Human Milk Banking in Poland

On October 14, 2021, CMCF Vice President, Jolanta Martinoff was invited to take part in the 6th International Congress of the European Milk Bank Association.

CMCF wishes to express its sincere gratitude to Aleksandra Wesolowska, President of the Milk Bank Foundation of Poland and Associate Professor at the Laboratory of Human Milk and Lactation Research on Regional Milk Bank in Warsaw, Medical University of Warsaw, Warsaw, Poland for the invitation to participate and for her leadership in this area.

Below is an in depth interview of Assoc. Prof. Wesolowska which appeared in Miris Interviews.

CMCF Vice President Renews Memorandum of Understanding

On October 21, 2021, in Kiev, Ukraine, Jolanta Martinoff, CMCF Vice President, signed an updated Memorandum of Understanding with Viktor Liashko, Ukrainian Minister of Health, renewing both parties’ commitment to improving the quality of newborn care.

This agreement builds on the longstanding partnership of the two parties and further clarifies the roles of each moving forward.

In particular, the memorandum provides for:

  • development of a family-centered approach of neonatal care in Ukraine
  • learning the world experience of providing assistance to prematurely born children and children with acquired or congenital surgical and somatic pathology
  • improving the legal field in the field of neonatology and child surgery
  • neonatological service development
  • implementation of international forms of analytical reporting and statistics
  • holding compatible meetings on perinatal aid policy
  • involvement of leading industry specialists, in holding conferences, seminars and trainings for doctors
  • organization of team training staff and ensuring effective communication

Below are images of the historic agreement itself, along with photos of its signatories; CMCF Vice President Jolanta Martinoff, and Viktor Liashko, Ukrainian Minister of Health as well as Rostyslav Tistyk, deputy of the Verkhovna Rada.

Donated Medical Equipment Cleared for Official Use in Ukraine

Children’s Medical Care Foundation is proud to announce that at long last, 54 pieces of advanced medical equipment it was able to secure the donation of from Polish pediatric hospitals in 2018, have finally been cleared for official use at pediatric medical centers throughout Ukraine.

Obtaining licensing to enable official use of this equipment, which included orthopedic beds, anesthesia machines, bactericidal and manipulation lamps, a trolley, a laboratory dryer, a respirator, an electromyography device, closed incubators, and resuscitation tables for newborns-the crucial final step in this multi-stage humanitarian aid shipment process-proved more challenging than initially envisioned, and would likely not have been possible without the help of a number of key allies-a few of whom we didn’t know we had-throughout government and the medical establishment.

Among those who deserve special thanks are Rostyslav Tistyk, deputy of the Verkhovna Rada, Orest Chemerys, Director of the Health Department of the Lviv Regional State Administration as well as the Health Department of the Lviv City Council.

And as with all foundation initiatives and efforts in Ukraine, we are extremely grateful for the ongoing support of the Ministry of Health of Ukraine.

We are pleased to also report that as word of the successful donation continues to spread throughout the pediatric medical community in Poland, several medical institutions have begun to approach our foundation to inquire about future participation, which warms our hearts and reaffirms our commitment. We look forward to facilitating future such donations.

Please direct all shipment-related inquiries to Jolanta Martinoff, foundation Vice President, at jolanta@cmcf.org.

CMCF Facilitates Donation & Transfer of Medical Equipment From Polish Hospitals to Ukrainian Pediatric Medical Centers

By stepping outside of its fellowship-granting comfort zone, CMCF was able to reach an exciting new milestone in its evolving history of efforts to elevate neonatal and pediatric care standards this week with the successful transfer $3,500,000.00 USD of unused medical equipment from children’s hospitals throughout Poland to their counterparts throughout Ukraine.

 The gifting of these otherwise idle ventilators, infusion pumps, neonatal respirators, incubators, monitors, orthopedic baby beds, anesthesia devices, bacteriological lamps, laboratory equipment, a resuscitation station and a transdermal bilirubin measurement device was the brainchild of CMCF Vice President-and former nurse-Jolanta Martinoff, and would not have been possible without the expertise and accumulated goodwill of Prof.-and longtime CMCF Board Member-Maria Katarzyna Borszewska-Kornacka and the persistence of CMCF’s Country Managing Director for Ukraine, Dr. Zoryana Ivanyuk.

