Emergency Care Education Program Brings Community Together in Ukraine

In early 2022, the Ukraine Ministry of Health reached out to International Medical Corps (IMC) to help address a suddenly growing need for trauma-based medical education throughout the Ukrainian health system.

“Understandably the health system has been suddenly stressed with thousands of direct military attacks on the health system,” says Kevin Collopy, Novant Health Mobile Integrated Health clinical outcomes and compliance manager.

IMC partnered with the Harvard Humanitarian Initiative (HHI) to develop Save a Life Education videos designed to provide a comprehensive emergency and trauma care training curriculum to hospitals, clinicians, and members of the community in Ukraine. Collopy serves as the prehospital trauma program director, tasked with overseeing curriculum and course development and instructor development and recruitment, and Sean Kivlehan, MD, MPH, serves as the overall project director. Among his many responsibilities, he is also the director of the Lavine Family Humanitarian Studies Initiative at Harvard University and director of the Brigham and Women's Hospital Global Emergency Medicine Fellowship.

Save a Life Educational Videos

The HHI developed live courses and four-to-five-minute videos designed to provide emergency care skills focused on one of seven educational topics: advanced trauma life support; stop the bleed; chemical, biological, radiological, nuclear, and explosive (CBRNE); pediatric trauma fundamentals; trauma nursing fundamentals; prehospital trauma fundamentals; and mass casualty management. All videos are open-access and recorded in Ukrainian with English subtitles.

“The primary outcome of the overall program was to deliver just-in-time essential education across the Ukrainian Health System while building a sustainable model of instructor development so the health system could continue supporting the programs by teaching one another,” explains Collopy.

Initiating the Pilot Course

The pilot course, pre-hospital trauma fundamentals (PHTF), featured five two-week deployments, during which each track was taught twice with train-the-trainer courses.  

“We collaborated with industry partners to look at options for using existing published trauma courses and ultimately determined developing our prehospital trauma course was the best solution as this provided us increased liberties to hand off the course to our Ukrainian partners to continue to teach while also having the flexibility to modify the curriculum as our experience evolved,” explains Collopy.

The team ultimately developed a two-day trauma course featuring 10 lectures and 16 break-out skills stations and simulations. The first deployment occurred in August 2022 and four U.S-based EMS educators departed with each deployment.

“Considering this was a novel course, we had to carefully select our instructors,” says Collopy. “We were fortunate as Ame Lozano deployed with our first deployment and agreed to stay for all five deployments serving as our course lead for the entire program.”

Lozano is a nationally registered paramedic (NRP) and works for Duke University Hospital, Denver Paramedics in Denver Colorado, and Angel Med Flight.

Largely recruited through the International College of Advanced Practice Paramedics (I-CAPP), instructors delivered courses in cities throughout Ukraine, including Kyiv, Dnipro, Zaporizhzhia, and Odesa.

U.S.-based EMS instructors were recruited to write scripts for the open-access training videos that are designed to be used either as just-in-time or as refresher training; to augment in-person courses and reach a broader population; and to strengthen local health systems by providing trusted, high-quality, open-access content.

IMC and HHI work with partners in Ukraine to provide advanced training for medical staff, public safety professionals, and the public, including how to manage emergencies and trauma, mass casualties, and cases related to CBRNE hazards. They’ve also worked with the American College of Surgeons, the Emergency Nursing Association, and the World Health Organization (WHO) to develop, distribute, and deliver training sessions for the seven education topics in Ukraine that so far have reached thousands of people in person. The videos can be accessed here. And the link to the program is here.

Impacts on Care and Community

As for Lozano, the work has changed her life.

“I’ve never seen a group of people come together like the Ukrainians have,” she explains. “The support and camaraderie they share among each other is inspirational and inspiring.”

Lozano was a part of the team sent to Ukraine to teach PHTF, and she signed on for two months of teaching: four weeks in Kyiv, four weeks in Dnipro, and a week in Odesa. The students were made up of nurses, surgeons, a mechanical engineer, a group of obstetricians from the prenatal hospital, medical students, military medics, and people with no medical experience who simply wanted to help.

“I was so happy to be there to support them as they moved forward. In this class of PHTF, I can teach many things,” says Lozano. “I can teach bleeding control, how to decompress a chest. I can teach intubation and how to open an airway and immobilize an injured spine and how to recognize brain stem herniation. I can teach proper insertion of an oropharyngeal airway, IV therapy, and how to communicate with a woman that has been sexually assaulted. But I can't teach endurance. I can't teach stamina. I can't teach people how to fight for themselves, their lives, their families, for the right to thrive, the will to survive. Our students brought the hunger for knowledge to class themselves.”

Lozano says in Ukraine, she and her colleagues passed the baton for teaching PHTF into the hands of the Ukrainian students who will teach more classes full of doctors, nurses, engineers, teachers, students, and other people trying to find a way to help.

Lessons from the Program

And upon her departure, Lozano says, “Rather than seeing this as the end of the journey, I choose to see it as the beginning of something new. The beginning of lifelong friendships, a new perspective of adversity, and the infinite magnitude of the human spirit.” She says she entered Ukraine to teach people about prehospital trauma, but in so doing, learned many lessons herself, one of them being that the human spirit is stronger than war. The students also expressed profound gratitude for the medical lessons.

“When we are met with obstacles, we have an intrinsic ability to overcome,” Lozano says. “Ukraine has taught me that the strength of the human spirit can heal wounds, it can restore faith, it can stand up to enemies, even when the odds seem stacked against you. After a night of air raid sirens and silent prayers, we would wake up early to teach, wondering if the people would come. They always did. Students would fill the room every morning, happy to be present, hungry for knowledge. There are many things in life that we have no control over, but we can control our reaction, our response, and the path we take from here. Ukraine has taught me to choose to be the infinite warrior rather than the perpetual victim. It has taught me to choose to fight back instead of hide.”

Another lesson is that true friendship can make people feel safe.

“The incessant boom of missile strikes, the threat of drones and rockets and bombs, the terror of explosions mere meters away was no contender,” she says. “We were strength in numbers. We were the personification of hope in human form. Amidst the adversity, we become stronger.”

Carol Brzozowski is a frequent contributor to EMS World.