Professor Olga Belousova is a paediatric gastroenterologist from Kharkiv (Ukraine), who arrived in Lithuania exactly one year after the start of a full-scale war in Ukraine. When the city and its university happened to be on the front line, Professor Belousova, who have been living and working in Ukraine for an entire year, had to leave her country. This year she received a grant from the IIE Institute, moved to Vilnius and started working at the Clinic of Children’s Diseases of the Vilnius University Faculty of Medicine. According to her, arriving in Lithuania was like “having a warm bath on a chilly day.” This was not the first time that Professor Belousova had visited Vilnius and Vilnius University: in 2019, she gave a presentation at the 4th Baltic Paediatrics Congress under the auspices of the European Academy of Paediatrics, at the Solidarity Symposium. “I didn’t suspect that the next time I would visit this beautiful city under such terrible circumstances. But I’m very glad that I am here, in Lithuania, a country that is very similar to Ukraine. I think that we’re connected not only by a common history, but also by a commonality of views, moral values, and mutual respect for each other,” Professor Belousova shared her impressions.
© Prof. Olga Belousova
Professor, though you haven’t been here in Lithuania very long this time, is there anything new that you have learned about medicine, practices, technology, the health care system, etc. so far? How is researching and working as a doctor here in Lithuania different compared with Ukraine?
I’m just getting used to a new place and adapting to a different life. I’ve become acquainted with the structure and staff of the paediatric centre where my mentor and friend, Professor Vaidotas Urbonas, works. I’ve been with him on rounds. In addition to this, I’ve also been on a trip to the Neonatology Centre at Santaros klinikos and have even attended the celebration of the 30thanniversary of the Obstetrics and Gynaecology Centre. Your hospitals look fantastic, everything is very well thought out, and it seems to me that they are very comfortable for patients. With great interest (and, to be honest, for the first time in my life), I visited the Breast Milk Bank, which made a great impression on me with its cleanliness, cosiness, comfort, functionality of the premises, and, most importantly, the love of employees for the work they do. In general, people, doctors, and colleagues are a separate emotion in my palette of impressions. Amazingly friendly people live and work in Vilnius. I’ve known Professor Arūnas Valiulis and Professor Vaidotas Urbonas for a long time, and now I’m getting to know other colleagues: Arūnas Liubšys, who is the director of the Neonatology Centre, and Ingrida Pilypienė, who is the head of the Newborn Department, professionals who are in love with their profession.
Let’s move on to the theme of the war in Ukraine. Has the war changed who you are as a person and as a doctor?
War is a very difficult subject. It irreversibly changes both people and spaces. Remember when the Covid-19 pandemic started, and everyone was telling each other that the world would never be the same again? So, I don’t know about Covid-19, but after this terrible, inhuman, bloody war, the world will definitely never be the same again, at least for us Ukrainians. We could not have imagined that in the 21st century you could lose everything in one day. A moment passes and you don’t have a home. Another moment and the hospital where you worked, the university where you studied, your school, your kindergarten explode. Parks and monuments that you remember from childhood disappear. The theatre you used to go to with your parents…. Your friends are dying. But the most important thing is the suffering of the children. For a whole year, from 24 February 2022 to 24 February 2023, I worked just as an ordinary doctor at a paediatric clinic and consulted and examined refugee children whose parents took them out of the occupied territories under shelling. No, my world will definitely never be the same again.
Is it even possible to compare what medicine was like before the war and what it’s like during the war?
Peacetime medicine immediately switched to the war mode. After the start of the war, the military and civilian medical networks were merged. Foreign doctors began coming to train Ukrainian specialists on how to help in the war. A shortage of medical supplies challenged the access to essential health services. In contrast, the interruption of preventative, diagnostic and treatment services increased the risk of adverse disease outcomes and threatened the continuity of treatment. A large number of health facilities are located in either conflict zones or in areas where control has changed, which leaves the health system vulnerable to infrastructural damage and severe disruptions. Consequently, there is limited or no access to medicines, health facilities, and healthcare workers in some areas. In the first months of the war, there were 90% fewer referrals for diagnostic tests. The level of vaccination of children has fallen 60% compared to March 2021 (although it was already low). The number of people who received treatment for oncological diseases decreased by half. People were forced to interrupt even the treatments they had started.
Besides, half of the respondents had problems accessing medical care. Ukrainians have problems accessing medical care due to the cost of medicines and the need to use the private medicine for a fee. This is hard because the poverty rate in Ukraine has risen sharply: according to the World Bank’s forecast, which was given in November 2022, it increased from 5.5% in 2021 to 25% in 2022. One in five Ukrainians cannot get the necessary medicines (due to increased cost or lack of medicines in pharmacies).
A day in the life of a Ukrainian doctor under the conditions of war: what does it look like? What are the most difficult things Ukrainian doctors have to encounter?
The conditions and the situations in Ukraine are very different, because it is impossible to compare what military doctors who provide emergency care on the battlefield have to face with the doctors who are in the other areas of the country. And these areas can also be different: there is Kharkiv, which is under constant shelling, there are Zaporizhzhia, Mykolaiyv, and other cities bordering the invaders, and there is the deep rear, for example, Uzhhorod and Chernivtsi. From the start of the war until recently, I was renting a room and working in Uzhhorod. Of course, I had to deal daily with enormous human grief, tragedies, and wounded children, but this is a different experience, a different degree of contact with the war. Physically, the life of a doctor, like any other Ukrainian who has decided to stay in the country, is very difficult. The provision of medical care is hampered not only by attacks on hospitals themselves, but also by the lack of water and the power outages caused by bombing. Now more than 80% of the energy system has been destroyed. In the region where I lived, electricity was only available for 4 hours a day, most often at night, and there was no heating at all. It quickly became clear that the power of the generators was only enough for operating rooms and intensive care units. The rest of the places had no electricity for days.
Still, physical difficulties are nothing compared to the death, pain and grief that we had to witness.
Being a doctor is considered one of the most prestigious professions in the world. Do you think the war in Ukraine has affected the outlook of what it means to be a doctor?
Without a doubt, yes. I think a doctor is a person with a higher degree of responsibility. It seems that we all understand this in theory, but real life differs from beautiful correct phrases. The profession of a doctor goes beyond the boundaries of the white coat and the medical office.
I am proud that my only daughter, who was forced to flee from the war with me, graduated from a secondary school in a foreign city, passed her tests, and became a medical student. Yes, she is still studying online, we still do not have the opportunity to return home, and I am very worried about this. In Ukraine, a doctor is not the most prestigious profession, and it is not a highly paid. Rather, this profession is very challenging and very stressful. It is not easy for my daughter to study when the world around her is collapsing, but it was her conscious decision and a dream, the desire to help people. I am very proud of her!
What more can be done to support Ukraine better, whether it is in the medical field or simply as civilians?
Your country provides extraordinary support. It is seen in literally everything. By early October 2022, according to the UN Office for Refugees and the latest estimates of the Ministry of Reintegration, more than 10 million people had left our country since February 24. Many women and children ended up in Lithuania, which has become their second home for some time. I am sure that this is also not an easy situation for local residents. The only thing I would like to ask everyone is to treat refugees with understanding. Many migrants are extremely stressed; Ukrainians are very traumatized, and perhaps they do not always notice that Lithuanians also experience discomfort in connection with such a mass migration.
I can assure you that Ukrainians are very peaceful, kind and intelligent people, and the issues that can arise now are exclusively due to psychological trauma. However, all our lives we will be grateful to each of you for the warmth that you give us and our children. We will never forget it.