 More about the particulars of which Polish hospitals participated and what items were donated can be found in these two recent articles. The broad outlines of this groundbreaking act of international cooperation are these:

In accordance with a Memorandum of Understanding signed between the Children’s Medical Care Foundation and the Ministry of Health of Ukraine in 2017, site visits of 10 neonatal and pediatric medical centers throughout Ukraine were conducted by representatives of CMCF to assess their adequacy to serve as hosts for a series of pilot neonatal medical trainings the foundation had been conceptualizing.

During these visits, conducted by Prof. Borszewska-Kornacka, and Jolanta Martinoff, it was discovered that a number of these hospitals were in shockingly short supply of even the most basic medical equipment. 

An idea occurred to Mrs. Martinoff-what if surplus medical equipment from partner institutions in Poland, much of it collecting dust in hospital basements, could be transferred to these institutions which were in such need of it.

Mrs. Martinoff convinced Prof. Borszewska-Kornacka to approach the director of the hospital whose neonatal intensive care unit she once headed to ask if he might consider such an equipment transfer, which, to her delight, he was willing to assent to. But that was just the beginning.

CMCF initiated contact with the Ministries of Health of Poland and Ukraine to obtain formal governmental permission for donation, and acceptance of the equipment. This involved multiple politically sensitive communiques back and forth-and re-starts through a transition of Ministry heads.

CMCF hired a private shipping company, and then another as the first fell through, and finally a third who did not shy away from the task. 

In addition to the obvious benefits to patient care Ukrainian hospitals having such modern equipment affords, it also expands the geographic reach of group trainings-an increasing organizational emphasis favored for its potential to more quickly disseminate modern medical knowledge-and at a fraction of the cost-of individual observerships.

 If you are aware-or have medical colleagues in Poland who you think might be-of surpluses of functioning medical equipment not currently in use by the hospitals at which you or they practice, you are strongly encouraged to contact CMCF president, Bjoern Martinoff, at bjoern@cmcf.org.

CMCF Mourns Passing of a Champion of Compassion

In Memoriam

Dr. Marian Zakharus

1980-2020

On March 9th, 2020, the Children’s Medical Care Foundation family lost a talented, ambitious exemplar of what it means to selflessly devote oneself to the care of children. Dr. Marian Zakharus, a pediatric surgeon at Danylo Halytsky Lviv National Medical University, a rising star in the field of pediatric surgery in Ukraine and an even more extraordinary humanitarian, passed away suddenly at the age of 40.

The enormity of the loss of Dr. Zakharus’ passing, both to the immediate care of children in the Lviv region of Ukraine, as well as to the broader effort to elevate standards of pediatric care throughout the country, is difficult to overstate. Though barely into his fortieth year at the time of his death, he was already a highly respected surgeon, known for his thoroughness, stamina, discipline, work ethic and extraordinary capacity for gentleness and compassion with patients and emotional supportiveness of colleagues.

Dr. Zakharus first became affiliated with the Children’s Medical Care Foundation when he applied for and was granted an observership at the Department of Pediatric Surgery at the Upper Silesian Child Health Center, Katowice, Poland, under the guidance of Prof. Janusz Bohosiewicz. He would later acquire further CMCF-sponsored training at the Department of Pediatric Surgery and Urology at the University of Medicine, Wroclaw, Poland, under the guidance of Prof. Dariusz Patkowski.

Dr. Zakharus was also selected to participate in a two-day training at the Aesculap Academy in Nowy Tomysl, Poland, on minimally invasive surgical techniques with two of Europe’s leading practitioners and former CMCF Fellows, Professors Piotr Czauderna and Dariusz Patkowski, head of Pediatric Surgery and Urology Department Wroclaw University of Medicine and head of the Department of Surgery and Urology for Children and Adolescents of the Medical University of Gdańsk, respectively.

Dr. Zakharus was beginning to distinguish himself as one of the leading practitioners in Ukraine of minimally invasive surgical techniques such as laparoscopy for the treatment of oncological diseases, and for the application of those techniques for the treatment of patients with congenital and acute abdominal pathologies.

