Ufond Blog. It is easier to destroy than to build
Medical reform has recently been announced in Ukraine.
Those who still have the strength to cultivate inner optimism hoped that this would be a change for the better, because the health care system undoubtedly needs to change, and in some respects even radical. Those who have been skeptical since the beginning of the announcement of this news, surprisingly and fortunately in the medical field, did not expect, and, as it turned out, were right. Agree on how something can be reformed without, firstly, proper funding, secondly, qualified personnel management in the relevant ministry, thirdly, without a clear motivated action plan, which would provide for the period of reform, the so-called "airbag" for all medical institutions and establishments, ie during the transition from the old system to the new one, they will function and the population will be provided with adequate medical care?
In addition, approved by the Acting Government Ulyana Suprun, the head of the Ministry of Health, started this reform in a very strange way and, using the so-called franchise of the popular American TV show "MythBusters", became a pseudo-Ukrainian myth destroyer, shocking the Internet community on its official website. Facebook. Almost every one of her posts resonates in the publications of Ukrainian doctors who are desperately trying to keep a note of common sense in a false and threatening Ministerial polyphony.
With the beginning of medical reform in Ukraine, the state of existing specialized medical institutions has deteriorated: they either cease to function at all, or are forced to reduce their staff, or are on the verge of a humanitarian catastrophe such as the National Institute of Tuberculosis and Pulmonology. FG Yanovsky National Academy of Medical Sciences of Ukraine.
This summer, the reform knocked on the door of the country’s main children’s hospital, Okhmatdyt. It provides for the reorganization of four structural units of the hospital. At the end of August 2018, Iryna Sadovyak, the chief physician of the Okhmatdyt NDSL, signed an order to reform the Center for Oncohematology and Bone Marrow Transplantation, which has been operating successfully for 14 years and building an effective treatment system. In fact, this means that Iryna Sadovyak has signed a death sentence for Ukrainian children who could receive high-quality and highly qualified treatment in Ukraine, and not abroad.
After that, the chief doctor of NDSL "Okhmatdyt" signed an order dismissing two employees of the Center for Oncohematology and Bone Marrow Transplantation - Honored Doctor of Ukraine Svitlana Borysivna Donska, who actually created this Center and headed it for many years, and Honored Doctor of Ukraine Oleh Anatoliyovych Ryzh. bone marrow transplant department.
As a sign of protest against the criminal actions of the management of the children’s hospital and in support of fellow doctors, almost all employees of the Center for Oncohematology and Bone Marrow Transplantation wrote applications for dismissal of their own volition. The children who were in the Center at that time continue their treatment and now thanks to the initiative and support of the resigned doctors. It seems that only these unemployed professionals and parents of sick children understand all the danger and cynicism of the Ministry of Health.
Subsequently, on September 3, former employees of the Center for Oncohematology and Bone Marrow Transplantation published an official appeal in the form of a collective open letter.
One of the authors of this letter is Sofia Matsiboh - A hematologist of the Children’s Department of Bone Marrow Transplantation of the National Children’s Specialized Hospital "Okhmatdyt" was fired at her own request. On her page on the social network, she publishes the following :
“ Why is the only Center for Oncohematology and Bone Marrow Transplantation in the country really ceased to exist and why we are leaving.
First, dry facts for those who want to understand what happened and what the country is losing:
FACT №1 :The Center for Oncohematology and Bone Marrow Transplantation NDSL "Okhmatdyt" was the only one in Ukraine where bone marrow transplants (BMT) were performed for children with oncohematological diseases: autoTKM, TCM from a fully compatible and partially compatible family donor. Since its founding in 2003, it has performed transplants for 235 patients - 120 autoTKM and 115 - from a family donor. Today, 167 patients (70%) of these patients are alive and do not have cancer, which is fully consistent with the European average. Surprisingly, our team managed to achieve all this in the old building, built in 1939!
To date, the Center has come close to launching a non-family TCM, which would eliminate the need to refer Ukrainian patients for treatment in foreign clinics, which costs 120-150 thousand euros. According to the basic technology, transplantation from a non-family donor is no different from a transplant from a family donor, which has been successfully performed at the Center for many years. Thanks to the cooperation between the All-Ukrainian Association of Pediatric Oncohematologists and the German Stefan Morsch Foundation, a practical solution has already been found for Ukraine to receive donors from international registries even without creating and filling a national registry of bone marrow donors.
FACT №2:Honored Doctor of Ukraine Svitlana Borysivna Donska, who founded and headed the Center for many years, was fired on August 20 due to redundancies, as her position was liquidated during the reorganization. She turned down a formal offer to become a consultant doctor at the Okhmatdit polyclinic because the polyclinic had never been and has nothing to do with the diagnosis and treatment of oncohematological diseases.
