Raising the bar in Ukraine
In January, Robert Westergren and John Ellefsen from Ortopediteknikk traveled to Lviv to share their knowledge with Ukrainian colleagues. The meetings with war-wounded soldiers were profoundly impactful.
Text: Sissel Fantoft
Translated by Ortopediteknikk AS
Robert Westergren is the team leader for prosthetics at Ortopediteknikk's Ryen department in Oslo and traveled for the first time to Lviv in Ukraine in 2024. In January, he returned with his colleague and orthopedic technician John Ellefsen.
Our mission was to train and educate specialists in our field in the supply of prosthetics to war-wounded patients, Robert explains.
–Since Russia's full-scale invasion of Ukraine in February 2022, at least 50,000 Ukrainians have had one or more limbs amputated, according to Ukrainian health authorities. Ukraine wants to treat as many patients as possible domestically and therefore needs to educate its professionals. Scandinavia is far advanced in this field.
– We contribute with our expertise to patients with amputated lower limbs who need leg prostheses. As part of the training of specialists, we helped patients on-site, says Robert.
Support from the employer
After the first trip to Lviv, Robert was initially determined not to return, partly because of the strain on his partner back home.
– Last fall, I was contacted by Protez Hub about this project, and I really wanted to contribute again. My girlfriend is a nurse herself, and she understands and supports me, he says. This time, Robert was determined not to travel alone.
– At an internal education event at our premises at Ryen, I presented the project to my colleagues and mentioned that I wanted to bring an orthopedic technician. John immediately volunteered.
– It was simply a request I couldn't refuse, both because our job is to help people, and because I have grown children, so I don't have the same need to consider family obligations. For me, it was a reassurance that Robert had been to Lviv before, and that the financing and logistics allready were in place. We even got travel insurance! says John, who works at Ortopediteknikk's department in Tønsberg.
Both were given paid leave by Ortopediteknikk while they were in Ukraine.
It's fantastic to have an employer that supports us so we can participate in such projects. It was a prerequisite for us to travel, Robert says.
Multiple Injuries from Mines
Robert and John traveled to Lviv via Krakow in Poland, flying first and then continuing by bus.
– The war in Ukraine is uncomfortably close, but I didn't think much about traveling to a country at war – I had a job to do and was focused on that, says John.
Lviv is located in the west of the country and has been relatively spared from the worst Russian attacks.
– Still, air raid sirens often warn of missiles or drone swarms on their way, Robert reports.
Robert and John worked closely with nine orthopedic engineers (CPO’s) from across Ukraine. Five war-wounded soldiers from a large rehabilitation center outside Lviv participated as patients.
– All were amputees. The front is divided into red, yellow, and green zones, where red is the most vulnerable. There, wounded soldiers are sent to a field hospital where they receive lifesaving treatment. The luckiest are then evacuated to the yellow zone, where there is less risk of new attacks, Robert informs.
In the yellow zone, evacuation to the nearest hospital is prepared, where amputation is most often performed.
– Those who work in field hospitals are often so busy stopping bleeding that they place tourniquets high up on the thigh. Thus, soldiers risk amputating more than might have been necessary, says John.
Of the five patients they met, two were thigh amputees and three were lower leg amputees.
– Those wounded from mines often have multiple injuries, and thus a completely different rehabilitation process than those with more isolated injuries. Moreover, these injuries are not as familiar to us; it is more common to work with patients who have undergone amputations due to deep infections, often with underlying cardiovascular diseases.
While we also manage trauma injuries, the frequency of such cases is significantly lower than what is now seen in Ukraine, Robert points out.
The Power of Shared Knowledge
Many soldiers choose to continue military service after amputation.
– One of those we met was a 22-year-old soldier who was determined to return to the front. It made a strong impression. Our Ukrainian colleagues told us that this is common, as many of the young soldiers have no other experience, says John.
Robert and John worked long days with their Ukrainian colleagues, and all communication was conducted in English with interpreters translating into Ukrainian.
– It becomes extra wearing to speak another language all day, so we introduced a routine after dinner at the hotel, where the two of us would take a walk around the city. It was nice to speak our own mother tongue again and debrief with each other. This was invaluable, says Robert.
– For me, it was fantastic to share the experience with John – both because we could reflect and talk together, but also because we made the most of the time we were there.
The Ukrainian professionals greatly benefited from John's expertise and long experience, for they do most things themselves. At the same time, I could focus more on the clinical aspect, he adds.
Cleaning Up
Robert and John returned to Norway full of strong impressions.
– The fact that Ukrainians have been under attack for three years and still have the motivation to create a system to best receive war-wounded patients is incredibly impressive. We met skilled and dedicated professionals, and for us, it was nice to be able to contribute our knowledge, says John.
– These are the people who are cleaning up after the horrific consequences of war, every single day and in enormous quantities. Those affiliated with organizations like Protez Hub are truly passionate, and it's very powerful to be part of such a project, adds Robert.
This fall, two representatives from Protez Hub visited Ortopediteknikk's headquarters at Ryen to learn about the Scandinavian system for patients who have undergone amputation.
– We keep in touch with our colleagues in Ukraine, and they are deeply grateful that we support their work so that they can offer the best possible help to their patients, says Robert.
Both he and John notice a great interest from Norwegian colleagues about their stay in Ukraine.
People are very engaged and want to contribute. If our story can inspire more people to help, that's good, he adds.
– Our contribution is to the Ukrainian people. Increased expertise among professionals can lead to increased quality of life for patients who have undergone amputation, says John.
Facts
- Robert Westergren and John Ellefsen traveled to Lviv, Ukraine as part of the project "Moving Forward: Development of Prosthetics and Rehabilitation in Ukraine."
- The project is a collaboration between the organizations Protez Hub, War Trauma Rehabilitation Project, and CF Patients of Ukraine.
- Protez Hub is a non-governmental and non-commercial organization founded in 2014 with the goal of contributing to the development of the prosthetic and orthotic industry and ensuring that quality services are available throughout Ukraine.
- The goal of the project is to increase the qualification level of specialists who work with people affected by war.
- The project was implemented thanks to the IREX Ukrainian Rapid Response Fund program.
- The stay lasted from January 18 to January 30, 2025.
How You Can Contribute
Protez Hub needs support to introduce best care practices, quality techniques, and technologies through the further development of the orthopedic technician profession in Ukraine. Assistance in training professionals contributes to increasing knowledge and expertise, which are crucial for the profession to have a sustainable future in the country. By supporting non-profit organizations like Protez Hub, you help ensure the quality of orthopedic technical services and their availability throughout Ukraine.