Marian took great pride in his affiliation with CMCF, and it is difficult to imagine a better ambassador for the foundation’s mission of generously sharing the latest of what is known in pursuit of ever better pediatric care standards. When members of CMCF’s US-based Board of Directors came to Ukraine, it was Dr. Zakharus who would greet them at the airport and assist them during their stays by personally driving them to important meetings. Stories abound of this kind of selfless volunteerism.

As impressive as his technical mastery in the operating theater was the personal effect he had on his patients. One colleague recalled how he would often have gifts or a joke for his young patients and that upon the recovery of one child from a particularly dire medical condition that Dr. Zakharus had treated him for, the parents asked Dr. Zakharus if he would be the child’s Godfather. Dr. Zakharus made it a tradition to visit the family in their distant village on the child’s birthday every year since. Another colleague, a neonatologist who had known and worked with him since medical school, said that he was adored by staff and patients alike and described him as “a great friend, the perfect surgeon, an amazing man, a loving son, just an awesome person”.

Though he was tragically taken too early, his legacy will live on and the standards he helped set will hopefully inspire those who come after. May he rest in peace.

CMCF Fellows Attends 3rd Congress of Joint European Neonatal Societies

Children’s Medical Care Foundation was proud to underwrite the attendance and active participation of Professor Halyna Pavylyshyn and Dr. Iryna Sarapuk of I. Horbachevsky Ternopil National Medical University at the 3rd Congress of Joint European Neonatal Societies held in Maastricht (Netherlands) on September 17-21, 2019.

Neonatal specialists from across Europe came together to share research findings and advances in diagnostic methods and treatment techniques for diseases of newborns. Infant-family-centered developmental care, neonatal neuroprotection, patient-centered care, neonatologist-performed echocardiography, stabilization of the preterm infant, non-invasive support and ventilation, neonatal gastroenterology and nutrition and clinical guidelines were just some of the areas investigated and discussed.

Professor Pavylyshyn and Dr. Sarapuk presented findings of their recent research focused on the importance of skin to skin contact in newborns infants which attempts to answer the question of what the optimal level is for premature infants.

Among the congress’s other distinguished presenters was Poznan University of Medical Sciences neonatologist-and multiple CMCF Fellowship awardee-Professor Tomasz Szczapa, who served on the congress’s Scientific Committee and was the one to introduce a session entitled aEEG in the NICU – Clinical Applications With Interactive Case Studies.

In addition to expanding knowledge and improving care giving skills, participation in congresses offers attendees the invaluable opportunity to get to know leading practitioners in the field of neonatology personally and to begin to form the kinds of lasting professional relationships that will bolster their continuing growth as physicians.

Once In A Lifetime Experience With Professor Lauterbach

My observership took place from March 3, 2019 to April 3, 2019 at the Department of Clinical Neonatology at the University Hospital in Krakow, Poland.

First, I would like to thank the Children’s Medical Care Foundation for giving me this opportunity to receive a monthlong training internship at one of its European partner clinics, the University Clinic in Krakow, Poland. Thanks to this fellowship opportunity, my dream of comparing my work with that of my colleagues in Europe came true; to see the differences and similarities in helping newborns and the ability to apply gained skills and knowledge in my practice.

This month of training was extremely useful-both for my professional growth and as an incentive keep on developing. Also, one of the positive moments in the internship was that the training was holding with the head of the department the nurse of our department; that’s why all positive practical knowledge are easier to implement while several people from the staff implementing them. Immediately upon returning home, a meeting of all our hospital staff was held and many of the innovations I had observed were integrated into our practice at the hospital.

A speech by the head of our department is planned for the regional neonatology conference so that more of our colleagues will be able to take advantage of the knowledge gained at this training in helping newborns in their hospitals.   I also want to acknowledge the willingness of all hospital staff-beyond just the physicians-to share their skills and knowledge. What I saw with my own eyes that was very valuable is that despite the considerable physical, technical and financial ways in which our two hospitals differ, conscientious and well-organized work results in high quality care, and much from what was observed and learned during the internship can be used in our work. In the brief period since returning to work in my medical department, we have already changed our approach to the prevention of nosocomial infections, anti-epidemic measures and neonatal examination on fetal infections. Tactics and duration of antibiotic therapy has also been changed.

