UCD Ukraine Trauma Project updates reported to the Oireachtas and Ukrainian Members of Parliament visit UCD

On Tuesday 25 June the Joint Committee on Foreign Affairs and Defence met to discuss the work of the UCD Ukraine Trauma Project organisation. See below for the update from Emeritus Professor Gerard Bury.

In addition, on Wednesday 3 July, Ukrainian Members of Parliament visited UCD, attending an event regarding the UCD Ukraine Trauma Project. UCD President Prof Orla Feely attended, as did many who have provided medical expertise, training and equipment for the Project. The event was hosted by Emeritus Professor Gerard Bury and Professor Chris Fitzpatrick.

Houses of the Oireachtas - UCD Ukraine Trauma Project update

The following representatives of the UCD Ukraine Trauma Project were present on the 25 June:

  • Emeritus Professor Gerard Bury – former Professor of General Practice at UCD School of Medicine.
    • Professor Christopher Fitzpatrick - Clinical Professor in UCD School of Medicine and a retired obstetrician and gynaecologist.
    • Mr. Shane Leahy - businessman and a founder of the charity One4Humanity.

Prof Gerard Bury provided the below important update to the Committee, regarding the UCD Ukraine Trauma Project.

‘‘The UCD Ukraine Trauma Project has delivered almost 500 emergency medical kits and four training programmes in Ukraine since late 2022. The equipment, drugs and training in advanced pre-hospital care techniques reflect best practice by Irish emergency services but are largely unavailable to the majority of emergency carers in Ukraine. Almost 30 former and serving volunteer doctors and paramedic staff from Ireland’s health services have trained and equipped approximately 400 Ukrainian doctors, nurses, paramedics and combat medics, based on our experience in day-to-day use of these interventions in Ireland. I acknowledge some of those clinicians, such as Professor Fitzpatrick, who is a wonderful example of a medical colleague who has delivered all that work, Mr. Ben Heron, an advanced paramedic supervisor with the National Ambulance Service who has delivered an enormous amount of work in each one of those training missions, and Dr. Cathal Berry of this parish who helped us to deliver one of the key programmes earlier this year. That work is greatly appreciated by our Ukrainian colleagues.

At the outset, we would like to acknowledge the extraordinary work of individuals and groups from Ireland with whom we have met in Ukraine such as One4Humanity, with whom we have developed a very good working relationship. We thank the people of Ireland, the HSE and the Irish Red Cross for their great generosity. An Tánaiste, Deputy Micheál Martin, and the Minister for Health, Deputy Stephen Donnelly, have also provided very valuable support and the Departments of Health and Foreign Affairs and Defence have made key contributions to our work.

The impact of the war on people in Ukraine has been appalling. In May 2024, the office of the UN High Commissioner for Human Rights, UNCHR, published an estimate of almost 32,000 Ukrainian civilian casualties, with 11,000 civilians killed. UK Defence Intelligence estimated 500,000 Russian military casualties up to May 2024 and in February 2024, President Zelensky said that 31,000 Ukrainian soldiers had been killed. All of these figures are likely to be underestimates.

Deaths and injuries caused by military weapons result in massive bleeding. Control of severe bleeding in the minutes after injury makes the difference between life and death. Dressings and tourniquets are essential but very early administration of drugs such as Tranexamic Acid, TXA, may save up to one in six lives that would otherwise be lost. TXA works best if given into the bloodstream within an hour of injury. Injection into a vein is effective but requires extensive training. Insertion of a needle into a bone, intraosseous access, is equally effective, straightforward to teach and carry out, but requires more complex and expensive equipment. The UCD Ukraine Trauma Project focuses on this key aspect of advanced pre-hospital emergency care.

The UCD Centre for Emergency Medical Science, UCD CEMS, has been responsible for training advanced paramedics in the statutory emergency services and our Defence Forces in advanced pre-hospital emergency interventions since 2004. We build on that experience in this project. In 2022, UCD CEMS agreed a programme with our Ukrainian pre-hospital care colleagues focused on massive bleeding and the evidence based, life-saving interventions which are largely unavailable in Ukraine, but which are widely available in Ireland.

Those wounded on or near the front lines in Ukraine often wait for many hours for evacuation to so-called "stabilisation centres". If TXA is to be of value, it must be given within a maximum of three hours. In Ireland in 2021, 87% of patients with major trauma received TXA within this critical three-hour window.

Four training missions have now visited Ukraine to train almost 400 emergency medical staff with 500 kits supplied. Irish Government rules in relation to neutrality are complied with throughout our work. Each kit contains core materials to control bleeding and cater for intraosseous and intravenous access in order to deliver TXA. Our most recent visit was on 24 April for ten days and included eight doctors and paramedics from Ireland working with Ukrainian medical trainers and interpreters. The team delivered three two-day courses to 136 candidates. Each course teaches the knowledge and skills needed to deliver TXA, as well as reinforcing the fundamentals of whole-patient care in major trauma, with plenty of time to maximise skillsets.

We have also developed a cascade component to our training. Candidates are trained to teach these skills to a colleague. The design and production of 3D simulated training materials in UCD has greatly helped in the dissemination of local training. All training staff are volunteers associated with UCD CEMS with medical and teaching expertise which enables delivery of course components to similar standards as those used in Ireland.

We have had the privilege of working with wonderful colleagues in Ireland and Ukraine. Around 50 volunteers have repeatedly prepared and packaged our kits for delivery to Ukraine. Our partners in Ukraine, Serhi Prytula Charity Foundation, has hosted our training missions and supplied excellent interpreters and facilities for each course. Medical colleagues from Ukraine who have attended previous courses have become tutors on our subsequent courses as well as running their own courses locally, often close to the front line.

