Perspective from a Physician in Ukraine
Dr. Déry discusses his time in Ukraine where he worked to provide training to physicians and other healthcare providers treating civilians and others impacted by the ongoing war.
Featuring:
MarkAlain Déry, DO, MPH, FACOI
MarkAlain Déry, DO, MPH, FACOI, is an Assistant Professor of Clinical Medicine at Tulane University, where he also serves as Director of the Tulane AIDS Education and Training Center, Director of the Tulane T-Cell Clinic, and Medical Director of the Antimicrobial Stewardship Program. He earned his master’s degree in public health at Loma Linda University and graduated with his degree in osteopathic medicine from the University of New England before completing his internal medicine training at Case Western Reserve University. After three and a half years on the Navajo Reservation as part of the Public Health Service, he relocated to New Orleans and completed an infectious disease fellowship at Tulane University. As an infectious disease expert with a keen interest in antimicrobial resistance, infection control, and multidrug-resistant organisms, Dr. Déry works to combat poverty’s negative health effects. He is passionate about HIV prevention and testing. Dr. MarkAlain Dery specializes in the diagnosis and treatment of HIV/AIDS. He is the founder of 102.3 WHIV FM, a radio station dedicated to human rights and social justice. Transcription:
Scott Webb: Hello and welcome to the American College of Osteopathic Internist Podcast, docs off the clock, juggling the business of medicine and caring for patients means doctors always seem to be on the clock. Docs Off the Clock features some of today's best voices in healthcare with tips on how to live a better balanced life. Thank you for stopping by today. I'm Scott Webb and joining me today to discuss his experiences in Ukraine is infectious disease expert. Dr. Mark Alain Dery. Dr. Dery, it's great to speak with you again. We spoke a while back. We watched some videos, I think that was on HIV. But today we're talking about your work in Ukraine, and I know folks in the area may know you best from your work as an infectious disease expert, right. and your efforts during the pandemic during COVID. But tell us about your background a bit and how it informed your decision to go to Ukraine, to help?
Dr. Mark Alain Déry: As I was training as a resident and ultimately to go into infectious diseases, I took a small detour studied and worked in the field of trauma and actually was an emergency medicine physician for about 10 years before I gave all that up and went full time, infectious diseases. So I had about 10 years of working as a trauma physician, mostly on a helicopter, kind of doing the, drop in on interstates or something where there was a motorcycle accident or, doing rescues. Getting people out of jams, maybe they fell into like a ditch or whatever, just that sort of stuff.
And that's always been a passion of mine and trauma's always been a passion of mine. When I went into infectious diseases, it was time for me to start doing that. Just because trauma, as I often say is a young person's sport. But when I got the phone call to go to Ukraine, it was time to, I dusted off my trauma of those days and it was time to head back.
Scott Webb: Yeah. And I watched a piece on you. And I know you do a lot of media and you're very good at this. So it always helps to have somebody on an expert on who's good at answering questions. But one of the things I learned from watching you and hearing you was that there certainly are doctors in Ukraine, but a lot of them are family doctors, like primary care physicians who aren't necessarily trained, don't have that same background that you have.
And so that's one of the things you've been doing right. Is working with them, trying to bring them up to speed as quickly as you can and unfortunately the situation that they're in. To help them with the trauma cases, with the cases that are inherent in this type of conflict, right?
Dr. Mark Alain Déry: Yeah, a hundred percent. So when we got Ukraine initially was to do evacuating individuals from the parts of the country that are affected by conflict. And that was the original purpose. And to a large degree still is for the entity that sent me out there, which is the Swiss foundation for innovation. But when we got there, the ministry of health was very clear to us that while transportation and evacuation was still a main priority, especially for civilians, and injured civilians.
It became very clear that their trauma doctors were busy managing trauma and what they needed help with was trauma physicians, teaching other healthcare workers, other non-trauma based physicians, nurses, medical students, nursing students, whoever, all hands on deck. The basics of trauma and a large part of this is born out of the necessity that civilian installations are being directly. Targeted in this war. It's not just the Russian Federation are targeting the Ukrainian military.