The evaluation of pain of newborns on the N-PASS scale in the department with adequate anesthesia was introduced. Now each newborn is examined together with the head of the department present with the subsequent administration of treatment and examination. The understanding of the diagnosis and prevention of necrotizing enterocolitis has improved considerably as well.

Methods of administering enteral and parenteral nutrition at our hospital, and the treatment of anemia have also improved. Sadly, there were also numerous life-saving innovations and methodologies that I was exposed to and learned about during the observership that we are likely to have to wait a while to implement in our medical department. These include the treatment of pulmonary hypertension with nitric oxide, ultrasound examination of the lungs, setting of a temporary Rikam pump with increasing hydrocephalus, invasive measurement of blood pressure, the use of high-frequency mechanical ventilation and electronic management of all medical reports.

I would really like to wish the Foundation continued success in providing professional growth opportunities to Ukrainian doctors.

Written by Dr. Mykola Shevchuk. Dr. Shevchuk is a neonatologist at Vinnytsia Regional Clinical Hospital named after M.I. Pirogov RPC DICN.

 

Words of Appreciation Expressed for Endoscopic Surgery Training Opportunity

May 31st, 2019

Dear Mr.Bjoern Martinoff,

We are group of pediatric surgeons from Odessa Regional Children′s Clinical Hospital, who took part in “Hand-on skills lab in endoscopic surgery for pediatric surgery” in Nowy Tomysl. For us this became possible thanks to supporting of your foundation. We just wanted to let you know how much we’ve appreciated this opportunity and how important this experience is for our practice.

We are truly motivated in acquiring new skills and knowledge to provide a high level of treatment for our patients, despite social and economic challenges in our country. That is why we are thankful for the organization of this high-level course for Ukrainian pediatric surgeons and making participation in it available for us. We hope, this will make a difference in surgical practice in our clinic, make many interventions safer and less traumatic for our little patients.
Moreover, it was a great opportunity to get a real team-work experience in laparoscopy which we will be able to apply in real circumstances. We can truly say, that participation in such a high-quality event would not be possible for us without your support.

Furthermore, teaching under the supervision of such great professionals as prof. Patkowski and prof. Czauderna, was a real pleasure and very motivated experience for us. We are looking forward to the next educational opportunities.

Once again, thank you for your support.

Best regards,

Kvashnina Anastasiia,

Dilanian Iona

Pavlenko Sergey

Ventilatory Support in Neonates Training Launched in Kharkiv

Do you know the real reason so many Ukrainian women go abroad to give birth?

There are large numbers of private maternity houses and state perinatal centers throughout Poland, the United States, England, Germany and other countries that welcome expectant mothers from beyond their own national borders, and many of these mothers come from Ukraine.

But why do Ukrainian women continue to choose hospitals so far from home? Is it for the comfort? Is it that some are wealthy and are doing it for status?

I’ve been giving a great deal of thought to this question lately, and I think I know how to explain it. Though some of the factors I mentioned may play minor roles in the decision, the biggest reason a woman makes this choice, I’m convinced, has to do with the safety of the tiny, delicate, extremely important being she is about to bring into the world.

…But new, private maternity houses nearer to her home are being constructed all the time, you might say..and existing ones are constantly being upgraded with better, more modern equipment..

While true, all of this matters little when a woman applies to these places the question of how confident she feels about each one’s capacity to effectively manage the kinds of unexpected medical complexities that can arise during childbirth. For too many of these nearby centers her answer to this all-important question is–not very confident.

So how does an expectant Ukrainian mother make this very difficult decision?

She researches hospitals to the best of her ability from those she sees advertised, and chooses the one that inspires in her the highest degree of confidence.

But what is most important in actually ensuring the safe delivery of a newborn? Is it a beautiful building? Pleasantly painted walls? New beds? Shiny, modern equipment?

The truth is that the single most important factor in ensuring safe delivery and optimum health-of both mother and newborn child-is the skill level of those entrusted with their care. If the treatment team is not well-trained and practiced in the most current protocols for what should be done, both in the moments leading up to-as well as the crucial first minutes after-a newborn baby enters the world, no amount of modern medical equipment, or fancy facilities, can prevent the kinds of otherwise avoidable tragedies that can, and often do, occur during childbirth at the hands of less skilled caregivers.

