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Neurosurgical Mission to Ukraine

James Rutka
James Rutka

One of the foci of our Strategic Plan (Transforming Surgery: Beyond the Cutting Edge) is to build upon our international outreach and to strengthen our partnerships regionally, nationally and globally. I am very proud of the fact that so many of our faculty and residents are already embedded in numerous countries around the globe to support this mission. Last year, I had the good fortune to travel to Ukraine on a neurosurgical mission as part of a Ukrainian Child Health Fellowship partnership between Sick Kids Hospital at the University of Toronto, and neurosurgical centres in Lviv and Kyiv. I was also very fortunate to be accompanied by fellow neurosurgeon Dr. Mark Bernstein, University Health Network, and Dr. Myroslava Romach, Director of this Fellowship.

Ukraine was selected because it continues to develop in technology and innovations in many scientific disciplines including surgery. However, the country still lags quite far behind in this regard, especially since it only gained independence from Russia on August 24th, 1991. As such, we wanted to spend a good amount of time in medical centres where there is considerable need. Our mission took place June 15 – 23, 2013. Our first destination was Lviv, a city of approximately 250,000 inhabitants in western Ukraine near its border with Poland. At the Lviv City Clinical Children’s Hospital, Mark and I gave a series of lectures on neurosurgical topics for staff at the Hospital and from several surrounding institutes. These lectures were delivered by us in English, but were simultaneously translated into Ukrainian by one of our host surgeons. We also attended the neurosurgery clinic and saw numerous children in need of expert neurosurgical care that sadly could not be performed at the Lviv City Clinical Children’s Hospital because of insufficient access to the required instrumentation and equipment to perform the required procedures safely. Many of these children would need to go to Kyiv, the capital city, if their families could afford the expense of travel and care at the National Neurosurgical Institute.

The next day, we prepared to assist our colleagues in Lviv with a neurosurgical case they had not done previously, but received permission to do while we were there: An awake craniotomy on a 14 year old girl who had seizures, and a left inferior frontal, language-area cystic tumour. As Mark is one of the leading authorities in the world on awake craniotomy and brain tumour resections, his teachings and instructions were invaluable in giving our host neurosurgeons the confidence to conduct this procedure. Here it is important to point out that the neurosurgeons at this hospital did not have many of the pieces of equipment we take for granted nowadays, such as an image guidance system and an operating microscope. Nonetheless, Mark was able to coach our host neurosurgeons through the craniotomy and tumour removal in a flawless fashion. Thankfully, the teenage girl awakened without any deficits, and her brain tumour turned out to be a ganglioglioma, a benign tumour for which only neurosurgical resection is required.

As part of this Ukrainian Child Health Fellowship, we have encouraged Ukrainian surgeons to come to the University of Toronto for extended observerships which they have been keen to do. In fact, in the fall of 2013, we welcomed 3 surgeons, 1 pediatric general surgeon, 1 pediatric neurosurgeon and 1 adult neurosurgeon from Lviv and Kyiv to learn from our surgical services at UHN and at SickKids. They learned a tremendous amount while here, and we have built up our relationships
with them during this time.

trip photos

Surgical Mission to Ukraine - Mark Bernstein and Jim Rutka

Mark and I plan to return with additional colleagues in May 2014 for another mission. As with so many of our colleagues in the Department of Surgery who have given of their time to reach out to countries and populations in need, our mission to Ukraine will require continuous and consistent communications, repeated visits to Ukraine, and exchange of information and technologies.

International surgery is a critical component of our Strategic Plan. We are in the midst of developing policies by which surgeons who are devoted to International Surgery can receive the necessary and deserved credit for their creative professional activity scores at the time of their annual assessments of productivity, and for their promotion dossiers. In my opinion, these policies and this type of recognition are long overdue.

James T Rutka,
RS McLaughlin Professor and Chair

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