Reposted from The Cancer Letter March 04, 2022
Ukraine NCI’s Nataliia Verovkina: “We left Kyiv yesterday. We don’t know what will happen with us even in one hour.”
Nataliia Verovkina, MD, PhD
Medical oncologist, Research fellow, Research and scientific department of chemotherapy of solid tumors, National Cancer Institute, Kyiv, Ukraine
We are faced with shortage of drugs, chemotherapy drugs, and other essential medication for oncology treatment, whether curative or palliative treatments.
Editor’s note: The cover of this week’s issue is a mosaic titled “Victory,” located at the National Cancer Institute in Kyiv. Created by Halyna Zubchenko and Hryhorii Pryshedko between 1970 and 1971, the mosaic symbolizes the institute’s scientific and technological progress in the fight against cancer.
In the mosaic, a patient, with his doctors, directs gamma rays onto a black monster symbolizing cancer.
The National Cancer Institute of Ukraine was founded in 1920 as the Kyiv X-ray Institute, and, in 1925, with a radium donation from Marie Curie, changed its name to the Kyiv Radiology Institute. The mural honors the institute’s history of radiation therapy.
Radiation therapists received a significant dose of radiation while administering treatment and often suffered from radiation sickness, which is shown in the mosaic through the dark circles under their eyes.
While this is a Soviet-era mosaic, Zubchenko and Pryshedko were Ukrainian artists. Both left a significant impact on the arts in Ukraine. Pryshedko also studied with Diego Rivera.
The mosaic is made of smalt, ceramic tiles, slag, and colored glass, and measures 9 by 12.7 meters.
A video celebrating the institute’s 100th anniversary—and the mosaic’s 50th—is available here.
Nataliia Verovkina, a medical oncologist and research fellow at the National Cancer Institute of Ukraine, is now in the town of Vinnytsia, having travelled there from Kyiv to get her son away from the war zone.
“I want to return to work, but first, I have to get my son to safety. I have a responsibility for my son,” Verovkina said to The Cancer Letter at noon local time on March 4, one week into Russia’s invasion of Ukraine.
She spoke with Matthew Ong, associate editor of The Cancer Letter.
A video of this conversation is posted here.
Matthew Ong: Dr. Verovkina, thank you so much for taking the time to speak with us.
Nataliia Verovkina: Hi Matt. Thank you very much.
Are you currently in Kyiv and are you actively treating patients?
NV: Personally, me, no, but my colleagues currently in Kyiv are trying to organize a process for treating patients. Currently in Kyiv, we have three oncology hospitals that are delivering oncology services.
By yesterday, we could provide some chemotherapy to our patients who are left in Kyiv, but we are facing a huge problem simply because patients have trouble simply getting to the hospital because of the military state in Kyiv. But we experience huge problems with delivering drugs to the hospital, because of our state in Ukraine.
The next big problem is palliative patients who cannot come to the hospital and are kept in their home. So, this is an urgent situation with palliative care for our patients who are in the conflict zone, not only in Kyiv. I can speak for Kyiv, but in other hotspots of Ukraine, I think the situation is much worse.
Currently, many refugees are overwhelming ways of Ukraine. They try to escape Ukraine however they can. So now, there are many refugees in the Western part of Ukraine. People are seeking homes.
So many million people are homeless and left without homes. Many people try to escape to neighboring countries, such as Slovakia, Hungary, Moldova. Oncology patients try to seek oncology help in neighboring countries; coordinate our efforts with our European colleagues.
The next problem is the absence of medical records for refugees in European countries, so patients who ask for oncology help, doctors simply don’t know what to do with them because there are no medical records. The patients don’t know about the treatment, because they are the patient.
The same problem I expect in Ukraine, but it’s easier because patients have paper medical documentations and doctors in Ukraine can manage the situation easily. But we are facing problems with drug delivery, even essential drugs also.
So, I’m talking to you, please help the Ukrainian nation to stand against Russia. And we do our best to help our oncology patients, and all help is greatly appreciated for all sites. Thank you very much to the whole world and please help us to condemn Russia and stop Russian aggression in Ukraine. Thank you.
Can you also describe what kind of scenes you are seeing right now immediately outside your hospital? And can you give me a sense of what your everyday work right now is like at the institute?
NV: In my hospital, in the institution, my colleagues who are left in Kyiv try to come to the hospital. We do chemotherapy. Currently, all planned surgery is stopped, but we do our best to start these operations. Again, urgent surgery is possible.
In other Kyiv hospitals, children’s hospitals, there are children who stay who require—I’m a bit worried, I’m sorry—who require very special care. For example, children who are receiving high dose chemotherapy or bone marrow transplantation, some children are kept in these hospitals. And my colleagues from other hospitals also are having trouble managing these patients.
Currently in my hospital, there is no such patient, but the situation can change anytime, you know. I think the most [pressing] issue in Kyiv now is logistical issues [of] drug delivery and safety of the patients coming to the hospital.
Is there a way out of Kyiv for you, your colleagues, and patients if the situation gets worse for the capital city?