It's not that at all. These are in fact war crimes and, and I've documented. And the majority of this is certainly reporters who do this for a living of documented this as well. And. Those war crimes will be adjudicated at another time. I'm certain, but the fact that civilian installations are being directly targeted here has made it such that physicians are finding themselves maybe next door to a building that has been missile and collapsed.
And everybody's looking at that doctor to do something. And that Doctor maybe a psychiatrist or maybe a pediatrician. They somebody who's never, or a pathologist. Somebody who's never done anything like this. And fortunately trauma, there's some very basic things that you can do. that can save lives. If somebody's bleeding, you stop the bleed. Well, how do you stop the bleed? There are tricks that you can do to do that.
How do you make sure that somebody's cervical spine remains intact after they may have fallen, let's say, in the building that was missile or what happens if somebody's shot? So there are these basic things that we can do in terms of training individuals. And what we did is we set up a course called the armed conflict trauma training course. And the idea was to teach physicians all across Ukraine, using zoom the basic skills of pre-hospital medicine and how to save lives in the setting of armed conflict.
Scott Webb: Obviously education is a big component here, and maybe you can talk about the three components, really the inspiration, what you're trying to achieve, what all of you're trying to achieve besides obviously independence and all of that. But for you, for the doctors, you know, the frontline sort of healthcare workers there, what are the goals?
Dr. Mark Alain Déry: Yeah the goals were essentially was to take a bit of the learning that they've done because a majority of the clinicians probably have taken some form of advanced trauma life support. And in that advanced trauma life support, they may have remembered kind of these basics, that we all learn in medical school, whatever, which is A, B, C right. Airway, breathing, circulation. So if physician comes upon somebody who is injured, And they start focusing on, they're like, oh, what do I do?
ABC airway. But if they're bleeding, the bleeding actually takes the priority on top of that airway. So one of the main things that we are trying to do was show them that the advanced trauma life support is good, but that's just really a foundation to build new information upon in the setting of armed conflict. So it was stop the bleeding, it's remove a weapon from somebody if they have it, basic things that doctors don't think about, because we're not trained in the military.
We're not trained in the setting of armed conflict, but one of the things, and one of the suppositions that we are considering is that we will probably be seeing more armed conflict as we move forward in time. I mean, Climate change is gonna probably force migrations of people around the world water shortages, food shortages, and we're gonna probably see some destabilization more and more as time goes on. And so the development of this class into something that's more standardized is a huge goal for us.
We really did have excellent buy-in. The American College of Emergency Physicians partnered with us, the Department of Defense partnered with us, the Harvard Humanitarian Initiative partnered with us as well. So we really had these amazing partners that really saw the big vision of the necessity to teach physicians how to manage themselves in a pre-hospital setting during armed conflict.
Scott Webb: What would you like Americans to know about the fighting there since you've been there? The goals ultimately of the Ukrainians in this conflict and how folks can get involved and help if they're moved to do so, which I'm sure they are?
Dr. Mark Alain Déry: Essentially the goals amongst Ukrainians are of course, to rid themselves of the Russian Federation, the Southern part of Ukraine borders, the black sea. I mean, so there's all. These thousands of little port cities and towns, and this is where all the refineries are. These are where all the major ports are. And this is how Ukraine is able to remain such as rich country, because they're able to transport goods in and out of the country. And of course the Russian Federation wants that.
That's what they're looking for. And so they're initially taking a little bit by little bit. In 2014 they took some of the Donska region what's called the Dombas, the Don Dombas. That's the Ukrainian word for region. They were able to take that region because there were still a lot of people there who were sympathetic toward the Russian Federation. But since February 24th, when the Russian Federation first invaded Ukraine they are now going into places, mostly the Eastern portion of the country.