FACT №3:Honored Doctor of Ukraine Oleh Anatoliyovych Ryzhak, Head Department of Bone Marrow Transplantation (BMT), a doctor who performed in 1998 the first autologous TCM in Ukraine, in 2000 the first TCM from a fully compatible family donor, and since 2015 launched successful TCM from a partially compatible family donor, was fired on the basis of two reprimands. The first was issued in April for allegedly misinforming parents about the availability of drugs in the hospital’s warehouse and advising them to buy expensive drugs from the world’s best manufacturers, instead of using what the state had purchased. A separate letter should be written about the terrible one and a half year delays in the international supply of medicines for oncohematological patients. The 2nd reprimand was issued in July for alleged systemic violations in keeping records of blood transfusions in the TCM department. The same reprimands were received by Donskaya. Note the cynicism of the highest quality from the new chief physician: the country’s most successful hematologists saved in terms of the number of lives saved are punished by dismissal, including for allegedly misreporting blood transfusions.
FACT №4: For us and for many hematologists in regional hospitals Donska and Ryzhak are carriers of a huge amount of professional knowledge and experience, both international and domestic, from which you can always get professional advice, not an extra administrative superstructure, which is a primitive fake of the Ministry of Health and chief physician . Quite the opposite - not only superfluous, but destructive and harmful for the treatment of children administrative superstructure is the Ministry of Health, the newly created directorates with salaries of 30-50 thousand UAH. and the chief physician, because they did not build anything themselves, but destroyed what we had been creating for 15 years. And Donskaya, firstly, is undoubtedly the most experienced diagnostician in the country in the field of pediatric hematology, secondly, recognized and most respected by the international professional community Ukrainian hematologist, and thirdly,
FACT №5: For many years in Okhmatdyt the Center was subordinated to the well-known and respected by all pediatricians of the country, Chief Olena Mykhailo Meshkova, an experienced methodologist and pediatrician. After the liquidation of the position of head. The center coordinated its departments with each other, as well as with the regional oncology departments of regional hospitals. , who was appointed head coach only six months ago and who also has no professional knowledge or experience for managing people or making adequate decisions in pediatric oncohematology.
WHAT DOES OUR OWN WILL RELEASE MEAN??
It is not an outburst of emotion, an act of protest or blackmail, and even team solidarity was not the determining factor. The statements of the Ministry of Health and the chief doctor that intimidated us and incited us to release Donska and Ryzhak are an absolute and absurd fake. We are self-sufficient adults, and Donska and Ryzhak, who have been our teachers for many years in our complex profession, have always encouraged us to develop and make responsible decisions independently. The artificiality of reprimands, their clearly repressive nature and their inconsistency with the facts, the adoption of orders for reorganization and dismissal in violation of a number of laws of Ukraine and despite the irreplaceability of the experience of these two doctors to treat the most severe hematological patients, left us no illusions about professional qualities of the chief physician and the new chief medical officer.
The reorganization of the Center and the dismissal of the most experienced and recognized by international associations of hematologists doctors Sadovyak and Dovbnya have already destroyed the only existing in Ukraine technology of donor bone marrow transplantation built in accordance with modern international rules and regulations. With such an attitude and unprofessional leadership, disintegration of established processes, we can not take responsibility for the results of treatment of new patients, for their lives. Our dramatic and difficult decision has become unalterable due to sober awareness: it is simply impossible to continue our professional activity responsibly and effectively, this is also our life’s work, in unfavorable conditions created by the administration.
As for several patients who are in the TCM department after different types of TCM, the recovery process of each of them is without serious complications, and will subsequently continue as planned at the place of residence. SB Donska, OA Ryzhak and we - their doctors as members of the All-Ukrainian Association of Pediatric Oncohematologists, if necessary, will promptly provide free of charge all necessary consultations to doctors in the regions that will guide our patients.
WHAT WILL HAPPEN TO TCM IN OKHMATDIT?
