Irish doctors help train Ukrainian medics in use of life-saving drug

The group met emergency workers in Kyiv “who are putting themselves in peril and very significant peril simply for doing their job”, Prof Bury, who heads up the training programme, said.

Hearing some of those stories about civilians — women, children and men — being killed or injured in huge numbers on a daily basis is very distressing. I take my hat off to my colleagues who are willing to do something about it.” 

The idea for travelling to Kyiv had its genesis in conversations with Ukrainian medical staff who arrived in Dublin as refugees following Russia’s attack.

Many were housed on the University College Dublin campus, and during medical English lessons, ideas were shared with their Irish counterparts.

This included paramedics and doctors connected to the UCD Centre for Emergency Medical Science.

“It became clear with some very close interaction with our opposite numbers in Ukraine, that we had expertise and experience in this county, that was of some interest to them and wasn’t widely available there,” he said.

They learned while Irish pre-hospital emergency services use this drug, TXA or tranexamic acid, in pre-war Ukraine it had been seen as a hospital treatment.

TXA helps blood to clot, and can be used in everyday situations, often in tablet-form, for heavy nose-bleeds or menstruation.

In major trauma situations, when delivered soon after injury, it can reduce bleeding deaths by nearly one third, research published in The Lancet by the London School of Hygiene and Tropical Medicine showed.

“We’ve had that being used by our advanced paramedics here for over a dozen years,” Prof Bury explained.

This information made its way to Ukraine, where authorities could see with bombs falling on schools, cafés and apartments, civilian emergency services need this drug as much as the army.

“What all that resulted in was a direct request from the Ukrainian Ministry of Education to provide training skills in advanced techniques that weren’t currently available to pre-hospital emergency care providers, across a whole range of agencies in Ukraine,” Prof Bury said.

Prof Bury, emeritus professor of general practice, said Irish expertise in using TXA outside of hospitals was central to the plan.

We are extremely grateful to the Ukraine Trauma Team by @UCDMedicine for their hard work in training more than 100 🇺🇦personell last week. It is their third visit to Ukraine where they provide vital training in countering haemorrhaging from combat wounds. 🇺🇦🤝🇮🇪 #StandWithUkraine pic.twitter.com/BzCOMbBkuc

— UKR Embassy to Ireland (@UKRinIRL) October 31, 2023

There was never any doubt but that they would travel over as he said video or online training can only do so much.

“And the technique for delivering it that we used in Ukraine was by intraosseous access — which means putting a needle into a bone — which is a relatively straightforward but important technique but much easier to teach than putting it into a vein,” he said.

The project has benefited the Irish medics as much as their Ukrainian students, he said.

“The kind of work that these Ukrainian colleagues are doing is extraordinary — it is really a privilege to meet with them and work with them,” he said.

They are extraordinarily impressive people. Whether you are a civilian practitioner or a military one, most people are dealing with the casualties of war-time weapons, of battlefield weapons.” 

He has travelled twice himself, with 12 people on the teams. The most recent crew included Cathal Berry, Independent TD and former head of the Defence Forces Military Medical School.

“We had two groups of 50 each, 105 trained last week. We delivered four courses overall at this stage; a couple of hundred people trained,” Prof Bury said.

“Sadly our Ukrainian colleagues tell us stories of dealing with the effects of those weapons on women and children, on civilians and on soldiers,” he said.

He had not been in Kyiv before the war, and was struck by how beautiful it remains despite the destruction.

“It is devastating to hear of the scale and the extent of the death and destruction that is happening there,” he said.

“I’m making light of it saying Kyiv is wonderful tourist city, but what is happening on the frontline is dreadful and continuing.” 

He jokes, however, while he had “no great anxiety” about working in the city, the almost 16-hour train journey on hard benches from the border to the capital will stay in his memory.

Prof Bury said they rely on external funding and supports, including from the HSE Global Health unit, Department of Health and Tánaiste Micheal Martin, as well as philanthropic donations and the Red Cross in Ukraine and Ireland.

Last week, the Ukrainian embassy in Ireland shared their appreciation in a social media post.

Prof Bury said they were “entirely dependant” on external funding, adding: “One of our students last week asked if the next course was going to be next week or the week after, so I wasn’t able to answer.” 

To put the need for TXA training into context, the Office of the United Nations High Commissioner for Human Rights recorded 27,768 civilian casualties up to October 8, including 9,806 killed and 17,962 injured.

It said the real figures could be considerably higher as reports continue to come in.

The HSE has also been supporting healthcare in Ukraine in other ways. So far this year, it has donated nine containers of medical equipment, including four decommissioned ambulances in October.

A spokeswoman said the programme involves donating medical supplies and equipment for hospitals.

Donations have included PPE, syringes, ventilators, defibrillators and patient monitors.