In the back of every expectant Ukrainian mother’s mind is this fear; the fear of what could happen if those responsible for her care and that of her newborn are not so skilled. This, I believe, is why so many expectant mothers elect to give birth at large state-of-the-art perinatal centers far from home or venture abroad to give birth.

But imagine if every maternity hospital in Ukraine possessed teams of highly skilled obstetricians, neonatologists, anesthetists and nurses who worked together efficiently and applied the principles of evidence-based medicine. If this were the reality, there would be no need for Ukrainian women to give birth far from home.

So How Do We Achieve This?

Training is the key. As caregivers, we can each increase our level of skill by learning from those more expert than ourselves. And by sharing generously what we’ve learned, we can increase the level of expertise of our medical colleagues. This is how we build out a seamless network of first-rate maternity hospitals throughout Ukraine!

But how do we get there? The good news is that there are many smart, compassionate people who want children to be born healthy in their own hometowns who are working on just this question.

So, where do we begin? At the beginning-by identifying and defining the challenge. With the support of the Children’s Medical Care Foundation, Professor Maria Katarzyna Borszewska-Kornacka, President of the Polish Neonatal Society, conducted an analysis of the state of neonatal care delivery in the most prestigious perinatal centers in Ukraine. Deficiencies in care delivery were identified, and a detailed report with recommendations for how to address them was produced.

A Plan is Hatched

Knowing that not all of the recommended changes could be implemented immediately, an achievable first phase plan was developed.

Ukraine’s three best perinatal centers, in the cities of Kharkiv, Kiev and Zhytomyr, were selected as designated sites for a series of best practice trainings.

  • Training topics were discussed and tailored to the needs of the individual centers.
  • Former Children’s Medical Care Foundation Fellows were recruited to be trainers from some of the best neonatal clinics in the world.
  • Donated state-of-the-art medical equipment was secured for use in the trainings.

This pilot program is designed to be the ideal platform for practical, real time learning for a wide range of medical professionals and staff who play a role in the care of a newborn baby.

The first of these trainings, “Ventilation Support for Neonates”, took place on April 13, 2019 at Kharkiv Regional Perinatal Center. A number of Polish experts in the field of neonatology, Children’s Medical Care Foundation and the Ukrainian Ministry of Health partnered to produce this 2-day training, which was a resounding success.

Subsequent trainings in this series are expected to include simulations of a variety of clinical situations and access to real patients.

By involving the young and willing we can achieve the goal of a future where Ukrainian mothers feel confident giving birth close to home knowing that their newborns will be safe and healthy! Stay tuned for more information on the upcoming trainings.

Written by Dr. Zoryana Ivanyuk

CMCF Sponsors Participation of Ukrainian Delegation at Neonatus 2018

 

The Children’s Medical Care Foundation underwrote the participation of 8 neonatologists from across Ukraine at the 6th International Conference on Neonatal Care, NEONATUS 2018, held in Poznan, Poland, on October 10th & 11th of 2018. This training was taught by Professors Janusz Gadzinowski (in photo) and Janusz Mazela-both former recipients of CMCF Fellowship grants, themselves-who also chaired the conference’s Scientific Committee.

Members of the Ukrainian Delegation included:

  1. Tetyana Nalizhyta, Head of the department of Intensive Care of Newborns at Vinnitsa Regional Clinical Hospital n.a. N.I. Pirogov, Regional Perinatal Center.
  2. Olga Bykovska, Assistant professor at National Pyrogov Memorial Medical University, Vinnitsa Regional Clinical Hospital n.a. N.I. Pirogov, Regional Perinatal Center, NICU
  3. Maryna Goshuk, NICU, Kyiv Perinatal Center
  4. Yulia Klymchuk, NICU, Perinatal Center of the Poltava Regional Clinical Hospital N.V. Sklifosovsky
  5. Tetiana Holota, NICU, Kyiv Perinatal Center
  6. Oksana Malanchak, Neonatal Department, Lviv City Clinical Hospital N3
  7. Olha Vityk, Neonatal Department, Lviv City Clinical Hospital N3
  8. Oksana Ostalska, NICU, Lviv City Children’s Clinical Hospital