NODUS Ukraine: Helping wounded Ukrainian soldiers with brain trauma and spinal cord injuries

From information provided by Yuliya Grassby, a former NODUS nurse volunteer (all photos from Yulia Grassby)
11.21.2016
Translated and edited by Voices of Ukraine

NODUS is the only private Neurorehabilitation and Neurosurgery Centre in Ukraine, the clinic opened it’s doors in 2008. It runs a non-profit Nodus Charity Project for Wounded Ukrainian Soldiers which began in August of 2014 specifically to give help to wounded Ukrainian soldiers with brain trauma injuries (TBI) and spinal cord injuries (SCI).

Dr. Ulyana Suprun, the Acting Minister of Health in Ukraine (pictured in red shirt), and other Ukrainian government officials visit NODUS to learn about their practices. They acknowledged the NODUS team, their quality services and high recovery success rates.

Dr. Ulyana Suprun, the Acting Minister of Health in Ukraine (pictured in red shirt), and other Ukrainian government officials visit NODUS to learn about their practices. They acknowledged the NODUS team, their quality services and high recovery success rates.

Yuliya Grassby worked as a hands-on nurse volunteer with injured soldiers in the clinic at NODUS from March-August 2016. She writes, “My work schedule was from 9 am to 9 pm, Monday through Friday. I cried and I laughed with my soldier patients. I listened to their battlefield experiences and taught them positive thinking and optimism. I know their pain from the inside and how they fight to survive. They came back alive from the war, but Ukrainian society is not ready to take them back and provide a quality life for people in a wheelchair. Rehabilitation is their chance to walk again and to live, and not just to survive. I feel this group of people is being sacrificed – and that is why I am a strong advocate for them.

I have researched thousands of charity organizations, big and small, related to healthcare issues in today’s world. Almost all of them are focused on AIDS/HIV, TB, malaria, child or maternal health, clean water, etc.  They all set their goals some years ago and are not able to be flexible.

The harsh reality currently facing Ukraine, in the official statistics given out by the United Nations Office for Humanitarian Affairs (OCHA), is that since the beginning of Russia’s invasion of eastern Ukraine in 2014, over 9,640 people have been killed and over 22,431 were wounded among Ukrainian armed forces as at Sept. 15, 2016. Every day, more and more soldiers, who fight so fearlessly to protect their country, get seriously wounded on the battlefield and the military hospitals accept dozens of these heroes daily. They risk their lives because they want to secure a better future for the country. Unfortunately, the Ukrainian healthcare system is not as advanced as it is in the Western world or in North America. Because of economic difficulties, the Ukrainian government is unable to provide sufficient funds to the hospitals so that doctors can get everything they need to save as many wounded soldiers as possible. This is well known now.

NODUS' ATO Ward 1: Volunteers Yuliya Grassby and James Clement visit wounded soldiers to talk about the war, their experiences and the future of Ukraine. Iliya Karpov (ATO volunteer participant/standing, suffered a brain trauma injury in January of 2015; he has had 3 rounds of rehabilitation at Nodus since February 2015 – was in a coma, then in a wheelchair, then used a cane – and this past summer, Iliya started his third round of rehabilitation to begin walking without a cane). Artur Kireev (officer, in yellow t-shirt) and Sergey Saliy (officer, in green t-shirt) were both wounded with spinal cord injuries. Artur graduated with a military degree. Sergey was a volunteer soldier.

NODUS’ ATO Ward 1: Volunteers Yuliya Grassby and James Clement visit wounded soldiers to talk about the war, their experiences and the future of Ukraine. Iliya Karpov (ATO volunteer participant/standing, suffered a brain trauma injury in January of 2015; he has had 3 rounds of rehabilitation at Nodus since February 2015 – was in a coma, then in a wheelchair, then used a cane – and this past summer, Iliya started his third round of rehabilitation to begin walking without a cane). Artur Kireev (officer, in yellow t-shirt) and Sergey Saliy (officer, in green t-shirt) were both wounded with spinal cord injuries. Artur graduated with a military degree. Sergey was a volunteer soldier.