Unfortunately, they probably won’t. Carrying out family transplants is in principle impossible without resuming the work of the reference laboratory, which determines how suitable the family donor is for the patient. All 6 specialists resigned from the laboratory. The Ministry of Health has launched an absolute fake that some other laboratories will take over part of the work of the laboratory. But no other public or private laboratory in the country has such equipment, and no such tests are performed, so there are no similar specialists. We would like to express our gratitude to the Krona Charitable Foundation for providing Okhmatdit with this unique equipment worth about half a million dollars, thanks to which accurate diagnosis and typing (donor testing) of families for hundreds of sick children was made. Regarding effective diagnosis, it was provided by a combination of the work of the laboratory with the experience and knowledge of SB Donska as a long-term leading specialist of the Ministry of Health in pediatric oncohematology. Carrying out autoTKM is also in question, as out of 7 doctors of the TKM department, only c. at. department - young doctor Oleksandr Lysytsia. Last year he spent a lot of time not in the department, but in training, we often "led" his patients, but it was training at the Academy of Management under the Administration of the President of Ukraine. Unfortunately, he has never performed such mandatory and technologically complex stages of autoTKM as bone marrow collection (transplant selection from a patient) and its cryopreservation. And maybe only in the other two clinics in Kyiv there will be 2-3 doctors who did it at all. As the Ministry of Health and Okhmatdit’s chief physician have already demonstrated that nothing is true for them, We do not rule out that for the sake of short-term PR effect they will try to create a Potemkin village from the TCM department and laboratory, recruiting any doctors formally from oncology, hematology, transfusion or laboratory research to create the illusion that the problem is closed. But this fake will be revealed very quickly, because TCM specialists grow only where the relevant types of TCM do.
INTERNATIONAL DISGRACE OF UKRAINE
It is the release of Donska and Ryzhak that has been a member of authoritative international groups and communities for many years, including the International Society of Pediatric Oncologists (SIOP) and the European Blood and Bone Marrow Transplant Group (EBMT), which bring together leading pediatric oncohematology from developed countries. After their and our release, they could not help but inform their colleagues abroad about what had happened in Ukraine. The international hematology community is still in silent shock. Especially the Germans, because with their support and help twenty years ago SB Donskaya began to implement in Ukraine modern highly effective protocols for the treatment of hematological diseases in children, which increased the level of cure of these diseases in children in Ukraine from 5% to 70 %.
One can only imagine the desperate attempts of the Ministry of Health to find a replacement for the fired domestic specialists abroad against the background of information about the senseless and criminal destruction of the Center for Oncohematology and TCM by the Okhmatdyt administration. The statement of the Ministry of Health about the involvement of foreign specialists in the operation of the TCM department is another desperate and irresponsible fake. Management of patients before and after TCM does not require remote consultations and consultations, but the constant presence of a specialist. We can only shrug bitterly: the Ministry of Health and Sadovyak "did not come" Kyiv doctors who gave the average European results for Ukrainian salaries, now "rich" Ukraine will attract doctors for European salaries, fees and per diems. It is unknown on what legal grounds and from which budget funds, except for grants.
Representatives of European countries will soon start asking awkward questions to various Ukrainian government officials, including Iryna Litovchenko, director of the Directorate for Strategic Planning and European Integration of the Ministry of Health. Having no medical education, she is responsible in the Ministry of Health for the development of transplantation in general and bone marrow in particular in Ukraine, and oversees the sending of children to TCM abroad at the expense of the budget. Litovchenko’s "contribution" to the development of TCM in Ukraine was, first of all, repeated but unproven accusations in the media and social networks of the leaders of the Center and the TCM branch of all mortal sins. Ukrainian journalists and MPs must ask her: What strategy has she developed for the Ministry of Health to develop bone marrow transplantation in Ukraine, and will the exhausted state budget be able to send an additional 20-25 children abroad who used to be able to undergo auto or family TCM in Okhmatdyt? Receiving from the state a salary of 40-50 thousand UAH, which is more than twice the monthly salary of any Honored Doctor of Ukraine, candidate or doctor of medical sciences, who saved thousands of patients, she must report to society for the disaster in the field, before to which it is directly related.
BUT WHERE WAS THE CORRUPTION?
WARNING! Both of the above-mentioned reprimands to Donska and Ryzhak do not contain a single word that would even indicate possible corrupt actions of these two doctors, or their abuse of office or attempts to obtain illegal benefits. These reprimands are not based on official complaints from the parents of the patients (because they did not exist!), Nor on medical errors or negligence that led to the death or deterioration of patients, such as infecting a child with an infectious disease through a blood transfusion. Because there were no such cases either! Donska and Ryzhak are clean before the law, and clean in terms of professional responsibility of the doctor to patients. This is an objective fact, and no one else has been proven! An NABU inspection was recently conducted at the request of MP Korchynska, Donska and Ryzhak provided comprehensive explanations to detectives and NABU did not find any grounds to continue the proceedings. The cases referred to the court are not mentioned at all. Accusations of corruption, extortion, bribery are legal and criminal charges. They should be investigated and brought to justice in accordance with legal norms and on the basis of written statements, and not on the basis of oral video and even more so of generalized oral translations. Although in reality this is no longer relevant, because the "potential corruption risks" have already been eliminated together with the TCM branch itself, and in reality there is no place to hospitalize anyone for fake bribes or bribes, or for free. and not on the basis of oral video and even more so oral generalizations. Although in reality this is no longer relevant, because the "potential corruption risks" have already been eliminated together with the TCM branch itself, and in reality there is no place to hospitalize anyone for fake bribes or bribes, or for free. and not on the basis of oral video and even more so oral generalizations. Although in reality this is no longer relevant, because the "potential corruption risks" have already been eliminated together with the TCM branch itself, and in reality there is no place to hospitalize anyone for fake bribes or bribes, or for free.
