplies before dispatching them to regions in need,” she says. “With postal services non-operational, our volunteers took on the risky task of delivering supplies by car to different regions.”  Art heals: Olena Lutsenko, a psychologist based in Kyiv, conducts an art therapy class for internally displaced children.  Paintings by the children  Paintings by the children  Paintings by the children Among the medical supplies from neighbouring countries, Shchebet discovered emotional letters filled with wishes for speedy recovery and good health of the people of Ukraine. In one package from Poland containing medicines to prevent haemorrhaging, there was a heartfelt letter stating, “I wish you won't need this. Comeback home, and alive.” Moved by such sentiments, she reciprocated the same spirit while sending medications to patients in war-battered zones. “While sending medications and food supplies to internally displaced people from the eastern parts of the country, who were now living in shelters,I provided detailed personalised prescription on how to take them properly,” she recalls. “To my surprise, people expressed their heartfelt gratitude not for the food or medical supplies but for these instructions. They felt a strong connection, even though we had never met. One woman even contacted me to say that reading my prescription made her feel cared for and understood on a personal level. This experience touched me deeply because it allowed me to show people that I genuinely care, even amid challenging circumstances.”  Novel learning: An educational container classroom to train young nurses, midwives and medical assistants, set up by Health Tech Without Borders with Geeks Without Frontiers and other operational partners | Courtesy: HTWB From the early stages of the war, Shchebethas been providing online consultations as well. In the absence of a national digital health platform for messaging and video consultations, most people reached out to Shchebet for help through Facebook. She responded to their needs by assisting with texts, voice messages and video consultations. Shchebet recounts that she handled many heartbreaking cases then. “Once a girl texted me saying that her nonagenarian grandma was ill,” she says. “The girl told me, ‘We are in a shelter right now, it's bombing outside. Grandma’s unconscious. What should Ido?’” She was out of Kyiv, somewhere close to the east; emergency services couldn't reach her there due to the bombing.   Students in the class | Courtesy: HTWB So, Shchebet asked her about her grandmother's symptoms. “I recognised it was an acute stroke,” she says. “It was devastating because I was not in a position to help her physically. So, what I did was give psychological support to the girl. I kept talking to her over the phone, convincing her that her grandma doesn't feel any pain, that she was just in a deep sleep and all that stuff. Unfortunately, the old lady passed away within the next 12 hours, but that girl later wrote to me and thanked me, even though psychological support was the only thing I could give her at the time.” Shchebet is also trained as a Gestalt therapist (looking at the whole picture more than just as a sum of the parts) and psychotherapist. Over her 15-year practice, she sought additional education on treating patients experiencing acute stress and post-traumatic stress disorder (PTSD), especially after the onset of the war in Ukraine in 2014, which brought an influx of internally displaced individuals to Kyiv. Although she doesn't possess a psychotherapy license, the specialised training equipped her with essential skills to communicate effectively with these individuals. Interestingly, the evening before the war began last year, she was attending a conference on mental health in the post-Covid period, not knowing that she would soon be dealing with the war's impact on mental health. Initially, she encountered cases of anxiety and acute stress as people were disturbed and unsure what to do. As time passed, she started seeing an increase in depression cases. PTSD began to emerge later, as it often develops over time. Currently stationed in the United States as clinical research coordinator at Nova Southeastern University, Florida, Shchebet continues to offer online services, addressing mental health and neurological challenges caused by the war in Ukraine. She notes that many people now complain about sleep disturbances due to frequent air raids occurring mostly at night. “People are experiencing nightmares and lack of energy during the day, leading to difficulties with concentration and memory,” says Shchebet. “Children also suffer, mentioning reduced energy for outdoor play due to safety concerns. They reveal experiencing headaches and back pain, as they have to remain indoors most of the time. Additionally, high levels of anxiety and depression contribute to headaches. Interestingly, I have observed an increase in chronic headaches, surpassing pre-war levels. Many individuals who never had headaches before now claim to experience them almost daily. Addressing this issue has become a priority in our efforts.” Olga Gershuni, a Netherlands-based Ukrainian public health scientist and programme director of nursing and mental health initiatives at the nonprofit Health Tech Without Borders (HTWB) in Ukraine, stresses that mental health concerns cover a broad range and are frequently overlooked until they manifest and become overwhelming for individuals. She highlights the different ways people cope with stress and traumatic circumstances. “For example, those who have witnessed traumatic events without being physically attacked may face different mental health issues compared to those directly involved in combat or returning home to find their families gone,” says Gershuni. “Amputation trauma can also profoundly impact individuals, and children displaced and separated from their families face unique challenges.” **Can a country torn by war house a ‘safe place’?