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Rebuilding More Than Smiles

Dr. Antonyshyn and another person working on a prosthetic face

The Sunnybrook Ukraine Surgical Education Initiative is equipping Ukrainian surgeons with the advanced techniques and tools they need to transform and save lives

The Russian invasion of Ukraine has killed and wounded thousands of soldiers and civilians and shattered communities. The devastation is heartbreaking, and those suffering have no one to turn to. Ukraine is at absolute capacity.

But there are bright lights. One of them is Oksana.

In November 2022, the 33-year-old Ukrainian mother arrived at what had been dubbed the “Canada Ward” at the Regional Community Hospital in Czeladz, Poland. She was in urgent need of a craniofacial surgery.

Caring for complex injuries

Oksana was frightened and grief-stricken when she first met Sunnybrook plastic surgeon Dr. Oleh Antonyshyn. Dr. Antonyshyn had travelled to the “Canada Ward” as part of a recent medical mission of the Sunnybrook Ukraine Surgical Education Initiative, which he founded in 2019 with support from Sunnybrook’s donor community.

Now part of the Canada Ukraine Surgical Aid Program, and supported by the Canada-Ukraine Foundation and many other generous donors, the Sunnybrook Ukraine Surgical Education Initiative aims to treat people who have been profoundly injured and to equip Ukrainian medical professionals with the skills and resources to care for patients with complex injuries in the future.

Dr. Oleh Antonyshyn operates during a recent mission.
Dr. Oleh Antonyshyn operates during a recent mission.

Oksana and 27 other people were brought from the restricted travel zone in Ukraine to Poland to receive surgery led by Canada’s medical team, which included many from Sunnybrook. Over the course of the three-week mission, Dr. Antonyshyn and his colleagues worked 16-hour days alongside surgeons and nurses from Ukraine and Poland.

For Oksana, that meant craniofacial surgery to repair the devastating injuries she received during a missile strike on her home that killed her 13-year-old son and injured her daughter.

In November 2022, months after the attack, Oksana’s physical and emotional trauma still ran so deep that she refused to allow a Global News crew covering the mission to film her face.

“When they first meet us, these patients are often a little wary. They’re isolated, away from their family and friends and in another country being cared for by a group of surgeons and nurses who may not necessarily speak their language,” says Dr. Antonyshyn. “It’s a frightening experience for sure.”

That changed for Oksana after an eight-hour complex surgery to repair her injuries.

“On the final day of our mission, when I went to say goodbye, Oksana turned directly to the camera crew and smiled,” remembers Dr. Antonyshyn, who smiled back at her too.

Glimmer of hope

The young mother’s transformation was even more profound when Dr. Antonyshyn met her next in April 2023 as part of another medical mission. In addition to preparing Oksana’s left eye socket for a prosthesis, the team helped to coordinate a referral to a prosthetist who travelled from Lithuania to help.

“Oksana was smiling and talking with us. She was like a different person and it was terrific,” says Dr. Antonyshyn. “This was my bright light, my glimmer of hope amid a true crisis and a moment I’ll never forget, because I was smiling, too.”

Teaching the next generation

Sunnybrook teams share their expertise using mobile operating rooms as classrooms and augmented reality apps on smartphones

Dr. Oleh Antonyshyn and many other Sunnybrook experts perform life-changing surgeries through the Sunnybrook Ukraine Surgical Education Initiative on their own time. They also go above and beyond to train the next generation of leaders in complex reconstructive surgery.

That’s where the “education” portion of the Sunnybrook Ukraine Surgical Education Initiative comes in.

Using the mobile operating room as their classroom, Sunnybrook’s specialists in craniofacial reconstruction, head and neck microsurgery, hand surgery, orthopaedics and plastic surgery mentored 15 Ukrainian surgeons over more than 120 hours during their medical mission in December 2022.

By bringing with them a mobile tertiary hospital, all necessary equipment and comprehensive surgical teams to address the most traumatic injuries and deformities, the Sunnybrook team can provide impact without affecting local systems.

“The team approach and the level of surgeries that are being performed are exactly what we need at the moment. We have to be prepared to deal with anything that is brought our way,” says Ukrainian surgeon Dr. Anton Bolotin, who benefitted from Sunnybrook’s expertise and guidance.

To help surgeons like Dr. Bolotin learn and practice the advanced techniques they need to transform and save lives in the future, Sunnybrook’s Dr. Antonyshyn and craniofacial surgeon Dr. Tara Lynn Teshima created a 3D-printed model of a skull with soft tissue and a facial fracture, along with replicas of surgical plates and screws. Junior surgeons and surgical trainees can scan the model and practice their microsurgery skills using an augmented reality app on their smartphone.

Sunnybrook’s clinicians also return from each mission with elevated skills and techniques gained from performing complex surgeries they don’t regularly see in Canada. They share their learnings at Grand Rounds, conferences and in publications in high-impact journals. In fact, Sunnybrook’s unique approach to mobile surgical care will soon be the focus of a publication in an international medical journal.

“Our model for these missions is fairly unique,” says Dr. Antonyshyn. “We are sharing how to prepare such a program so that others might replicate our success. Without donors, none of this work would be possible.”

Facial fracture model sample
Facial fracture model sample