From now on, it is necessary to collect or allocate 40 thousand dollars from the state budget to go to Belarus for auto-TCM, and from 120 thousand euros for European clinics, families of those patients who are shown a family transplant. This is the result of the fight against imaginary and unproven "bribes" of 5 thousand dollars in the TCM department.
Dear journalists, people’s deputies, officials, philanthropists and activists! Now it’s your turn to raise this huge amount of money for children with cancer who could be treated in a quality and cheap way in Ukraine.
Or resume TCM in Okhmatdyt! Because our modest capabilities of ordinary doctors to save children, unfortunately, have been exhausted. Yulia Bazaluk, pediatric hematologist of the highest category, 27 years of experience,
signed the petition .
Natalia Kavardakova, hematologist, senior category, 20 years of experience,
Sofia Matsiboh, pediatric hematologist, 7 years of experience,
Alyona Zinchuk, pediatric hematologist, 8 years of experience,
Olena Kreminska, laboratory doctor, head of the reference laboratory, 20 years of experience,
Tetyana Ponomarenko, biologist, head of the molecular genetic research department of the reference laboratory, 24 years of experience,
Tomara Smolenska, biologist, head of the immunocytomorphological research department of the reference laboratory, 20 years of experience,
Oleksandra Sharamok, pediatric hematologist, doctor -laboratory laboratory assistant, 34 years of experience.
Tetyana Didyk, biologist of the reference laboratory, 4 years of experience,
Lesya Mazurenko, biologist of the reference laboratory, 12 years of experience,
Olga Kohut, pediatric hematologist, 4 years of experience,
Igor Kireev, transfusiologist, 9 years of experience.
One day after the publication of the letter, on September 4, at the initiative of these doctors and parents of sick children, an action against the destruction of bone marrow transplants in Ukraine was held outside the Verkhovna Rada of Ukraine and the Ministry of Health. No one came out from the government to the protesters - people in government offices were closely guarded by police.
- A month after the dismissal of seven oncohematologists-transplantologists, they were replaced by one young pediatrician. Nevertheless, there are going to be two transplants with unknown risks to the lives and health of patients and donors, bordering on crime. And the tests of five patients were taken to Poland because now it is impossible to do them here! - informs Sofia Matsibokh, a former hematologist at the Center for Oncohematology and Bone Marrow Transplantation.
As for Iryna Sadovyak, the chief physician of the Okhmatdyt NDSL, she sees no problems in the work of the Center, supports medical reform, and considers Ulyana Suprun an authority.
- The whole hospital works without changes; the department of bone marrow transplantation and immunotherapy works as usual; the new head of the department, doctor Oleksandr Lysytsia, provides the treatment process for 14 patients; laboratory staff are trained with the support of international organizations, next year they will go on an internship in the United States; in two weeks we are waiting for the Italian delegation of doctors who will form an internship plan for the medical staff of the department - says I. Sadovyak.
So while hospital staff retrain and train, children in need of immediate treatment will wait. But, unfortunately, some of the children may not wait…
Нещодавно Уляна Супрун в одному зі своїх інтерв’ю сказала про те, що мета реорганізації Центру – створення подібних відділень в областях. Але вона не сказала, що там, на місцях, немає такого забезпечення, як у Центрі в Охматдиті, немає такої сучасної і точної лабораторії, немає тієї дорогоцінної практики, яка є у спеціалістів, які зараз відстоюють своє право лікувати. Центр онкогематології та трансплантації кісткового мозку в НДСЛ «Охматдит» був стержнем з єдиною випрацьованою роками схемою лікування, що об’єднував обласний Черкаський, Запорізький, Одеський центри дитячої онкології і гематології. Без цього стержня робота обласних центрів не зупиниться, але буде значно повільнішою, а час – це дуже дорога ціна реформи для життя хворої дитини.
The most unfortunate thing in the situation with the Center for Oncohematology and Bone Marrow Transplantation at NDSL "Okhmatdyt" is that, most likely, the purpose of such a reorganization is money and banal profits. After all, those who raise money for the treatment of children for foreign clinics and receive their percentage for the provided patient will now earn in medicine. It is unprofitable for them to have such a Center in Ukraine.
