INTERVIEW. War in Ukraine: “At the Dnipro hospital, we were confronted with the horror of war,” says a neurosurgeon from Toulouse

Professor Franck-Emmanuel Roux, neurosurgeon, head of the neurosciences center at the University Hospital Center (CHU) of Toulouse, spent eight days in Dnipro, as part of a cooperation being established with this Ukrainian hospital.

You returned from a mission in Ukraine for the Toulouse University Hospital, what was the context?

The Dnipro Regional Civil Hospital covers a population area of ​​two to three million people. Due to the war and its proximity to the front line, located less than 100 kilometers away, in Kamianske, it is becoming the largest military hospital in Europe. We arrived after it had been bombed a few days earlier. In the corridors, we passed carpenters carrying out repairs. In eight days on site we saw around a hundred patients, war wounded, civilians and soldiers, and more traditional patients suffering from brain tumors, spinal pathology or having had a stroke. Our team was made up of Dr Benoît Viault and Professor Vincent Bounes, emergency physicians, Dr Géraldine Faure, anesthesiologist-resuscitator, and myself for neurosurgery. These specialties had been listed in advance by the Dnipro hospital to set up cooperation.

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What was special about your intervention?

In humanitarian missions, everyone learns from each other and, when it comes to war wounds, the Ukrainians have a lot to teach us. We saw terrible wounds, burns, shrapnel, significant bruising… We were confronted with the horror of war. These missions are also moments of testimony and support and Dnipro caregivers had until now not seen civilian neurosurgeons, except through video conferences. So they were very touched and so was I. I was particularly surprised by their desire to welcome us well and by their desire to communicate about our visit, on television and on social networks. They wanted to send a message to the population, to tell them that they were not alone.

How are the Dnipro hospital teams holding up?

The people who work at this hospital show extraordinary courage by coming every day. These caregivers are everyday heroes. While some have left, they have been on deck for two and a half years, they carry an enormous mental load all the time, with the numerous air alerts. The neurosurgery service is a good service, with expertise and scientific publications, but it has gone from 1,500 operations per year before the war to more than 3,000 today. There is therefore sometimes a lack of operating equipment. The goal is to come back after establishing what they need.

You have experience of humanitarian medicine (regular missions to Cambodia) including in war zones (Bosnia in 1994, Gaza in 2001), what was different about these interventions in Dnipro?

We find the same behaviors in tragedy: the desire to continue despite everything, to care for everyone and to resist. When I came home, I reminded my children of this quote from Thucydides: “there is no happiness without freedom, nor freedom without courage” and what I saw in Ukraine was exactly that. . A few hundred kilometers from the front and the Russians, I saw two Ukrainian women walking hand in hand, it is a concrete representation of what freedom can be.

What’s next, do you want to leave again?

Of course I want to go again! This is the start of cooperation between the Toulouse University Hospital and the Dnipro hospital and we must plan over a long period of time to forge links, reassess needs, correct and improve. We will also work with the faculty of medicine, through video courses and on site. These missions are fundamental, I don't have the impression that we have done anything extraordinary.