Military mission to Ukraine focuses on dental and medical care (05/02/99)

Military mission to Ukraine focuses on dental and medical care

by Linda Neal and Yaromyr Oryshkevych

SILVER SPRING, Md. - In 1993, the California Air National Guard (CAANG) sent the first national guardsmen and active duty members to assist Ukrainian communities during their transition to democratic programs. The mission included collecting bioenvironmental data, conducting optometric examinations, dispensing eyeglasses, and providing dental and medical care to soldiers and children possibly affected by Chornobyl.

In 1996, the California National Guard sent health professionals to Rovesnick, Ukraine, to help examine, diagnose, and treat several hundred children from the Chervonograd region afflicted with dental enamel hypoplasia and associated medical problems.

Most recently on October 19-23, 1998, the California Air National Guard, the Ukrainian National Guard and the Lviv State Medical University presented a dental/medical symposium on U.S. emergency medicine. The CAANG brought various emergency equipment, and two portable dental chairs and units, and shared current medical and dental knowledge in order to improve health care and benefit future generations.

Lt. Col. Linda Neal, R.N., coordinated the project. The coordinator for Lviv State Medical University was Prof. Nina Smolyar, director of the Children's Stomatology (Dentistry) Department director.

Interpreters were: Lt. Col. Yaromyr Oryshkevych, D.D.S., family dentist; Lt. Col. Victor Onufrey, M.D., radiation oncologist; Lt. Col. George Turiansky, M.D., dermatologist; Maj. Roman Bilynsky, M.D., pediatric neurologist; and Maj. Roman Golash, microbiologist.

On October 19, Prof. Smolyar, Col. Albert Richards, commander, 163rd ARW, CAANG, and Lt. Col. Neal, director of nursing, CAANG opened the conference. The first presentation, by Lt. Col. Turiansky, discussed HIV infections in the U.S. Army.

That afternoon Maj. John Wall, M.D. recounted the history and future of U.S. emergency medicine; Lt. Col. Vincent Dang, M.D., described how to initially stabilize accident victims, and M. Sgt. Michael Lavigne, emergency medical technician, explained how to rapidly assess and stabilize accident victims. Participants enthusiastically endorsed these programs for potential medical emergencies in Ukraine.

The next day October 20, Maj. John Ogle, M.D. described how U.S. physicians are trained in emergency medicine, Col. John Owen, M.D. provided the protocol for emergency cardiac pulmonary resuscitation (CPR), and Maj. Francis Razor, R.N. explained the workings of the Emergency Medicine System (EMS) in the U.S.

In the afternoon session, Maj. Wall discussed management of breathing during emergencies, Lt. Col. Dang described treatment of chest injuries, and Col. John Owen, M.D., began a discussion of emergency care of the heart.

On October 21, M. Sgt. Bailey, described evacuation of trauma patients, and Col. Owen, detailed treatment of acute heart attacks during the first hour. A session at the Lviv Main Military Hospital included: Lt. Col. Turiansky, M.D. presenting his HIV lecture again, while Maj. Ogle, showed the use of modern technology in emergency medicine, and Capt. Susan Richards, R.N. described the tracking of immunizations. Col. (Dr.) Serhij Oleksandrovich Petruk (hospital commander) invited them to address the hospital staff.

The October 22, Lt. Col. Dang described treatment of abdominal injuries, Maj. Wall, discussed treatment of heat stroke and frostbite, and Maj. Arnold Zigman illustrated treatment of electric shock. In the afternoon session, Maj. Ogle, described the role of emergency physicians in disasters; this relatively new field stimulated much discussion. Capt. Richards, then addressed treatment of home poisonings.

On October 23, the medical conference featured extensive post-lecture discussions about U.S. procedures and resuscitation equipment unavailable in Ukraine.

The dental conference began Monday afternoon, October 19 with Capt. Raffi Najarian, D.D.S. discussing treatment of various dental emergencies. This overview stimulated enthusiastic questions, and discussions continued afterwards.

On October 20, Lt. Col. Keith Aguillera, D.D.S. discussed the topic of endodontics with skeptical but spellbound participants. He illustrated "systems" of root canals, rather than a canal, in teeth, and stimulated significant discussions. Col. Tim Malan, D.D.S. described extractions of different teeth. Lt. Col. Aguillera discussed the current approaches to bonding, tooth-colored restorations, and denying oxygen to suppress dental decay.

The schedule for October 21 allowed for lectures on emergency medicine, a military hospital tour, and visits with families of interpreters.

On October 22 Capt. Terri Rogers, D.D.S., dental coordinator, described how to prevent periodontal disease (ultimately leading to tooth loss) through consistent home care and professional visits; Capt. Najarian discussed anesthesia, and Lt. Col. Aguillera demonstrated new technology and new dental materials. The participants endorsed this emphasis on preventive dentistry and use of local anesthesia. The crowded "hands-on" sonic scaler demonstration and anesthesia workshop included hand scaling by participating students while others observed.

Col. Malan began the final day, October 23, with a discussion of oral pathology and encouraged early recognition of oral cancer. Lt. Col. Oryshkevych, summarized the week's dental topics with a discussion of preventive dentistry and esthetics, which included hundreds of color transparencies showing teeth before and after esthetic treatment. He emphasized proper radiographic diagnosis of pathology, and using correct procedures with current technology.

Also during their stay in Lviv, the California guardsmen visiting Shevchenkivskyi Hai viewed Ukrainian wooden architecture, and received insight into centuries-old Ukrainian rural culture. The tour of Lviv included the pharmacy museum, a breathtaking view from Vysokyi Zamok, and liturgical music at the Dominican Cathedral. A glass and Christmas ornament factory visit preceded the Friday night farewell dinner at the Kolyba restaurant in Briukhovychi, where everyone expressed mutual thanks and bid farewell to newfound friends.

Speakers reflected on the people who made this conference successful and memorable. The Ukrainians presented a glass-blown Kozak sword to Col. Albert Richards and a glass-blown bulava to Lt. Col. Neal. The CAANG presented medallions, which were struck to commemorate the California-Ukrainian National Guard State Partnership Program. Some unplanned midnight diplomacy included a major general of the Ukrainian militia in Odesa and Col. Richards recounting their relative military experiences. Parting toasts established rapport between the CAANG and the Odesa militia.

This first of hopefully many conferences in Ukrainian cities demonstrates the National Guard's increasing peacemaking role. The evident mutual desire for peace and cooperation is limited only by technology and finances. This memorable Ukrainian-American mission shared medical and health care information. Since the conference participants were often quite familiar with the subject matter, future missions should use more specialists and focus on practicing professionals, but include students. The U.S. military Ukrainian linguistic corps has many specialized health professionals who can fill this requirement.

This week in October 1998 will have a lasting influence. The late nights spent translating the specialized terminology produced technically-sound coherently-presented topics. The interpreters used medical dictionaries extensively, questioned and prompted each other's thinking, and suggested fluid-sounding phrases with the help of student Oksana Kinash.

This unforgettable experience exhausted everyone, but became a labor of love aimed at helping each other further our medical knowledge. Hopefully, we left the Ukrainians with a good impression of Americans. We certainly left with a positive impression of Ukraine.

Our goal, "Advancement Towards a Healthier World," appears to have made significant strides forward.

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