Karta Ukraina
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Poor healthcare system affects crisis preparedness in Ukraine


The trauma care available in Ukraine is of a high standard, but how care is organized has significant problems. Corruption and an inability to use care resources the best way hurt the country’s crisis preparedness from the outset, according to Amir Khorram-Manesh, Associate Professor at the University of Gothenburg.

Amir Khorram-Manesh is an Associate Professor in surgery with a focus on disaster medicine and trauma at the University of Gothenburg, as well as chief physician at Sahlgrenska University Hospital. After the European Union negotiated a fragile cease-fire, in 2015 he joined an international group of experts tasked by the EU to support Ukraine’s crisis preparedness. At that time, the group visited the capital city of Kyiv and the country’s second-largest city, Kharkiv, to establish training programs in crisis and disaster management.

The run-up to the crisis

Even at that time, while the lead up to the current crisis in Ukraine was occurring, and Amir Khorram-Manesh recalls that he suspected where it was headed.

Amir Khorram-Manesh portrait
Amir Khorram-Manesh. Private photo.

“We had a positive reception in Kyiv, where we met with key individuals in healthcare administration and doctors. Then, once we established contact with the university in Kharkiv, we saw a clear desire to be updated on disaster medicine, and it was evident that the city was much closer to the Russian border.

We offered training in the form of lectures and practical exercises that work very well here at home and that have also worked well elsewhere in the world, such as in Thailand. But I fear it has not been well maintained in Ukraine. Today there are several private companies in Ukraine that use the equipment and materials we brought, and it is unclear whether the government agencies or hospitals have oversight over the training we established.”

Fundamental societal problems

He concludes that trauma care at hospitals in Ukraine is relatively high quality and that medical staff are more than capable of handling the injuries that can happen in a war. However, proper governance and organization are lacking, particularly with everything related to emergency medical services. At the same time, he is concerned that the country’s Soviet legacy may be an obstacle if the crisis culminates in war. The country’s crisis preparedness would benefit from a comprehensive change in society.

“There were and still are problems with corruption. It was common for key people to ask what they could benefit personally from new programs and organizational changes. Important material is not delivered or perhaps isn’t used as it should be, and there is no ability to optimize the use of healthcare resources. The country’s ability to offer emergency care before patients reach hospitals, known as pre-hospital care, is also very poorly organized.”

Handbook of Disaster and Emergency Management

Amir Khorram-Manesh is editor and co-author of the international Handbook of Disaster and Emergency Management, a revised edition published last year.

Download the book free of charge at Researchgate