Trenches litter the ground, military vehicles whiz by, and the sounds of explosions and gunfire resound. At times, darkness fills the reconstructed battlefield in central Poland. On the ground, wounded actors and mannequins bleed profusely after being allegedly hit by gunfire or shrapnel. Around them, Ukrainian recruits provide first aid under the watchful eye of 12 Canadian Armed Forces (CAF) medical care instructors.
Since last March, Canada has been participating in the Polish-led training program to hastily train Ukrainian medical technicians to be sent to the battlefield. The training, condensed into three weeks – compared to the months of training offered to medical technicians in Canada – focuses on combat survivability.
Through the four modules taught to them, future medical technicians learn mainly “how to preserve the life [of wounded soldiers] on the battlefield until they are taken to a medical center”, explains Kristina Melvin, the FAC warrant officer heading the team of trainers on mission in Poland.
To reproduce as closely as possible the stress and anxiety experienced in the heat of battle, a simulation center has been set up. “We’re able to reproduce the sounds of explosions and gunfire, or other things, which can distract [future medical technicians] and cause them stress while they have to put their knowledge into practice,” she says.
The mannequins also offer a direct immersion in reality. “We use equipment that offers very high fidelity” to the injuries that can occur on the front line, explains Kristina Melvin. For example, “we can simulate an injury to a bleeding limb, and the bleeding will only stop when the recruits put enough pressure with a tourniquet on that limb”.
To combat the “triad of death” (coagulopathy, acidosis and hypothermia), medical technicians learn not only to apply a tourniquet – to themselves or another person – in less than a minute to stop bleeding, but also to clear the airway and combat the hypothermia that quickly occurs after heavy bleeding. “We practice the techniques over and over again to make sure it becomes second nature to them.”
Four cohorts have already completed the training program. And several medical technicians trained by Canadian troops are already in action. “The techniques we’ve taught them are saving lives,” enthuses Kristina Melvin. But there are also heartbreaks in store, explains Melvin, who has already served in Afghanistan and Sierra Leone to fight Ebola, among other places. “Many of our students are leaving for the front line, and we understand the risks they run.”
Matériel médical canadien
In addition to sending medical care instructors to Poland, Canada is supporting health care in Ukraine, having provided $8.5 million in humanitarian funding to the World Health Organization (WHO) “to meet the vital needs of people affected by the crisis in Ukraine”, Global Affairs Canada tells Le Devoir. This aid included the delivery of pharmaceuticals and medical supplies, such as trauma and emergency surgery kits, blood transfusion equipment and emergency health kits.
The Public Health Agency of Canada’s National Strategic Emergency Stockpile System (NESS) has also donated 345,000 units of essential supplies, such as beds and blankets, to Ukraine in 2022. “These efforts do not compromise the RNSU’s ability to respond to public health events in Canada,” says the Public Health Agency of Canada.
Enhancing the value of Quebec materials
In Quebec, Collaboration Santé Internationale (CSI) – whose mission is to recover and recycle surplus equipment from Quebec’s healthcare network – sent 80 pallets of medicines, medical supplies and equipment to Ukraine via the humanitarian corridor set up by Poland.
“We give a second life to obsolete equipment that no longer meets the standards of the Ministry of Health and Social Services,” explains Jacques Paradis, CSI’s General Manager. Since the organization was founded in 1968, equipment that is still functional is sent to developing countries or to communities devastated by disaster or conflict, such as Ukraine.
In addition to this recovered equipment, CSI’s shipments to Ukraine have included donations from private partners, such as pharmaceutical companies that have offered medicines. We began by sending barrels of medicines and medical equipment in March 2022,” says Paradis. Thereafter, we continued our humanitarian action throughout the year to help hospitals in Kiev, Lviv, Zaporijjia, Kherson and Zalischyky through our various partners in Ukraine.”
The MSSS reports that among the equipment recovered from the healthcare network that has been sent to Ukraine are wound management supplies (dressings, compresses, suture trays), boxes of endotracheal tubes and gastrostomy tubes.
Solidarity among colleagues
Initiatives between medical colleagues also arose. In the early days of the war, the Centre for Global Surgery of the McGill University Health Centre (MUHC) produced video clips translated into Ukrainian to help overseas colleagues who had to learn to treat war wounds in a hurry.
“It was mainly to help [colleagues] who were not necessarily involved, in their usual practice, in war care, trauma surgery or resuscitation, but who had to get involved because of the seriousness of the situation and the volume” of casualties, says Dr. Tarek Razek, Head of the MUHC Trauma Department.
These vignettes not only served to transfer knowledge, but also to demonstrate to Ukrainian doctors the support of their international colleagues. “There’s a lot of collegiality in the medical world,” he says. A collegiality that endures, as Dr. Razek says he is still in regular contact with Ukrainian surgeons.