“Everyone in Ukraine is in danger. There's no safe place. Me and my colleagues are caring [for] patients and …ourselves. My patients lack levodopa, fingolimod, ocrelizumab, rituximab. Thousands of people are sitting in cold shelters that exacerbate chronic back pain, so I receive lots of phone calls with requests for painkillers and anti-inflammatory drugs."
So began an email from 24-year-old Solomiia Bandrivska, MD, an AAN member who completed her neurology residency one month ago and has been serving as the only neurologist in her hospital for the last seven days, while the rest of her team remains stuck in a bomb shelter.
Life has been forever upended for Dr. Bandrivska and colleagues since Russian President Vladimir Putin announced a "special military operation" in Eastern Ukraine on February 24. Minutes later, missiles began to strike locations across Ukraine, including its capital, Kyiv, where Dr. Bandrivska works. A mass exodus of 1 million refugees over the past seven days has triggered a humanitarian crisis. Many physicians remain, including neurologists, dedicated to care for the sick and the wounded.
“I stay with my patients from the beginning, and will stay till the end," Dr. Bandrivska wrote in a series of emails, photos, and videos to Neurology Today beginning on March 1. “The war is real, and the danger is incredible; the most important thing we need is peace."
Dr. Bandrivska's Facebook page reveals life before the war in striking contrast of the horrors of today—Christmas photos with her neurosurgeon husband and their cat, videos of fireworks and a rock concert, and a post of her acceptance as a new member to the American Headache Society, among other professional accolades. Over the past several days, her page has been flooded with messages of aid from friends in nearby countries offering accommodations, food, and other assistance.
One 24-year-old neurology intern, who asked to remain anonymous to protect her family, had just completed the process of passing her neurology examinations and was doing her internship at a hospital in Kyiv when the Russian army invaded Ukraine. “Today we are getting ready to receive the wounded in our hospital…which has been completely converted into a military hospital," she wrote, adding, “The situation is tense, but our clinic will do its best."
The neurology department is working with limited staffing, she said, partly because many of its doctors cannot get to work due to the destruction of bridges.
“In our clinic all patients, as well as medical personnel, are in safe places, shelters for now, and therefore our administration try to keep medical personnel to a minimum for the time being (because now all our departments work as urgent departments and are waiting for [the] increase in patients, wounded patients)," the neurology intern said, adding: “We don't know how long this whole situation will last, and now we are fighting for our freedom."
Tetyana Nehrych, MD, PhD, head of the neurology department at Danylo Halytsky Lviv National Medical University, has been working as a neurologist for 28 years specializing in autoimmune diseases and multiple sclerosis. “On February 24," she wrote, “[when] Russia started bombing our cities in Ukraine, my first instinct as a mother and grandmother was to save [the] children. In thirty minutes, I packed luggage for me and [my] two grandkids, 3 and 8 years old and left to a safer place."
It took them 12 hours to cross the border to family in Poland. Dr. Nehrych's staff stayed in Lviv and nearby rural areas, and she continues to care for her patients online and organizes help for the army.
“I could never imagine that in [the] 21st century in the center of Europe, thousands of people will die from bombs and bullets protecting their independence and territorial sovereignty, and mothers with children will be forced to escape their countries after [the] Russian army destroyed their homes and cities," she said.
The war is no less heartbreaking for Ukrainian-American neurologists who have family in the Ukraine. Thirty-four member neurologists are in Ukraine, according to the last census, and an indeterminate number of Ukrainian-American neurologists practice outside of Ukraine. Yuliya Snyder, MD, is one of those AAN member neurologists. Born in Kharkiv, she attended medical school and residency there before moving to Rochester, NY, to undergo child neurology training at the University of Rochester Medical Center starting in 2008. She currently works as a child neurologist at Rochester Regional Health.
Her father and mother have five siblings each who are still in Eastern Ukraine, mostly in Kharkiv, Dr. Snyder said, as are her cousins and countless friends. “It is dangerous to even go out and get water," they tell her, sending videos too graphic to share that show people struck by shelling and killed in the streets. “It is frustrating to be unable to help them," she said, expressing a sentiment shared by others who fear for their loved ones in Ukraine today.
AAN member Lina Maria Chervak, MD, a PGY-3 in neurology at the University of Cincinnati, was born in Crimea, and moved to the United States at age 8, leaving grandparents, aunts, uncles, and cousins in Ukraine. “Some have moved to Western Ukraine where her father grew up, but even there the situation is dangerous and an active war zone," she said. Her male cousins have joined the Ukrainian Army in Western Ukraine and are waiting to be called to active duty, including one who became a father of twins very recently. She is also hearing reports from family that hospitals are running out of supplies and taking patients to basements to protect them from shelling.
“In Western Ukraine, where some of my family has fled, refugees are straining the cities, and Russian saboteurs are singling out buildings to mark them with paint for missile targets," she added.
Work Group Created by AAN
In response to the crisis, the AAN has created a work group to respond to requests from neurology colleagues in Ukraine. Lyell K. Jones, Jr., MD, FAAN, professor of neurology at the Mayo Clinic in Rochester, MN, who serves as its chair, said: “We've heard from many AAN members anxious to help neurologists and their patients whose lives are disrupted by the crisis in Ukraine. Our AAN Ukraine Crisis Response Workgroup is actively developing plans to directly assist neurologists in the region and provide tools to support the care of neurology patients who have been displaced." The AAN will notify its members of the work group's plans over the upcoming days.
Donations May be Sent to the Following Organizations
UNICEF: UNICEF is supporting health, nutrition, safe drinking water, sanitation, and protection for children and families caught in the conflict in Ukraine.
Médecins Sans Frontieres/Doctors Without Borders: MSF is conducting a range of activities in Ukraine to help people travel to health care facilities and access prescribed medications.
International Medical Corps: The global nonprofit has been delivering primary health care and mental health services in eastern Ukraine since 2014 and is raising funds to expand those services for people affected by the latest conflict.
International Committee of the Red Cross: The Switzerland-based international organization seeks to help people affected by the conflict and support the work of the Ukrainian Red Cross.
The UN Refugee Agency: UNHCR is working with the authorities, UN, and other partners in Ukraine, and governments in neighboring countries and is ready to provide humanitarian assistance wherever necessary and possible.
Save the Children: Based in London, Save the Children helps to deliver lifesaving aid to vulnerable children in Ukraine and around the world.