I worked as a nurse volunteer in Ukraine for eight months most recently. These are some facts that I learned while living and doing volunteer work in Ukraine:

  1. Military hospitals in Ukraine (including leading ones such as Irpen and Lviv) focus to help TBI and SCI injured soldiers mostly with acute care.  There are no individual neurorehabilitation programs – only standard protocols, standard timeframes. When you’re acute care is over, you are on your own. They practice survival skills (no quality of life training) – no walking, no work-related therapy or assistance.  Ukraine does not have the same “Americans with Disabilities (ADA)” laws to protect the rights of these injured soldiers. Ukraine is not yet ready to provide a quality life for disabled people.
  1. Major military hospitals in Ukraine have some help from Ukrainian and international charitable foundations.  However, injured soldiers with TBI and SCI often “do not fit” under the criteria for financial assistance. Often it is too long to wait and too expensive. The major military hospitals leave much to be desired!
  1. Ukrainian military hospitals no longer admit volunteer soldiers, only regular military servicemen. It is not really fair, but it is a reality.

I feel so sorry for these brave soldiers who risked their lives to protect the country and are now left on their own to practice a “survival of the fittest” situation.

NODUS is located just outside Kyiv, in Brovary, Ukraine. I am now one of the NODUS Charity Project representatives and volunteers in the United States.

In August of 2014, the private neurological and neurosurgical rehabilitation research center created and implemented a non-profit Charity Project for Wounded Soldiers.  This is the only private clinic in Ukraine that runs such a project. Under the umbrella of the charity project, medical care is provided to both servicemen and soldier-volunteers in the outpatient and clinic-based formats. Most of the soldiers the clinic treats are gravely injured and most of them have severe traumatic brain injuries (TBI) and spinal cord injuries (SCI). Rehabilitation for each patient is protracted, lasting a minimum of three to six months on average, and may run up to 12 months or longer. Treatment expenses for each patient may run about from $2000 to $4000 a month based on each individual case.

NODUS’ ATO Ward 1: Soldiers Vasiliy Mihailenko (tankist, injured right arm) and Artur Kireev after their procedures and individualized exercise programs. In order to survive and to ensure successful treatment, they practice a sense of humor. You cannot go through the many rough times without a good laugh.

NODUS’ ATO Ward 1: Soldiers Vasiliy Mihailenko (tankist, injured right arm) and Artur Kireev after their procedures and individualized exercise programs. In order to survive and to ensure successful treatment, they practice a sense of humor. You cannot go through the many rough times without a good laugh.

As of August 2016, 142 Ukrainian soldiers have gone through the individual rehabilitation programs.  The clinic covered 100% of the treatment costs for 119 of them.  Twenty-three soldiers received a 25% discount for their rehabilitation programs.  At the present time, 250+ soldiers are on the waiting list to be admitted to the clinic.

NODUS’ ATO Ward 1: Artur Kireev. Smiling and positive emotions are part of the treatment. Artur is a huge fan of the Minions. One day, Yuliya found and bought a cake for ATO Ward 1 which made Artur smile.

NODUS’ ATO Ward 1: Artur Kireev. Smiling and positive emotions are part of the treatment. Artur is a huge fan of the Minions. One day, Yuliya found and bought a cake for ATO Ward 1 which made Artur smile.

You may ask: “Why do these 250+ soldiers want to get their treatment and rehabilitation at this clinic!”  I have an answer:  the services in this clinic are on a level of health care comparable to that of Western Europe and the US.  They use successfully targeted and proven effective health practices.  This center may become a leader/role model in Ukraine for neuro-rehabilitation services. NODUS is a center of excellence and innovation within its specialty.  Its multidisciplinary team has credentials and experience needed today in Ukraine to work in the field of neurorehabilitation. The excellent work and results of this clinic were noted by many social, charitable, and governmental organizations in Ukraine as well as international organizations such as the Red Cross, the North Atlantic Treaty Organization (NATO), and the Organization for Security and Co-Operation in Europe (OSCE).  The clinic’s results and recognition are well-documented on its Facebook page   and its public web site.  On August 20, 2016, Ulana Suprun, Acting Ukrainian Minister of Health, and other governmental officials visited the clinic and soldiers/patients as recognition of excellent services and the charity project outcomes.  The clinic charity project was recognized by the Ukrainian Ministry of Defense on August 22, 2016.

