Doctors With Frontline Experience To Deliver Lifesaving Child ‘Blast Injury’ Training To Ukraine’s Medics

A team of doctors with frontline experience have joined forces to train Ukrainian medics on how to treat children who have been injured by explosive weapons as the war reaches the one-year mark with nearly 1,500 child casualties.

Doctors with international expertise, trained in countries including the US and Australia, will share their expertise and knowledge online with Ukraine’s medical system which has been significantly strained by the ongoing conflict.

The webinar series, titled Support for Ukraine - Paediatric Blast Injury, has been produced in response to the number of children hurt by explosive weapons over the past year.

The training initiative expands upon the Paediatric Blast Injury Field Manual - the world’s first handbook for child blast injuries designed for first responders, doctors and surgeons, and those providing aftercare for children in war zones who often lack specialist training.

The manual was developed by Paediatric Blast Injuries Partnership established by Save the Children and Imperial College London in 2019 and has been translated into six languages. It has been distributed in conflict zones including Syria, Yemen, Afghanistan and will be sent to Ukraine in the coming weeks.

Mines and unexploded ordnances pose a deadly risk for more than two million people in Ukraine; the country’s State Emergency Service said more than 250,000 explosive remnants of war have already been removed and destroyed since conflict escalated in February last year

Research has shown that children are seven times more likely to die from blast injuries than adults as they have soft chests, abdomens and skulls that are easily penetrated by blast fragments and waves, as well as flexible limbs that are also easily dismembered.

Medics from Ukraine told Save the Children that blast training for doctors in their country is vital as a major new offensive is expected in the coming weeks.

Dr Rostyslav Bezuhlyy, a Ukrainian Accident and Emergency Medicine Consultant based in Bristol in southwest England, said:

" Doctors in Ukraine are telling us blast injuries have become so frequent, it’s almost the new normal. It's a horrific reality, but one that needs to be addressed which is why this training is a lifeline for doctors treating children with devastating injuries."

The Support for Ukraine webinar series is a collaborative project produced by Save the Children, British Orthopaedic Association (BOA), British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and Paediatric Blast Injury Partnership (PBIP), a coalition of doctors and experts founded by the children’s charity and Imperial College London.

The current series, which began in January, will see 15 surgeons deliver expert training online over the next five months. Already over 100 Ukrainian medics have taken part.

Dr Paul Reavley, Consultant Paediatric Emergency Physician at Bristol Royal Hospital for Children, a former UK military doctor, led the first training session. He said:

"It is devastating that many children are seriously injured by explosive weapons in the world today. There are an estimated 230 million children living in high intensity conflict zones, defined by areas with more than 1,000 conflict deaths per year.

"Very few of us see severely injured children; we have to deal with the unfamiliarity and psychological barriers to treating a child with conflict injuries. On top of the emotional challenges that comes with, there are also technical difficulties of dealing with this kind of injury on smaller patients."

James Denselow, Head of Conflict and Humanitarian Team, Save the Children said:

"Almost one year ago, Ukraine's children woke up to an entirely new reality - their homes no longer safe, their schools closed, their playgrounds threatened by bombs. The sounds of combat have become their new normal. Hundreds of children have been killed and injured as innocent bystanders to a war that has claimed the lives of thousands, and displaced millions.

"We're proud to work with colleagues from the Paediatric Blast Injury Partnership to run these expert webinars. It is vital that we give medics across Ukraine the tools they need to save children's lives."

The Paediatric Blast Injury Field Manual is a comprehensive guide to injuries suffered by children from attacks like airstrikes, and weapons like artillery and landmines. It features step-by-step instructions that cover situations ranging from resuscitating children on the battlefield and saving limbs, to rehabilitation and psychological care.

Dr Reavley, who is also the lead author of the Paediatric Blast Injury Field Manual, added: "Dealing with conflict trauma and children is not impossible and the Ukrainian doctors we are training will do so much good work with this knowledge. In Ukraine, all clinicians are now faced with the challenges experienced in conflict zones around the world and will continue to do so for some time. They need support to successfully treat some of the most severely injured children. This training, along with the blast manual, will help them achieve that success and save so many young lives."

Dr Shehan Hettiaratchy, Consultant Plastic and Reconstructive Surgeon and BAPRAS member, who trained in Australia and the US, said:

"Plastic and Reconstructive surgery was born out of war and war injuries remain some of its greatest challenges. When surgeons are managing casualties who require complex reconstruction after war-related injuries, that’s where we can use our expertise to offer essential knowledge and training."

Save the Children has been operating in Ukraine since 2014, delivering essential humanitarian aid to children and their families. This includes supporting their access to education, providing psychosocial support, distributing winter kits and hygiene kits, and providing cash grants to families so they can meet basic needs such as food, rent and medicines, or so they could repair their housings damaged in hostilities.

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