NV: Now, patients could be evacuated to safe places in Ukraine and they can receive all oncology medical help in regional oncology centers. They just have to come to the center and ask for help.
Currently, Ukraine centers that are not in hotspots of the conflict can provide this help, but we are faced with shortage of drugs, chemotherapy drugs, and other essential medication for oncology treatment, whether curative or palliative treatments.
So, currently, we do what we can, but we don’t know for how long our resources [will last]. Now, we try to estimate drugs that are currently in Ukraine, but the sources are limited, so we are asking for humanitarian help for our oncology patients.
What else do you want audiences in the United States and Europe to pay attention to?
NV:
We have some patients, male patients, because of the military state of Ukraine, males from 18 to 60 years are not allowed to cross the border of Ukraine. Some of our patients are men who are undergoing curative treatment, oncology curative treatment.
And I think it is an urgent issue to establish a way for patients who need specialized oncology care for curative purposes to develop mechanisms to cross the Ukrainian border to receive the curative treatment outside Ukraine. This is a big issue.
Have your family and relatives moved to safety, or are they planning to?
NV: Currently, my family and my son are on the way to safer places in Ukraine. We left Kyiv yesterday. Currently, we are in Vinnytsia and we are traveling to the western part of Ukraine. And really, we don’t know what will happen with us even in one hour.
So, we are in a big stress. We are threatened, but we will stand for our country. We want to stop Russia’s bloody invasion, and we demand all the world to help Ukraine stop this bloody and terrible war.
And I really appreciate you even taking the time during this crisis to communicate this. So, the World Health Organization also told me that oxygen supplies, even something as basic as that, are being exhausted across most hospitals. Are you seeing that as well?
NV: Some hospitals, yes. I cannot talk about my hospital, because currently we aren’t doing operations. I think the situation will change, but I cannot tell you the exact information at this moment. I don’t have enough information regarding my hospital.
Our audience includes more than 250 institutions across the United States and elsewhere in the world. If you could speak directly to them as you are now, what do you want to tell them and how can they send help?
NV: How exactly they can help our oncology patients; yes? We really have an urgent need for medicines for patients who cannot be evacuated from Ukraine, because many patients will not have the possibility to cross the Ukrainian border and these patients will require oncology help in Ukraine.
I think we would need medicines. I think we would need support for professional societies, professional help, maybe consultation, because we will be organizing processes for treating our patients in Ukraine. The situation differs depending on the region of Ukraine.
So, medicine, financial—I think financial help is most efficient, and our government is working on this.
Are all the hospitals within the institute still in good shape through the war? Are they still able to get access to electricity and water supplies so far?
NV: In Kyiv today, yes. In Kyiv, for today, all the hospitals in Kyiv are working and we have electricity and water supplies on time, because our administration is working on this and monitoring this closely. In Kyiv, yes.
I don’t know the situation in Kharkiv, I think the situation is much worse in Kharkiv, but I’m in Kyiv—I was in Kyiv till yesterday.
But what will happen the next day or next few [days], we don’t know. Our soldiers, our rescue teams, the government and the administration are working hard to do their best for efficient work in the medical system.
My colleagues are working in hospitals more than hours, more than days, and some of them have been left in the working places since Feb. 24, when this war—terrible war—started.
Dear Russian doctors, please go to the protests, stop this bloody war, because it threatens not [only] Ukraine, it threatens all the world, it’s threatening patients that we are treating together, because our patients are the same as Russian patients.
Some doctors in Kyiv experience trouble getting to the workplace, because it might not be safe and there are problems with public transportation. And some doctors are willing, but physically are not able to get to work, because there is no way to get to the workplace safely.
Kyiv experienced huge air strikes, air raid sirens, so we have to hide in the shelter whenever we are at home, at the workplace, and it’s terrible. I think it’s terrible, terrible for all of us.
So, days [and] nights, we have to sleep in the shelter. Sometimes we have to spend many times in the shelter and my colleagues provide medical care for patients in shelters, but there are some patients who cannot be evacuated in shelters.
So, we cannot stop operations when the air [raid] sirens start, so the doctors are operating, even on the air strike sirens, and they do not stop in urgent operations. All my colleagues are working harder than they can. We do all our best to stop this nightmare.
And there are some patients in the intensive care unit who are also hard to evacuate to the shelter. So, they experience a huge problem with these, not only oncology, but other patients also.
If there’s a chance for this conversation and this video to reach Russian audiences, do you have a message that you would like to share with them?
NV: Yes, especially Russians. I want to talk to my Russian colleagues.
Dear Russian doctors, please go to the protests, stop this bloody war, because it threatens not [only] Ukraine, it threatens all the world, it’s threatening patients that we are treating together, because our patients are the same as Russian patients.
And currently, we cannot provide them with essential medical care. Please, go to the protests, stop Putin, stop this war, because it’s threatening the whole world, and you also.
Thank you so much for taking the time. And I wish you a safe journey, for your colleagues and your patients, and most importantly, your loved ones and your family. Thank you so much.
NV: Thank you. Thank you. Let’s work here as Ukrainians.
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