** Olena Lutsenko, a psychologist and art therapist based in Kyiv, primarily focuses on working with women, children and adolescents. “Women found themselves in a situation where all the responsibility for raising children fell on their shoulders, as their husbands went to the frontline,” she says. “Prolonged stress and psycho-emotional overstrain led to physical exhaustion, sleep disorders, lack of self-confidence, lowered self-esteem, increased aggressiveness and the development of guilt.” Meanwhile, children and adolescents do not have the personal resources and experience of problem-solving that adults do, she explains.“Because of war, they become even more dependent on their parents, who have to take excessive care of them and literally save their lives,” she says. “This is especially true for teenagers, who, due to the constant threat of danger, have almost lost the ability to move freely and spend time with their peers as they did before the war. Of course, such restrictions worsen their emotional state and hinder the development of their communication skills.” Art therapy techniques, which encompass providing psychological support through creative mediums such as drawing, painting, visualisation, dance, expressive writing, drama and music, are generally considered to have minimal contraindications. However, according to Lutsenko, specialists in this field have encountered several challenges in their work since the outbreak of the full-scale war. “We faced obstacles in using familiar methods and exercises, such as those centered around creating a ‘safe place’,” she recalls. “In Ukraine, the concept of safety had been physically erased due to the conflict, making it exceedingly difficult to establish a new sense of security within a short timeframe. Another concern is the risk associated with engaging in visualisation exercises with closed eyes, as it could lead to a loss of control and management over the therapeutic process. The third issue revolves around the potential danger of re-traumatisation through the use of metaphors that might prove unsuccessful and distressing during a wartime setting.” So, art therapists like Lutsenko worked innovatively on the techniques in order to make them effective for contemporary Ukraine. “At each session, we adopted breathing exercises to stabilise the emotional state [of participants],” says Lutsenko. “Instead of an unattainable 'safe place', we create places of 'strength and recovery'.” Prior to launching support groups for children and internally displaced individuals, the All-Ukrainian Art Therapy Association, led by art therapist OlenaVoznesenska, initiated an open emotional support group for adults. Commencing in early March 2022,this endeavour extended for nearly a month and saw participation from educators, psychologists and art therapists. This session proved pivotal in the development of new art therapy techniques tailored to conditions affected by war. “We found ourselves simultaneously as both participants and researchers,” says Lutsenko. Lutsenko underscores that these innovative methods greatly aided individuals in expressing their inner experiences even without relying on words. She recalls a session with teenagers, where she asked them to fashion a landscape using plasticine. “In the course of the exercise, a 14-year-old girl crafted two mountains adjacent to each other and a third mountain separately, after which tears welled up in her eyes,” she says. “To restore her emotional equilibrium, we employed a technique known as the'butterfly hug'. Subsequently, the girl disclosed her feelings. She conveyed her concerns and longing for her father, who had been stationed on the frontlines for a year. Through this metaphorical expression, she was able to articulate her struggle and process her emotions.” Lutsenko also recalls numerous remarkable occurrences while working with children. She recounts an incident involving a girl who had fled a Russia-occupied region along with her mother. “Although she had attended classes for a month and a half, she had fallen silent,” says Lutsenko. “However, during an art therapy session conducted in collaboration with Brian McCarty, an American artist and photographer known for his work with children from war-torn areas, she began speaking. She voiced her longing for her home and her fervent desire to return there as swiftly as possible. She even says, ‘Record my story and let the entire world hear it.’” The experiences gained and the practical techniques honed during the initial year of the conflict were documented by Lutsenko and her colleagues from the All-Ukrainian Art Therapy Association, ultimately culminating in the publication titled *‘Art Therapy for Children in Times of War’.