Author Kateryna Stebelska
Those who still have the strength to cultivate inner optimism hoped that this would be a change for the better, because the health care system undoubtedly needs to change, and in some respects even radical. Those who have been skeptical since the beginning of the announcement of this news, surprisingly and fortunately in the medical field, did not expect, and, as it turned out, were right. Agree on how something can be reformed without, firstly, proper funding, secondly, qualified personnel management in the relevant ministry, thirdly, without a clear motivated action plan, which would provide for the period of reform, the so-called "airbag" for all medical institutions and establishments, ie during the transition from the old system to the new one, they will function and the population will be provided with adequate medical care?
In addition, approved by the Acting Government Ulyana Suprun, the head of the Ministry of Health, started this reform in a very strange way and, using the so-called franchise of the popular American TV show "MythBusters", became a pseudo-Ukrainian myth destroyer, shocking the Internet community on its official website. Facebook. Almost every one of her posts resonates in the publications of Ukrainian doctors who are desperately trying to keep a note of common sense in a false and threatening Ministerial polyphony.
With the beginning of medical reform in Ukraine, the state of existing specialized medical institutions has deteriorated: they either cease to function at all, or are forced to reduce their staff, or are on the verge of a humanitarian catastrophe such as the National Institute of Tuberculosis and Pulmonology. FG Yanovsky National Academy of Medical Sciences of Ukraine.
This summer, the reform knocked on the door of the country’s main children’s hospital, Okhmatdyt. It provides for the reorganization of four structural units of the hospital. At the end of August 2018, Iryna Sadovyak, the chief physician of the Okhmatdyt NDSL, signed an order to reform the Center for Oncohematology and Bone Marrow Transplantation, which has been operating successfully for 14 years and building an effective treatment system. In fact, this means that Iryna Sadovyak has signed a death sentence for Ukrainian children who could receive high-quality and highly qualified treatment in Ukraine, and not abroad.
After that, the chief doctor of NDSL "Okhmatdyt" signed an order dismissing two employees of the Center for Oncohematology and Bone Marrow Transplantation - Honored Doctor of Ukraine Svitlana Borysivna Donska, who actually created this Center and headed it for many years, and Honored Doctor of Ukraine Oleh Anatoliyovych Ryzh. bone marrow transplant department.
As a sign of protest against the criminal actions of the management of the children’s hospital and in support of fellow doctors, almost all employees of the Center for Oncohematology and Bone Marrow Transplantation wrote applications for dismissal of their own volition. The children who were in the Center at that time continue their treatment and now thanks to the initiative and support of the resigned doctors. It seems that only these unemployed professionals and parents of sick children understand all the danger and cynicism of the Ministry of Health. Subsequently, on September 3, former employees of the Center for Oncohematology and Bone Marrow Transplantation published an official appeal in the form of a collective open letter.
One of the authors of this letter is Sofia Matsiboh - A hematologist of the Children’s Department of Bone Marrow Transplantation of the National Children’s Specialized Hospital "Okhmatdyt" was fired at her own request. On her page on the social network, she publishes the following :
“ Why is the only Center for Oncohematology and Bone Marrow Transplantation in the country really ceased to exist and why we are leaving.
First, dry facts for those who want to understand what happened and what the country is losing:
FACT №1 :The Center for Oncohematology and Bone Marrow Transplantation NDSL "Okhmatdyt" was the only one in Ukraine where bone marrow transplants (BMT) were performed for children with oncohematological diseases: autoTKM, TCM from a fully compatible and partially compatible family donor. Since its founding in 2003, it has performed transplants for 235 patients - 120 autoTKM and 115 - from a family donor. Today, 167 patients (70%) of these patients are alive and do not have cancer, which is fully consistent with the European average. Surprisingly, our team managed to achieve all this in the old building, built in 1939!
To date, the Center has come close to launching a non-family TCM, which would eliminate the need to refer Ukrainian patients for treatment in foreign clinics, which costs 120-150 thousand euros. According to the basic technology, transplantation from a non-family donor is no different from a transplant from a family donor, which has been successfully performed at the Center for many years. Thanks to the cooperation between the All-Ukrainian Association of Pediatric Oncohematologists and the German Stefan Morsch Foundation, a practical solution has already been found for Ukraine to receive donors from international registries even without creating and filling a national registry of bone marrow donors.
FACT №2:Honored Doctor of Ukraine Svitlana Borysivna Donska, who founded and headed the Center for many years, was fired on August 20 due to redundancies, as her position was liquidated during the reorganization. She turned down a formal offer to become a consultant doctor at the Okhmatdit polyclinic because the polyclinic had never been and has nothing to do with the diagnosis and treatment of oncohematological diseases.
