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president's column

Read archives from AAN Past President Orly Avitzur, MD, MBA, FAAN, who served from May 2021 to April 2023.

May 2022

Neurologists Lead Grassroots Activist Campaigns to Help Ukraine

On February 24, the entire free world watched in horror as Russia invaded Ukraine. Since then, many civilians have been killed, homes, hospitals, and shelters have been demolished, and there is no end in sight. Like many of you, I have been awed by the bravery of those who stayed behind to protect their nation and its citizens, including health care professionals who remained to treat their existing patients and the casualties they knew would inevitably follow.

Two days after the bombing and shelling began, I discovered that the American Academy of Neurology had almost three dozen members in the region. I was soon able to connect with three women (Dispatches from Ukrainian Neurologists: ‘We Need Medicines for Our Patients and Peace in Our Country,’ Neurology Today®, March 3, 2022) and hear their heartbreaking stories. Each felt a responsibility to continue to care for neurologic patients despite overwhelming risks to their own safety. Among them, 24-year-old neurologist Solomiia Bandrivska, MD, who had been in practice but a month, vowed never to leave, and has continued to send me updates. A recent post was a screenshot of her ePoster acceptance by the European Academy of Neurology with an invitation to the 8th EAN conference in Vienna in June, a reflection of academic pursuits in times of normalcy before war. Prior messages over the past weeks had been selfies in scrubs, and short descriptions of living in the hospital 24/7, enduring long, exhausting days.

While some members of our organization are working around the clock on the medical front lines of Ukraine, others are volunteering here in the United States and abroad, and their accomplishments have been extraordinary. AAN member Svetlana Faktorovich, MD, an attending neurologist and electrophysiologist at the Marcus Neuroscience Institute at Boca Raton Regional Hospital in Florida, immigrated from Kyiv as a child. Over the initial days of war, she realized that she needed to do something proactively to alleviate the anguish gripping her while watching the destruction of her homeland. When she came across a post from the Ukrainian League Against Epilepsy noting the critical need for anti-seizure medication (ASM) on the Women in Neurology Group page on Facebook, she began to raise money with the goal of contributing to this cause. She asked her hospital if she could purchase medications wholesale and with its help was able to start making shipments of ASM to the region. Upon confirmation of her first successful delivery into Lviv, Dr. Faktorovich set up a nonprofitthrough her hospital and expanded her list of purchases to include critical medication, certified trauma kits, sleeping bags, and other supplies. Together with Bosnian war survivor Senada Azdem, she is now actively raising funds for their next cargo. Through their collaboration with two nonprofit organizations, the Polish American Medical Society and the Global Empowerment Mission, they are able to send shipments into Ukraine where they are needed most. Dr. Faktorovich has also enlisted commitments from other US neurologists for future telehealth services, having recruited about two dozen Russian- and Ukrainian-speaking neurologist volunteers to date, among many other English speakers.

Within days of the Russian invasion, Aris Hadjinicolaou, MD, FRCPC, FAAP, current Boston Children’s hospital clinical neurophysiology fellow, received a request from Ukrainian pediatric epileptologist Olha Tychkivska, MD, with whom he completed epilepsy training at the Toronto Hospital for Sick Children, to help her draft an appeal from the Ukrainian League Against Epilepsy. The letter, which later inspired Dr. Faktorovich, included the concern that sudden stoppage of ASM could have catastrophic consequences for patients. Many NGOs and governmental agencies had been working on critical access to food, shelter, medical supplies, and medications, but ASM had not been prioritized. What happened next is so extraordinary that I decided to chronicle it in a Neurology Today Q&A with AAN member Agnieszka Kielian, MD, a fellow in pediatric stroke and neurocritical care at Boston Children’s Hospital. It is a stunning example of grassroots activism, the impact of neurology networks, and the successes borne of a growing coalition of determined and innovative neurologists.