* Gershuni emphasises that Ukraine is going through a phase where healers, especially mental health professionals, also need support to cope with symptoms of burnout and exhaustion. So, HTWB launched the'Helping Healers Heal' or the 3H programme. “With numerous atrocities taking place in Ukraine, a significant number of health care providers had left, creating a gap in mental health support,” explained Gershuni. “To address this, we invited psychologists and experts in psychiatry from the US to conduct webinars, focusing on addressing mental health issues caused by war. Our primary focus was on guiding Ukrainian psychologists and mental health providers in treating their clients and dealing with the challenges they faced. However, it soon became evident that these professionals needed support themselves, leading us to initiate a mental health support programme specifically for them.” Gershuni's team with Geeks Without Frontiers, an NGO, took significant action to address the shortage of medics by providing fully equipped containers for training young nurses, midwives and medical assistants. These containers served as classrooms, equipped with laptops, tables, chairs and a generator for uninterrupted study sessions. This simple yet crucial initiative allowed students to continue their education and contribute to the much-needed health care workforce in the country during war. Gershuni and Shchebet also played a major role in the development of a medical chatbot released by HTWB. “We created this chatbot to help teach critical medical skills to frontline combat medics, clinicians and first responders when treating and transporting war casualties,” says HTWB founder Jarone Lee. Kumar emphasises that in addition to trauma care expertise, medics working in frontline field hospitals must possess an understanding of war mechanics, including the trajectories of projectiles and artillery. “They need to knowhow far bullets can reach and which type of protection is more effective in different scenarios,” he says. “Knowledge about mine clearance is also essential, as these areas often have minefields that must be safely navigated. Operating in such environments demands discipline to avoid crossing dangerous lines. There is much to learn and understand to ensure effective and safe operations in these challenging circumstances.” **Should healers take sides in a war?** Global humanitarian projects like Project HOPE and volunteer medics such as Kumar adhere to a strict policy of not taking sides while providing aid in war zones. Therefore, their services are exclusively dedicated to civilians and not combatants. However, PFVMH's values are different, as the organisation has a clear allegiance to Ukraine. In the early days of the war, a hyper-nationalistic outburst from Druzenko on the channel Ukraine-24 caused a major controversy. He stated that he had instructed his doctors to “castrate” Russian prisoners of war. The statement received international condemnation, and Druzenko apologised the same day. “It was under immense emotional strain [that] I made that regrettable statement,” he tells THE WEEK. “I was shocked by the brutality of the Russian soldiers invading the suburbs of Kyiv, our ambulances were facing constant challenges and we were barely getting one or two hours of sleep per day. At that time, my wife [Svitlana Druzenko, a paediatric traumatologist], who leads our medical team on the frontline, and I received extremely brutal letters, emails and messages. And,I made an emotional outburst. I never ordered my team to carry out any such actions, and my statement was not true.” That controversial episode, however, prompted Druzenko to place even greater emphasis on how his medics behave when encountering Russian prisoners of war. “We conducted an examination, and I am proud to say that our medics treated them adhering to international standards for handling prisoners of war, despite the horrors Russians had brought upon our land,” he says. He mentioned that his team treated a Russian prisoner of war just two months ago near Donetsk. There is a saying that crisis is a great teacher. Professionals like Gershuni and Druzenko attest that the war has caused the Ukrainian medical field to adapt, innovate and evolve. “In May, I attended a nursing conference in the western part of Ukraine, that focused on clinical medicine during the war, and psychological and physical rehabilitation,” recalled Gershuni. “One striking observation was how exceptionally well-trained Ukrainian health care professionals were. Their experience in dealing with extreme trauma makes them highly valuable in training others. Many have had experience working from field hospitals or tents, under challenging conditions.” War also taught them to innovate and collaborate. “The war environment provided doctors with a wider scope for manoeuvring and taking risks,” says Druzenko. “We learned to utilise sophisticated equipment creatively, like the MOVES CLC (closed loop communication) reanimation unit, originally designed for NATO special forces, which we used efficiently on stabilisation points, even impressing the manufacturers. This level of innovation and collaboration reminds me of the flourishing of medicine and the emergence of famous Ukrainian doctors like Alexander Shalimov after WorldWar II. I believe that after the war, Ukraine’s medical field will thrive, given the right legal framework, as we will have hundreds, if not thousands, of doctors with unique experiences and expertise.”
nyp366888891
2024年12月9日 14:09
转发文档
收藏文档
上一篇
下一篇
手机扫码
复制链接
手机扫一扫转发分享
复制链接
Markdown文件
HTML文件
PDF文档（打印）
分享
链接
类型
密码
更新密码