FACT №3:Honored Doctor of Ukraine Oleh Anatoliyovych Ryzhak, Head Department of Bone Marrow Transplantation (BMT), a doctor who performed in 1998 the first autologous TCM in Ukraine, in 2000 the first TCM from a fully compatible family donor, and since 2015 launched successful TCM from a partially compatible family donor, was fired on the basis of two reprimands. The first was issued in April for allegedly misinforming parents about the availability of drugs in the hospital’s warehouse and advising them to buy expensive drugs from the world’s best manufacturers, instead of using what the state had purchased. A separate letter should be written about the terrible one and a half year delays in the international supply of medicines for oncohematological patients. The 2nd reprimand was issued in July for alleged systemic violations in keeping records of blood transfusions in the TCM department. The same reprimands were received by Donskaya. Note the cynicism of the highest quality from the new chief physician: the country’s most successful hematologists saved in terms of the number of lives saved are punished by dismissal, including for allegedly misreporting blood transfusions.
FACT №4: For us and for many hematologists in regional hospitals Donska and Ryzhak are carriers of a huge amount of professional knowledge and experience, both international and domestic, from which you can always get professional advice, not an extra administrative superstructure, which is a primitive fake of the Ministry of Health and chief physician . Quite the opposite - not only superfluous, but destructive and harmful for the treatment of children administrative superstructure is the Ministry of Health, the newly created directorates with salaries of 30-50 thousand UAH. and the chief physician, because they did not build anything themselves, but destroyed what we had been creating for 15 years. And Donskaya, firstly, is undoubtedly the most experienced diagnostician in the country in the field of pediatric hematology, secondly, recognized and most respected by the international professional community Ukrainian hematologist, and thirdly,
FACT №5: For many years in Okhmatdyt the Center was subordinated to the well-known and respected by all pediatricians of the country, Chief Olena Mykhailo Meshkova, an experienced methodologist and pediatrician. After the liquidation of the position of head. The center coordinated its departments with each other, as well as with the regional oncology departments of regional hospitals. , who was appointed head coach only six months ago and who also has no professional knowledge or experience for managing people or making adequate decisions in pediatric oncohematology.
WHAT DOES OUR OWN WILL RELEASE MEAN??
It is not an outburst of emotion, an act of protest or blackmail, and even team solidarity was not the determining factor. The statements of the Ministry of Health and the chief doctor that intimidated us and incited us to release Donska and Ryzhak are an absolute and absurd fake. We are self-sufficient adults, and Donska and Ryzhak, who have been our teachers for many years in our complex profession, have always encouraged us to develop and make responsible decisions independently. The artificiality of reprimands, their clearly repressive nature and their inconsistency with the facts, the adoption of orders for reorganization and dismissal in violation of a number of laws of Ukraine and despite the irreplaceability of the experience of these two doctors to treat the most severe hematological patients, left us no illusions about professional qualities of the chief physician and the new chief medical officer.
The reorganization of the Center and the dismissal of the most experienced and recognized by international associations of hematologists doctors Sadovyak and Dovbnya have already destroyed the only existing in Ukraine technology of donor bone marrow transplantation built in accordance with modern international rules and regulations. With such an attitude and unprofessional leadership, disintegration of established processes, we can not take responsibility for the results of treatment of new patients, for their lives. Our dramatic and difficult decision has become unalterable due to sober awareness: it is simply impossible to continue our professional activity responsibly and effectively, this is also our life’s work, in unfavorable conditions created by the administration.
As for several patients who are in the TCM department after different types of TCM, the recovery process of each of them is without serious complications, and will subsequently continue as planned at the place of residence. SB Donska, OA Ryzhak and we - their doctors as members of the All-Ukrainian Association of Pediatric Oncohematologists, if necessary, will promptly provide free of charge all necessary consultations to doctors in the regions that will guide our patients.
WHAT WILL HAPPEN TO TCM IN OKHMATDIT?
