Neurosurgeon Oles Garashchuk doesn’t like winter holidays. For medical staff, it’s usually that time of the year when their workload spikes. But no one expected the winter of 2013-2014 to be that busy.
For the 38-year-old neurosurgeon, the EuroMaidan Revolution began in Kyiv’s state hospital No. 17 where he’s been working for the past 16 years. When the first wounded protesters arrived to the hospital, Garashchuk understood that this protest wouldn’t be the same as the Orange Revolution that brought pro-Western forces into power in 2004.
Garashchuk himself was among the 500,000 people that took to the streets on Dec. 1, 2013 following the beating of the several hundred students earlier at night. By the end of that day, 109 protesters were hospitalized, according to the City Department of Health.
Next time Garashchuk joined the protest on Dec. 11 during the standoff between the protesters and now disbanded Berkut riot police when they tried to clean-up the barricades on Maidan Nezalezhnosti Square.
“I live close to Maidan, and it was that time that I heard from my window ‘Kyiv, get up!’ and that was enough,” he recalled. “We went together with friends, but in the morning I had to go back to the hospital.”
The revolution, Garashchuk says, was a great example of the nation’s self-organization.
“When people knew they would do their best by being there, they went to Maidan, if not they were working all in their own places for the common goal,” Garashchuk says, as he’s talking to the Kyiv Post sitting on a wooden bench in a hall of the hospital. His eyes check out every patient passing him.
When the first protesters were killed, as violence escalated and police troops pitted against the formerly peaceful protesters, Garashchuk and his colleagues lost their sleep.
He recalled that by the night of Feb. 18, 2014 their 200-bed hospital had to stop taking in patients. They registered 160 people on that day and hospitalized about 60 of those. Almost all had gun wounds. They didn’t register all the patients fearing police could come in for questioning; the hospital staff never revealed all the information about the protesters they treated.
“They were brought to the hospital by cars, buses…anything,” Garashchuk recalls. “At that time we had spare hands, medicine, saline drips, but we didn’t have enough operating tables. My colleagues had to do surgeries on patients’ beds. It still gives me goosebumps.”
All those who used to work at the hospital, including students and interns – everyone arrived to help.
“The pile of bags in our staffroom was hitting the ceiling,” he says.
The hospital’s staff had to put two ultrasound machines near the entrance so they could check for life-threatening conditions right away. Often there were ambulances from western Ukrainian cities like Rivne or Lutsk in the hospital backyard ready to evacuate those patients who could be transported.
“They helped us to ease the workload so we could take in more patients again,” Garashchuk said.
On Feb. 20, 2014 they hospitalized another 30 victims. Most of them were in critical condition with gunshot wounds to the heads. But those were not among the most difficult operations in Garashchuk’s career.
“It’s always a challenge, but that’s not like those high-tech (things) that doctors do here. They sew up hearts in this hospital,” he says.
At least 47 people were killed on Feb. 20, marking the bloodiest day of the revolution, and its end. But for doctors, it didn’t bring easier days, as the revolution was soon followed by war.
Military surgeon
As Russia instigated its war against Ukraine in spring 2014, Garashchuk volunteered to serve. He felt it’s an obligation to defend his land.
“I would not dodge the draft even if there was a chance. It’s my principle,” he explained.
However, he wasn’t called to serve in Donbas until next February, when Ukrainian soldiers had to retreat from a town of Debaltseve, a crucial railway hub, taken by pro-Russian separatists.
Garashchuk packed his surgery instruments, changed his operating gown to a Soviet-style khaki uniform, and went on for a 15-month service in the war zone.
His family supported his decision even though “no one was too happy” about it, he says.
In spite of his high-level qualification, Garashchuk couldn’t start working as a military doctor until he went through a two-month training in barracks together with 360 other doctors mobilized from all over Ukraine. The trainings were of no avail.
“When you are constantly working, you feel confident, but when you march in formation and listen to lectures for two months, it seems that your muscle memory is fading, so you do not feel quite comfortable,” he says, recalling the ineffective trainings.
