I was surprised to receive a Twitter note a few days after Russia invaded Ukraine. Mustafa Kayyali, a Syrian man was introduced to me.
“We are a group of medical doctors with specialization in paramedics, trauma, and war medicine,” Mustafa wrote. “We have suffered from the aggression of Russian forces for the last 8 years, and we trained people to deal with urgent cases, and how to save their lives. We would like to help Ukraine and its people.” He made it clear Syrian doctors had unique experience with treating victims of chemical weapons attacks. Chemical weapons have been used repeatedly against civilians in Syria by the dictator Bashar al-Assad’s army and the Russian forces that support him.
I passed Mustafa’s message to my contacts. The first Syrian doctor training for Ukrainian medical staff was completed two weeks later. Many more trainings followed and, as of today, many thousand Ukrainian doctors had been instructed by Syrian medical personnel on how to treat patients who have suffered chemical and biological warfare injuries. General surgeon Dr Abdullah Abdulaziz Alhaji conducts the training sessions. The Academy of Health Sciences was established by Dr Abdullah Abdulaziz Alhaji in 2011, following the outbreak of conflict in Syria, to offer medical training for local doctors as well as civilians. It offers paramedics training, nursing and physical therapies programs.
“When the Syrian regime attacked our population, we suffered from the reduction of medical staff. Many doctors were killed, arrested and fled Syria. Our Academy was established with 15-day courses to train in trauma first aid. There were no paramedics or emergency specialists before in Syria,” Dr Alhaji explains. “With time, Assad’s war machine became more aggressive—more bombings, more shells, more rockets. As war continued, so did the number of things that we did. The use of chemical weapons was causing severe suffering in Syria. So we trained our students and taught them how to treat different types of injuries.”
Because Russian airstrikes destroyed its buildings, the Academy was forced to relocate several times. It moved to Idlib in the area near the Turkish border that is under the control and supervision of opposition forces. “For several months, we have been watching the situation in Ukraine, and we thought that we should help doctors there,” says Mustafa Kayyali, vice-president at Academy of Health Sciences. “Many of my colleagues studied in Ukraine, worked there, and we knew that it is a loving country.”’
He continued, “We are happy to help, because people of Syria and Ukraine are fighting against the same enemy.”
It was the Syrian medics’ experience with patients affected by chemical weapons that caught the attention of Ukrainian doctors. There is an increasing sense of urgency in preparing for Russia’s use of banned weapons in Ukraine as NATO and the U.S. both warn.
An injured man receives treatment at an evacuation point where people can flee the area to safer areas in Zaporizhzhya. It was set up on March 29, 2022 by volunteers following the Russian invasion.
Emre Caylak—AFP/Getty Images
“When Russia started to bomb civilians and residential areas in Ukraine, we lost all illusions that it would stop and would act in the framework of an international humanitarian law,” says Mladena Kachurets, a former deputy health minister of Ukraine and director of the department of personnel development and education at Dobrobut, one of the biggest private clinics in Kyiv. She immediately responded to the Syrian doctors’ idea. “We understood that we have to prepare for the worst, that we have to be ready and cannot ignore a threat of chemical weapons attacks,” Kachurets says. A successful session in which a few doctors from Ukraine were connected via video link brought together several Syrian and Ukrainian physicians. Four online lectures were then scheduled for all Ukrainian medical professionals. Ten days have passed since the first of these lectures.
“There was a huge interest in these lectures, both from doctors and nurses. The training sessions were advertised on social media and over 13,000 people showed interest. Medical workers from all parts of Ukraine, including medical staff from hospitals in war-torn areas, joined them online,” Kachurets said.
Continue reading: How Ukraine can win the war
“We posted the recordings on Facebook and YouTube so those who were unable to attend live could watch them later. We are now working on Ukrainian translation to make sure every doctor and nurse in Ukraine has access to the lectures.” As of now, the recordings have been watched more than 30,000 times. There are more lectures planned for the Ukrainian public.
Yuliya Schuklina, MD was the head of the Otolaryngology Department at the big Kyiv hospital. Since the Russian invasion, she has lived with her hundreds of fellow doctors on the grounds of the hospital, helping to treat chronic and wounded patients.
“The war changed all of us,” Dr. Shuklina says, speaking via a videocall during a short break in between treating patients and before a siren, announcing an air raid alert in Kyiv, interrupts our conversation. “In the first days of war, I was very confused. I have 26+ years experience as an otolaryngologist and surgeon. However, I have never been involved in the sorting or treatment of combat-injured patients. We are studying and watching a lot of lectures these days.”
“‘I studied how to react to a chemical weapons attack at the university, but I forgot it because I never thought I would have to apply it,” she says. “At the session with Syrian doctors, I learned how to determine what kind of a toxin has been used and how to provide help accordingly. This is very different from a regular injury where you can see the effects visually. It is not the case with the victims of a chemical weapons attack, you can’t assess the damage with a naked eye.”
“We really appreciate Syrian doctors sharing their first-hand experience. I don’t feel panic anymore hearing about the possibility of a chemical weapons attack. There is an order of action. Now I know I will not be confused, I will not be a burden, and will be able to help,” Dr. Shuklina says. “I hope, though, this knowledge will only remain theoretical.”
Following the sessions, Dr. Shuklina contacted hospital management to request antidotes. The dosages vary depending on the weapon. “There is a lot of humanitarian assistance, including medicine, delivered to Ukraine these days,” says Kachurets, the former deputy health minister. ”But our doctors are focused on what they need to treat injured people who have multiple trauma, shrapnel wounds, broken limbs. In their lists of necessary supplies, I haven’t seen personal protective equipment to prepare for chemical attacks. I think it should be added to supply lists, and the stockpile of antidotes for different types of toxins must be created in advance.”
Kayyali hopes to host some lectures in person for Ukrainian doctors. “If there is a safe location somewhere in Ukraine, we would be happy to travel there and do a face-to-face session,’” he says. His message to his Ukrainian colleagues is: Stay strong and get more medical help.
“The war can last long, for years, we Syrians know it. Training more people is necessary, not only for the military, but also for general citizens. People must be trained to treat those affected by chemical weapons and even nuclear weapons,” Kayyali says. “You are dealing with criminals and you can expect anything to happen.”
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