Unfortunately, they probably won’t. Carrying out family transplants is in principle impossible without resuming the work of the reference laboratory, which determines how suitable the family donor is for the patient. All 6 specialists resigned from the laboratory. The Ministry of Health has launched an absolute fake that some other laboratories will take over part of the work of the laboratory. But no other public or private laboratory in the country has such equipment, and no such tests are performed, so there are no similar specialists. We would like to express our gratitude to the Krona Charitable Foundation for providing Okhmatdit with this unique equipment worth about half a million dollars, thanks to which accurate diagnosis and typing (donor testing) of families for hundreds of sick children was made. Regarding effective diagnosis, it was provided by a combination of the work of the laboratory with the experience and knowledge of SB Donska as a long-term leading specialist of the Ministry of Health in pediatric oncohematology. Carrying out autoTKM is also in question, as out of 7 doctors of the TKM department, only c. at. department - young doctor Oleksandr Lysytsia. Last year he spent a lot of time not in the department, but in training, we often "led" his patients, but it was training at the Academy of Management under the Administration of the President of Ukraine. Unfortunately, he has never performed such mandatory and technologically complex stages of autoTKM as bone marrow collection (transplant selection from a patient) and its cryopreservation. And maybe only in the other two clinics in Kyiv there will be 2-3 doctors who did it at all. As the Ministry of Health and Okhmatdit’s chief physician have already demonstrated that nothing is true for them, We do not rule out that for the sake of short-term PR effect they will try to create a Potemkin village from the TCM department and laboratory, recruiting any doctors formally from oncology, hematology, transfusion or laboratory research to create the illusion that the problem is closed. But this fake will be revealed very quickly, because TCM specialists grow only where the relevant types of TCM do.
INTERNATIONAL DISGRACE OF UKRAINE
It is the release of Donska and Ryzhak that has been a member of authoritative international groups and communities for many years, including the International Society of Pediatric Oncologists (SIOP) and the European Blood and Bone Marrow Transplant Group (EBMT), which bring together leading pediatric oncohematology from developed countries. After their and our release, they could not help but inform their colleagues abroad about what had happened in Ukraine. The international hematology community is still in silent shock. Especially the Germans, because with their support and help twenty years ago SB Donskaya began to implement in Ukraine modern highly effective protocols for the treatment of hematological diseases in children, which increased the level of cure of these diseases in children in Ukraine from 5% to 70 %.
One can only imagine the desperate attempts of the Ministry of Health to find a replacement for the fired domestic specialists abroad against the background of information about the senseless and criminal destruction of the Center for Oncohematology and TCM by the Okhmatdyt administration. The statement of the Ministry of Health about the involvement of foreign specialists in the operation of the TCM department is another desperate and irresponsible fake. Management of patients before and after TCM does not require remote consultations and consultations, but the constant presence of a specialist. We can only shrug bitterly: the Ministry of Health and Sadovyak "did not come" Kyiv doctors who gave the average European results for Ukrainian salaries, now "rich" Ukraine will attract doctors for European salaries, fees and per diems. It is unknown on what legal grounds and from which budget funds, except for grants.
Representatives of European countries will soon start asking awkward questions to various Ukrainian government officials, including Iryna Litovchenko, director of the Directorate for Strategic Planning and European Integration of the Ministry of Health. Having no medical education, she is responsible in the Ministry of Health for the development of transplantation in general and bone marrow in particular in Ukraine, and oversees the sending of children to TCM abroad at the expense of the budget. Litovchenko’s "contribution" to the development of TCM in Ukraine was, first of all, repeated but unproven accusations in the media and social networks of the leaders of the Center and the TCM branch of all mortal sins. Ukrainian journalists and MPs must ask her: What strategy has she developed for the Ministry of Health to develop bone marrow transplantation in Ukraine, and will the exhausted state budget be able to send an additional 20-25 children abroad who used to be able to undergo auto or family TCM in Okhmatdyt? Receiving from the state a salary of 40-50 thousand UAH, which is more than twice the monthly salary of any Honored Doctor of Ukraine, candidate or doctor of medical sciences, who saved thousands of patients, she must report to society for the disaster in the field, before to which it is directly related.
BUT WHERE WAS THE CORRUPTION?
WARNING! Both of the above-mentioned reprimands to Donska and Ryzhak do not contain a single word that would even indicate possible corrupt actions of these two doctors, or their abuse of office or attempts to obtain illegal benefits. These reprimands are not based on official complaints from the parents of the patients (because they did not exist!), Nor on medical errors or negligence that led to the death or deterioration of patients, such as infecting a child with an infectious disease through a blood transfusion. Because there were no such cases either! Donska and Ryzhak are clean before the law, and clean in terms of professional responsibility of the doctor to patients. This is an objective fact, and no one else has been proven! An NABU inspection was recently conducted at the request of MP Korchynska, Donska and Ryzhak provided comprehensive explanations to detectives and NABU did not find any grounds to continue the proceedings. The cases referred to the court are not mentioned at all. Accusations of corruption, extortion, bribery are legal and criminal charges. They should be investigated and brought to justice in accordance with legal norms and on the basis of written statements, and not on the basis of oral video and even more so of generalized oral translations. Although in reality this is no longer relevant, because the "potential corruption risks" have already been eliminated together with the TCM branch itself, and in reality there is no place to hospitalize anyone for fake bribes or bribes, or for free. and not on the basis of oral video and even more so oral generalizations. Although in reality this is no longer relevant, because the "potential corruption risks" have already been eliminated together with the TCM branch itself, and in reality there is no place to hospitalize anyone for fake bribes or bribes, or for free. and not on the basis of oral video and even more so oral generalizations. Although in reality this is no longer relevant, because the "potential corruption risks" have already been eliminated together with the TCM branch itself, and in reality there is no place to hospitalize anyone for fake bribes or bribes, or for free.