Director of NODUS, Dr. Oleksandr Kulik shows Ukraine's Acting Minister of Health Dr. Ulana Suprun their facilities.

Director of NODUS, Dr. Oleksandr Kulyk shows Ukraine’s Acting Minister of Health Dr. Ulana Suprun their facilities.

Now, I have a question: do the brave Ukrainian soldiers deserve to have such care?  Ukraine is not a user-friendly country for people with TBI and SCI, which makes them part of a vulnerable group.  Some of the injured soldiers in the charity project were rejected by other Ukrainian hospitals and clinics with no hope of returning to a normal life.  This clinic gives them a real chance and the hope to get back on their feet!”

NODUS’ ATO Ward 2: Artur Galtzcov and Roman Kubyshkin need to sit in a wheel chair for at least 3 hours per day as part of their recovery procedure from their comas. Yuliya Grassby is a tennis player and serves on the Board of Directors of the Black Hills Tennis Association. She brought the soldiers tennis tournament t-shirts from the Association is awaiting their recovery to teach them how to play tennis.

NODUS’ ATO Ward 2: Artur Galtzcov and Roman Kubyshkin need to sit in a wheel chair for at least 3 hours per day as part of their recovery procedure from their comas. Yuliya Grassby is a tennis player and serves on the Board of Directors of the Black Hills Tennis Association. She brought the soldiers tennis tournament t-shirts from the Association is awaiting their recovery to teach them how to play tennis.

Below are just a couple of examples of success stories:

Elijah with NODUS staff.

Elijah with NODUS staff.

Illiya was injured in an accident in January of 2015 in the ATO [anti-terrorist operation] zone. With the severe effects of his closed craniocerebral injury, and serious internal bleeding in the brain, he was examined in the Main Military Medical Clinical Center of the Order of the Red Star’s “Main Military Clinical Hospital.”
The patient experienced a distinct syndrome of social, existential and professional disadaptation. He was completely reliant on outside care. On 02.20.2015, he was transferred  to a rehabilitation treatment program at NODUS.
The main purpose and direction of his treatment:
– Prevention and reduction of the maximum possible degree of disability;
– Maximum physical, mental, social, economic usefulness, which he will be able to have within the existing trauma;
– Improving the quality of life of the patient;
– Activation of the muscles;
– The elimination of cachexia and somatic comorbidities.

After completing two courses in the rehabilitation center, Illiya was discharged with a significant reduction of disability. He is now able to:
– Walk independently without crutches
– Take his own food
– Talk
– Is oriented in time and space
– Correctly takes command
– Exhibits a decrease in tetraparesis events and numerous contractures
– Has gradually corrected stereotyped complex movements in amplitude, speed, strength, rhythm.
– Has gained a significant recovery in communication (language has properly acquired semantic language, and of an emotional nature) compared to his previous monotonous, misunderstood and early treatment.
Source: http://www.nodus.ua/pasient/istoria_reabilitasii-19.html#overview

Peter S., 37, received gunshot wounds in the spine, the spinal cord, penetrating chest injuries, multiple fractures and bruises in March of 2015 during a combat mission in the ATO zone.

He was delivered to the Dnipropetrovsk Oblast Clinical Hospital–Mechnikov, where he underwent several operations. He continued treatment in hospital for Ukrainian Internal Affairs.

On September 22, 2015 he arrived for treatment at NODUS in the charity program free rehabilitation for wounded soldiers in the ATO zone and volunteers, to undergo free rehabilitation treatment. At admission, he had complaints about the lack of movement in his lower extremities, pain in the lumbar spine, shooting pain and painful spasms in the muscles of the hips and legs, headaches, memory impairment. Moved solely in a wheelchair. After diagnosis, the patient was given an individually customized rehabilitation program.

Peter completed 2 courses of rehab treatment with distinct improvements. He almost almost does not lie in bed, walks independently, leaning on crutches. He is currently in his third course of rehabilitation treatment.
Source: http://www.nodus.com.ua/pasient/istoria_reabilitasii-42.html#overview

The clinic team strives selflessly to return defenders of Ukraine back to a normal life. However, the minimal Ukrainian government and foundation funding sources have been depleted. The clinic must rely almost exclusively on private donations, gifts of equipment, and thousands of volunteer medical and nursing hours to successfully help patients and run its programs. Despite their tremendous effort, they cannot even afford today to buy the necessary equipment since their purchasing resources have been exhausted.