Garashchuk recovered his skills very quickly and conducted his first neurosurgery in the military in a city of Severodonetsk – and it was a successful one. After that, he got permission to do neurosurgery in the so-called “Sector A,” one of five military sectors in Donbas, marking the front lines in the northern parts of Luhansk Oblast.
“There, on March 30, 2015, we started an era of military surgery in Sector A,” he says.
Before that, all soldiers with brain or head injuries were brought to the regional hospitals – for instance, to eastern Ukrainian cities of Kharkiv or Dnipro (former Dnipropetrovsk), suffering dangerously long transfers. When Garashchuk and a team of neurosurgeons started working in Severodonetsk, hundreds of soldiers were saved. Garashchuk and his team performed around 320 surgeries over that year.
Not everyone welcomed him gladly in the territory where some of the citizens were pro-Russian.
One of the doctors from Luhansk refused to lend him a proper head torch, and offered Garashchuk to light a patient’s brain with old Soviet-made endoscope. It didn’t work, so they had to use a headlight for tourism instead. When its battery died, surgeons had to postpone the procedures until someone brought a new battery from a local store.
Luckily, a few of Garashchuk’s mobilized colleagues from Kyiv hospital were on his side in Donbas. Together, they formed a team in the city hospital of Severodonetsk.
“As for efficiency and coordination, it was the same we had here (in Kyiv),” he said of his team.
Even the state hospital for 550 beds in Severodonetsk was planned in the same way as familiar institutions in Kyiv, so Garashchuk says he couldn’t get lost in it, “owing to the Soviet Union for its typical constructions.”
Medical military standards often complicated their work. Field hospital doctors were not allowed to perform any major surgeries when they received injured servicemen: “(According to the standards), a neurosurgeon in the field has to stop external bleeding. Do you need to be a neurosurgeon to do it?”
But in the war, every minute counts. For a critically injured military officer, three hours is the maximum amount of time during which he or she has to be transported to the hospital for a surgery.
“They (soldiers) had to be transported by helicopters, so it often took a couple of hours to organize a transportation even though there were always helicopters when we asked for them,” Garashchuk recalls.
His team often sacrificed the standards to save lives of Ukrainian soldiers. Two years after the start of the war, those standards were finally simplified, giving a chance to the military doctors in the field hospitals to perform surgeries. Garashchuk was two months away from demobilization when it happened.
It was a tough time for Garashchuk. Often they got patients at 8 a.m. no matter what time they finished the last surgery on the night before. But this rhythm wasn’t entirely new for the surgeon.
“My way of life wasn’t very civilian even before (the mobilization),” Garashchuk says with a warm smile.
Most people who were shot, got in a car accident, or were severely beaten at the right bank of Dnipro River in Kyiv end in the hands of Garashchuk and his team.
“It’s easier to work here (in Kyiv), but I had a feeling I was more useful there,” he says.
After Garashchuk and other doctors were demobilized, the war-zone wounds are healed by remaining military surgeons.
Medical reform
Not once, Garashchuk got offers from abroad to come and work there. His sister, also a medical doctor, works in Germany.
“I had a chance (to go work abroad), and sometimes I regret (that I didn’t go), but then I think again and it’s all good as it is,” he says.
Energetic and worried about the country’s future, Garashchuk keeps his eye on the pace of medical reforms. As of him, it is too early to estimate the progress done by Acting Minister of Health of Ukraine Ulana Suprun, appointed in July. However, he sees improvement in medical provision, saying that his hospital is provided with everything on a basic level, much better than it used to be before the EuroMaidan Revolution.
The medical reform, that started in 2016, is focused on reducing the number of hospitals and optimizing the state medical services. Garashchuk supports the idea. For instance, he says, five medical institutions operate in the city of Smila in Cherkasy Oblast, where only 68,000 citizens live.
“Why so many? (The buildings) have to be heated, electricity paid, water supplied. And what about their medical equipment – it is outdated as well,” he says.
Besides, salaries should be increased to doctors and managers of the system, especially those controlling the state provision.
“Quality medicine cannot be cheap,” he says.