From now on, it is necessary to collect or allocate 40 thousand dollars from the state budget to go to Belarus for auto-TCM, and from 120 thousand euros for European clinics, families of those patients who are shown a family transplant. This is the result of the fight against imaginary and unproven "bribes" of 5 thousand dollars in the TCM department.
Dear journalists, people’s deputies, officials, philanthropists and activists! Now it’s your turn to raise this huge amount of money for children with cancer who could be treated in a quality and cheap way in Ukraine.
Or resume TCM in Okhmatdyt! Because our modest capabilities of ordinary doctors to save children, unfortunately, have been exhausted. Yulia Bazaluk, pediatric hematologist of the highest category, 27 years of experience,
signed the petition .
Natalia Kavardakova, hematologist, senior category, 20 years of experience,
Sofia Matsiboh, pediatric hematologist, 7 years of experience,
Alyona Zinchuk, pediatric hematologist, 8 years of experience,
Olena Kreminska, laboratory doctor, head of the reference laboratory, 20 years of experience,
Tetyana Ponomarenko, biologist, head of the molecular genetic research department of the reference laboratory, 24 years of experience,
Tomara Smolenska, biologist, head of the immunocytomorphological research department of the reference laboratory, 20 years of experience,
Oleksandra Sharamok, pediatric hematologist, doctor -laboratory laboratory assistant, 34 years of experience.
Tetyana Didyk, biologist of the reference laboratory, 4 years of experience,
Lesya Mazurenko, biologist of the reference laboratory, 12 years of experience,
Olga Kohut, pediatric hematologist, 4 years of experience,
Igor Kireev, transfusiologist, 9 years of experience.
One day after the publication of the letter, on September 4, at the initiative of these doctors and parents of sick children, an action against the destruction of bone marrow transplants in Ukraine was held outside the Verkhovna Rada of Ukraine and the Ministry of Health. No one came out from the government to the protesters - people in government offices were closely guarded by police.- A month after the dismissal of seven oncohematologists-transplantologists, they were replaced by one young pediatrician. Nevertheless, there are going to be two transplants with unknown risks to the lives and health of patients and donors, bordering on crime. And the tests of five patients were taken to Poland because now it is impossible to do them here! - informs Sofia Matsibokh, a former hematologist at the Center for Oncohematology and Bone Marrow Transplantation.
As for Iryna Sadovyak, the chief physician of the Okhmatdyt NDSL, she sees no problems in the work of the Center, supports medical reform, and considers Ulyana Suprun an authority.
- The whole hospital works without changes; the department of bone marrow transplantation and immunotherapy works as usual; the new head of the department, doctor Oleksandr Lysytsia, provides the treatment process for 14 patients; laboratory staff are trained with the support of international organizations, next year they will go on an internship in the United States; in two weeks we are waiting for the Italian delegation of doctors who will form an internship plan for the medical staff of the department - says I. Sadovyak.
So while hospital staff retrain and train, children in need of immediate treatment will wait. But, unfortunately, some of the children may not wait…
Нещодавно Уляна Супрун в одному зі своїх інтерв’ю сказала про те, що мета реорганізації Центру – створення подібних відділень в областях. Але вона не сказала, що там, на місцях, немає такого забезпечення, як у Центрі в Охматдиті, немає такої сучасної і точної лабораторії, немає тієї дорогоцінної практики, яка є у спеціалістів, які зараз відстоюють своє право лікувати. Центр онкогематології та трансплантації кісткового мозку в НДСЛ «Охматдит» був стержнем з єдиною випрацьованою роками схемою лікування, що об’єднував обласний Черкаський, Запорізький, Одеський центри дитячої онкології і гематології. Без цього стержня робота обласних центрів не зупиниться, але буде значно повільнішою, а час – це дуже дорога ціна реформи для життя хворої дитини.
The most unfortunate thing in the situation with the Center for Oncohematology and Bone Marrow Transplantation at NDSL "Okhmatdyt" is that, most likely, the purpose of such a reorganization is money and banal profits. After all, those who raise money for the treatment of children for foreign clinics and receive their percentage for the provided patient will now earn in medicine. It is unprofitable for them to have such a Center in Ukraine.
Author Kateryna Stebelska