Today, Ukraine continues to defend itself daily against Russian hostility.  Every day we hear about increasing numbers of wounded soldiers in the news.  The NODUS team’s social responsibility is to continue running its non-profit charity project. At the present time, the clinic is exploring all possible sources of assistance within Ukraine and outside of Ukrainian borders. With no funding sources, NODUS will have to downsize its charity project/space availabilities for soldier patients.  They need your help!  

NODUS stats of September 19th, 2016:

42-45 patients are being treated and undergoing rehabilitation courses.
10 of them are ATO participants + 1 civilian girl (volunteer) who suffered a mine blast trauma.
The breakdown of these 10 is as follows:
6 men – clinic-based treatment and rehab
4 men – out-patient format
8 men – serviecemen of the Military Forces of Ukraine, 1-special unit, 1- soldier-volunteer
6 men – drafted
Other – professional servicemen

In the framework of the charity project for wounded soldiers:
142  completed their treatment and rehabilitation.
263 men are on the “Waiting List” to be admitted to NODUS

1 month is the minimum neuro-rehabilitation course.
37 patients – had a 6 month course of treatment and rehab, 16 patients – spent 9 months, 8 patients – 12months, 14 patients had 2 treatment and rehab courses, 8 patients – 3 courses, 5 patients – 4 courses. 1 man was discharged pre-term of the rehab course completion for gross negligence of rehab rules and the clinic’s requirements.

YOUR DONATIONS CAN HELP NODUS:

All donations are meant to cover a specific task: to pay for an individual’s reahibilitation, a surgery on a wounded soldier or purchase equipment, disposable items, etc. All such expenditures are related to the implementation of NODUS’s non-profit charity project for wounded soldiers.

The following information comes from Inna Danchenko, who is both a NODUS volunteer and with Volunteers’ Hundred Dobrovolya.

There are TWO options to help the NODUS Charity Project: 

1. Finance the rehabilitation of a wounded soldier or any related medical expenses (as per Individual Rehabilitation program cost). 

Costs vary between $2,000–4,000 USD per month approximately.  

2. Finance the purchase of, or donate as a gift, a piece of  equipment that will allow NODUS to expand and upgrade the rehabilitation possibilities at NODUS in order to allow more gravely-inquired soldiers and volunteers to undergo treatment and the most efficient rehabilitation in Ukraine in the framework of this unique Charity project.

How financial help to a wounded soldier works:

Please contact Dr Kulyk or NODUS Administrator Ms. Oksana Dzyuma (who speaks English well) Tel +380 44 579 90 25 . She will answer questions & inquiries and provide bank details for a donation.

The Director of NODUS is Dr. Oleksander V. Kulyk, Neurosurgeon.
His contact information is as follows:
Oleksandr V. Kulyk, PhD, MD
Director of NODUS Neurological and Neurosurgical Rehabilitation Research Center
Heroyiv UPA 7A Street Brovary, Kyiv Region 07400 Ukraine
Office phone/fax: +38 (044) 579-9025
Cell phone: +38 (050) 395-0878
Email: A.Kulyk@nodus.ua

The CHARITY PROJECT of the NEUROLOGICAL and NEUROSURGICAL REHABILITATION RESEARCH CENTRE “NODUS” FOR WOUNDED UKRAINIAN SOLDIERS financial information page: http://www.nodus.ua/eng/main-info.php

If a Charity or other Fund or institution is willing to donate to help a soldier or a Charity Project in general (paying for a piece of equipment needed or purchasing disposable materials, etc) they can contact Inna Danchenko (in English, Italian, or French) cell: +38066 7444620 or by e-mail: Inna.N.Danchenko@gmail.com. As a volunteer of the Volonteers’ Hundred DOBROVOLYA, she acts as the NODUS Charity Project Coordinator.

Related References:
Inna Danchenko and Dr. Oleksandr Kulyk on Channel 5’s Information Morning show – segment entitled: “Rehabilitation of those wounded during the ATO (10/06/2016) in Ukrainian: https://www.youtube.com/watch?v=e54pfh8N_U4 

Creative Commons License
This translation work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. The rights pertaining to the original work remain unaffected.

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