AAN member Yuliya Snyder, MD, who was born in Kharkiv and attended medical school and residency there, currently works as a child neurologist at Rochester Regional Health in New York. Since my interview with her for Neurology Today , she has used her close contacts in the region to reach an official from the Ministry of Health of Ukraine who provided her with a list of needed medical supplies and medications. Dr. Snyder has also been in touch with other organizations and individuals in the US and abroad, and like the other volunteers, has learned that the logistics of humanitarian aid delivery have been challenging. Most of the infrastructure has been shut down, and there was little to begin with prior to the war. Much of the work is currently being done by single volunteers who are risking their lives driving humanitarian aid from Poland to Ukraine, Dr. Snyder said. Together with University of Rochester Medical Center/Golisano Children’s Hospital child neurologist and neurogeneticist Alexander R. Paciorkowski, MD, she has also launched a GoFundMe page in order to raise funds to organize the delivery of needed medical supplies directly to physician colleagues in Ukraine in collaboration with the Ukrainian Ministry of Health.

In 2008, James C. Johnston, MD, JD, FAAN, helped found the partnership GlobalNeurology, serving Ethiopia and other regions. In 2009, he established an affiliate 501(c)(3) nonprofit, Global NeuroCare, which handles their charity work. It is dedicated to improving neurologic care for vulnerable populations, whether in developing regions or those impacted by disaster or conflict. The organization has been accredited by the World Health Organization and holds Special Consultative Status with the United Nations (UN) Economic and Social Council, which allows it to provide expert analysis on neurologic issues, implement and monitor international agreements, present written and oral statements at UN meetings, and serve as a delegate at the UN sessions to advance its goals and objectives. Its latest focus is to help Ukraine. It has partnered with Meest to fly supplies to Poland and has arranged for trusted contacts to transport and deliver shipments into Ukraine. Additionally, one of his on-site colleagues will coordinate help which may include telemedicine although right now acute trauma care is most urgently needed. Dr. Johnston recommends sending equipment donations to RazomforUkraine.org as it, along with many local Ukrainian societies, has lists of the most essential needs or can earmark donations appropriately.

We acknowledge that there are countries including Iraq, Syria, Yemen, Libya, and Palestine which have gone through their own serious crises. I would like to share the AAN’s thoughts on why we chose to address the current crisis in Ukraine and our plans to develop a pathway for when and how to address other global conflicts in the future.

Almost immediately after Russia invaded Ukraine, we began hearing from our member neurologists in the region who needed help as they struggled to provide their neurology patients with continued care. As we formed the AAN Ukraine Crisis Response Work Group, we made their charge twofold. They needed to identify direct ways to help our member neurologists in Ukraine as well as identify a roadmap for how the AAN responds overall to future global conflicts. On Tuesday, April 5, 2022, the AAN hosted a Head Talks session at the AAN Annual Meeting called, “Crisis in Ukraine: How Can Neurology Help in Times of Global Conflict?” The session was moderated by Lyell K. Jones, Jr., MD, FAAN, chair of the AAN Ukraine Crisis Response Work Group. Panelists included myself, Ralph F. Józefowicz, MD, FAAN; Jerome H. Chin, MD, PhD, MPH, FAAN; and Aaron Berkowitz, MD, PhD, FAAN. The panel received questions and comments from the audience. Our hope is that the ideas shared during the Head Talks session can help inform the work group in this important task as they begin developing those guiding principles. Finally, we continue to meet with other neurology organizations to try to create an even greater community response now and for the future. We invite you to follow our progress.

Postscript: Growing up, I had been told that my maternal grandparents came from Poland. But upon hearing these stories of the extraordinary work being done by my colleagues, my mother revealed that her parents’ city of origin was called Lwów. Many geopolitical changes followed but since the dissolution of the Soviet Union in 1991, Lwów, now called Lviv, became part of the newly independent Ukraine.

Orly Avitzur, MD, MBA, FAAN
President, AAN
oavitzur@aan.com
@OrlyA on Twitter