Editor’s note: On the opening day of its April meeting in Paris, the World Medical Association issued a strongly worded emergency resolution condemning Russia’s invasion of Ukraine and its bombing of medical facilities, and calling for an end to hostilities. Read more from AMA President Gerald E. Harmon, MD, on why targeting civilians and health care in war is unconscionable.
The images of bombed-out hospitals and apartment buildings in Ukraine evoke feelings of outrage and grief. For some, those emotions go even deeper.
“I look at some of these pictures and I say: I've been there, I've walked those streets. I know what it was like before,” said George Hrycelak, MD, a retired general surgeon and AMA member who is executive director of the Ukrainian Medical Association of North America (UMANA).
“It's really, really sad, because the cities are beautiful cities and it's terrible to see what's happening,” Dr. Hrycelak added. “It really doesn't seem to make any sense at all.”
These feelings are shared by doctors and physician organizations around the world.
"The AMA is outraged by the senseless injury and death the Russian army has inflicted on the Ukraine people,” said AMA President Gerald E. Harmon, MD. “For those who survive these unprovoked attacks, the physical, emotional and psychological health of Ukrainians will be felt for years.
“In addition, the Russian military targeting of health care facilities violates every standard of decency,” said Dr. Harmon, a family physician in South Carolina. “We join physicians everywhere—and especially in Ukraine—who are calling for an end to this war so we can work on healing the terrible damage already inflicted."
The AMA Foundation is providing $100,000 in aid to support the efforts of the International Medical Corps and Heart to Heart International in addressing the humanitarian crisis for citizens in Ukraine, including the estimated 5 million people who have been forcibly displaced thus far, including more than 1.5 million children. Visit these organizations’ websites to learn more and support their ongoing efforts.
Physicians’ international response
Following reports of the shelling of a hospital in Ukraine’s Donetsk region, the World Medical Association (WMA) reminded the Russian Federation about the international principle of medical neutrality, which it has committed to observe.
“We emphasize that medical facilities must not be military targets, doctors and health care workers must not be prevented from performing their professional duties, and all efforts must be made to ensure that patients and casualties have full access to health care,” says a statement issued by the WMA, of which the AMA is a member.
“The WMA deplores the unprecedented aggression in Ukraine by the Russian leadership,” said diagnostic radiologist Dr. Frank Ulrich Montgomery, WMA Council Chair and former president of the German Medical Association. “It calls on Russian leaders to respect the work of doctors and nurses in the country and the neutrality of health care institutions. Our thoughts are with Ukrainian colleagues, and we appeal for a speedy end to hostilities.”
There have been more than 40 confirmed attacks on Ukrainian medical facilities resulting in 12 deaths and 34 injuries, according to the World Health Organization (WHO).
The attacks include the bombing of a maternity hospital in the city of Mariupol, an act that was condemned in a joint statement by the WHO, the United Nations Children’s Fund and United Nations Population Fund.
"To attack the most vulnerable—babies, children, pregnant women, and those already suffering from illness and disease, and health workers risking their own lives to save lives—is an act of unconscionable cruelty,” says the statement. “We call for an immediate cessation of all attacks on health care in Ukraine. These horrific attacks are killing and causing serious injuries to patients and health workers, destroying vital health infrastructure and forcing thousands to forgo accessing health services despite catastrophic needs.”
The U.N. agencies noted that, even during a foreign invasion, health care services are being delivered—and so are babies. There have been more than 4,300 births in Ukraine since the Russian army invaded and 80,000 more are expected over the next three months, but oxygen and other medical supplies used for the management of pregnancy complications are running dangerously low.
Meanwhile, doctors are facing unimaginable challenges in caring for children with cancer who are recovering from bone-marrow transplants even as they evacuate others to safer areas. That was described in a recent JAMA medical news report, “Physicians in Ukraine: Caring for Patients in the Middle of a War.”
“We are determined because we think this is our contribution for our future win over Russian aggressors,” said Dr. Roman Kizyma, director of pediatric oncology at the Western Ukrainian Specialized Children’s Medical Center in Lviv.
In a JN Learning™ podcast on the AMA Ed Hub™ online platform, “Ukrainian Doctors Share Current Experiences,” physicians in Ukraine shared how they are providing care in a wartime environment while keeping their families safe and being awoken by the sound of bombs.
Pivot from CME to bulletproof vests
Founded in 1950, the Ukrainian Medical Association of North America has maintained a roster of roughly 500 members through the years, said Dr. Hrycelak, who also served as president of the Ukrainian National Museum of Chicago from 1988 to 2000.
His parents met in a displaced-persons camp in Austria, which housed refugees from Eastern Europe who had fled their homes to escape communist rule. Dr. Hrycelak was born in the camp and the new family eventually was able to immigrate to the U.S.
“America was kind enough to accept us in 1950,” he said.
Socially, UMANA served as a gathering point for physicians with a common heritage. Professionally, it helped Ukrainian immigrants and Ukrainian-Americans navigate the complexities of starting a practice in the U.S. UMANA has remained vital with many members who immigrated to the U.S. after Ukraine gained its independence in 1991 now holding leadership positions—along with the children of its founding members becoming active in the organization.
“Many physicians and health care professionals wanted to start their career here,” said Dr. Hrycelak. “So it was quite natural for them to gravitate to the medical association, because there were people that understood their language, their culture, and could help them get their licenses in order, get their training completed and start their careers.”
For established physicians, UMANA sponsored continuing medical education programs. In the last few weeks, however, the focus of the organization has changed entirely as relief efforts shifted into high gear.
“Ukraine is again being destroyed and Ukrainians are dying,” Dr. Hrycelak said. “We're doing everything that we can to help the country survive—and hopefully, flourish.”
This includes a massive relief effort with different chapters taking on different roles.
- The New York Metro chapter is raising money to assemble individual first aid kits designed to save a life within an hour of injury.
- The Syracuse chapter has obtained 500 bulletproof vests.
- The Maryland chapter is raising awareness and conducting letter-writing campaigns.
- The Montreal chapter is providing translation services and looking to collaborate on telehealth efforts.
In Chicago, Dr. Hrycelak said, they collected 40 tons of medical equipment and supplies that will be flown to Poland and then delivered on the ground to where it’s needed—in either Ukraine or refugee facilities.
“The medical community has been very generous,” Dr. Hrycelak said.
“The response has been very gratifying, and we want to thank everybody that's helped us,” he added. “We hope, obviously, for some sort of positive conclusion to this whole disaster.”
Learn about the Ukraine Medical Help Fund that has been set up by the WMA, European Forum of Medical Associations and the Standing Committee of European Doctors.