All of our kits have now been dispatched to pre-hospital care staff and we have daily requests for more. The greatest impact on all of us has been made by those we have trained. Doctors, dentists, nurses and professional paramedics are familiar colleagues but the extraordinary people we have met include vets, medical researchers, lawyers, hotel workers, teachers, recent college graduates and retired people who are all now volunteering as combat medics. All are caring for terribly injured patients on a daily or weekly basis. Their commitment to their patients and their country is very striking. We have met those moving directly to or from the front line and those who have lost loved ones to the war only days previously. All are fiercely committed to learning what we have to teach, putting it into action and teaching their colleagues.

Many Irish agencies and individuals do amazing work in Ukraine and it has been our privilege to meet some of them. An example of these would be former and current members of Dublin Fire Brigade and the National Ambulance Service who are among a group which has driven eight emergency ambulances, five donated by Dublin Fire Brigade, and 40 4x4 vehicles purchased by themselves and their friends and families, to Ukraine. Mr. Tony McEvoy who is with us today is one of those extraordinary people.

Through our courses we have made important contacts with colleagues in Odessa National Medical University which have generated a recent memorandum of agreement between UCD and that university and we hope to see academic developments focused on emergency care. Working with colleagues in Odessa led us to develop a great working relationship with Mr. Shane Leahy of One4Humanity in order to obtain a bespoke maternity Hospitainer for Mykolaiv in southern Ukraine where the hospital unit had been destroyed. Shane and his colleagues subsequently transported a large consignment of our equipment to Kyiv.

One4Humanity was founded by Shane Leahy and Norman Sheehan in 2023 and provides humanitarian emergency response assistance by tapping into the founders’ business knowledge and contacts to provide essential assistance such as medical aid. Their team has delivered 16 self-contained hospital units right across Ukraine, including to Kherson, Kharkiv and Kramatorsk. These units are predominantly trauma units but also include maternity and laboratory units. One4Humanity, working with Cemark, a CRH company, has delivered more than $80 million worth of medicines and medical aid donated by their key partners: Heart to Heart International, a US charity. They currently have a large consignment en route to Ukraine containing 25 pallets or 6,500 kg of medicines for hypertension, anxiety, asthma and other conditions.

One4Humanity's Project Conor in Odessa supports more than 380 families raising children with severe disabilities, mental disorders, autism and genetic diseases.

Our project has had the privilege of offering some medical advice and support to the project. One4Humanity is in advanced talks with Suhaila Tarazi, director general of Al-Ahli Hospital in Gaza City with a view to providing them with a Hospitainer starter hospital: operating theatre and recovery rooms. One4Humanity is working closely with Hospitainer, WHO and the International Medical Corps, IMC, which have already delivered Hospitainer units in Gaza.

The Al-Ahli Hospital is run by the Anglican Church in Jerusalem and is strongly supported by the Anglican Archbishop of Dublin, Michael Jackson. Once the first unit is delivered, One4Humanity will look to scale up.

The important opportunity today for us is to be able to say some thank yous. We have raised not €900,000, but in fact we have hit the €1 million mark thanks to the Irish Red Cross which donated a further €100,000 to our Ukraine trauma project yesterday. That adds to the €300,000 we already had raised from the Irish Red Cross, to the €400,000 from HSE global health engagement on behalf of Government Departments, €60,000 from UCD and the remainder from the generous donations of Irish people. All of this money has been spent on the purchase of emergency and training kits, including all equipment and drugs, and travel for teaching teams. We thank many individuals - ambassadors Larysa Gerasko and Therese Healy for their warm support and hospitality; the Tánaiste, Deputy Micheál Martin, and the Minister for Health, Deputy Donnelly, and their staff; Ms Liz McMahon and Ms Anna Marie Carroll and their colleagues in Irish Red Cross; Ms Ciara Norton and Dr. David Weakliam of HSE Global Health; Deputy Cathal Berry for his enormous support; all of our colleagues at UCD; and the many volunteers who have worked very hard to make each mission happen.

Turning to our plans for next steps, the recent surge in attacks on Ukraine has created a constant demand for new supplies from our partners there. We plan a further ten-day training mission in autumn 2024, aiming at up to 150 further participants who will receive emergency kits. The recent generous contribution from HSE and the Irish Red Cross, taken with charitable donations, will fund those missions and perhaps some additional work. We have requested further funds from other agencies but at the moment the funds we have should enable us to accomplish some significant work later this year.

Having described our work, we have some things to ask of this committee. Our work has shown us the great needs that exist for specialist medical support in Ukraine. Our team remains committed to making our contribution and we ask for the support of the joint committee in a number of ways to progress that work: first, to support the continuing work of our project and for our further efforts to fund training and equipment; second, given the scale of current crises in Ukraine and Gaza, to support the work of other voluntary and charity agencies such as One4Humanity. Mechanisms to allow for the transfer of suitable vehicles would be a measure of immediate assistance in Ukraine; and finally, to consider the establishment of formal mechanisms for Irish medical professionals who wish to volunteer their time and skills in major medical emergencies overseas. Those mechanisms might then allow our colleagues to contribute as part of the Irish Government’s response to requests for emergency assistance in humanitarian crises. Our experience suggests that such an interest exists and that there are specialist areas in which the expertise of Irish clinicians can be of great value.’’