And this is where you're seeing a majority of conflict occur. Because they do have ships in the Black Sea and because Belarus is friendly, what the Russian Federation, Russia is able to send rockets into central Ukraine as well as Northern Ukraine as well through Belarus or through the Black Sea. There was large regions of the country that we've been to that have been bombed as well, especially the capital city Kyiv, which initially the Russian Federation made an immediate B line for thinking They could take it.
One of the things that's the most surprising of all here is just how unprepared the Russian Federation is in terms of the military. I think that there was a sense that the Russian Federation had a strong military force and they probably do in numbers just because the country is so large that they're able to recruit anybody they want. But that doesn't necessarily mean that they're willing to fight, one. And two, they're just not prepared and that's largely due to the fact that they don't give real information to Putin.
Because We do know that Putin, if he gets information that he's not happy with, he will oftentimes take that out on the messenger rather than actually creating good military plan. And so what we are finding is that you have a David and Goliath situation, but goliath here, the monster here is the Russian Federation and they're grossly unprepared. They are grossly incompetent and you are fighting people on their own land. And when you're fighting people on their own land and you're putting people in a situation where they have nothing else to lose, they're going to fight aggressively.
And so what you're finding is fact, men and women are on the front, fighting aggressively, the entire country supports the Ukrainian military here. They have donation boxes everywhere, and it's really a DIY donation. I mean like the military is literally being funded by pennies or dimes at a time. It's pretty remarkable. And then of course the Ukranian president President Zalinsky who was the John Stewart of his time, playing in the John Stewart like TV program as a comedian knows how to tell stories. He knows how to inspire the Ukrainian people and he's done an amazing job, inspiring people.
So if people do wanna donate. Donating directly to the Ukrainian military is a great way to do it. And certainly the organization that sent me was the Swiss Foundation for Innovation, that Swiss Foundation for Innovation and that's sfi.org. And they are a tremendous organization. And you know that if you do donate to them, that money will go directly into the Ukrainian programming that they are doing currently right now, with respect to evacuating innocent civilians, who've been injured in the war.
Scott Webb: Well, It's been great to speak with you today. You always seem to be fighting the good fight, whether it's HIV, COVID Ukraine, you always seem to be on the front lines or certainly near them helping teaching. It's really amazing. So thanks so much for your time and your efforts and you stay well.
Dr. Mark Alain Déry: Thank you so much.
Host: And thank you for spending a little time with us today. We look forward to future podcasts where we'll continue to explore issues of importance to you. For additional information, please contact the ACOI directly at 1-800-327-5183. Or by visiting our website at acoi.org. You can also email us at acoi@acoi.org. And until next time, be well.
Scott Webb: Hello and welcome to the American College of Osteopathic Internist Podcast, docs off the clock, juggling the business of medicine and caring for patients means doctors always seem to be on the clock. Docs Off the Clock features some of today's best voices in healthcare with tips on how to live a better balanced life. Thank you for stopping by today. I'm Scott Webb and joining me today to discuss his experiences in Ukraine is infectious disease expert. Dr. Mark Alain Dery. Dr. Dery, it's great to speak with you again. We spoke a while back. We watched some videos, I think that was on HIV. But today we're talking about your work in Ukraine, and I know folks in the area may know you best from your work as an infectious disease expert, right. and your efforts during the pandemic during COVID. But tell us about your background a bit and how it informed your decision to go to Ukraine, to help?
Dr. Mark Alain Déry: As I was training as a resident and ultimately to go into infectious diseases, I took a small detour studied and worked in the field of trauma and actually was an emergency medicine physician for about 10 years before I gave all that up and went full time, infectious diseases. So I had about 10 years of working as a trauma physician, mostly on a helicopter, kind of doing the, drop in on interstates or something where there was a motorcycle accident or, doing rescues. Getting people out of jams, maybe they fell into like a ditch or whatever, just that sort of stuff.
And that's always been a passion of mine and trauma's always been a passion of mine. When I went into infectious diseases, it was time for me to start doing that. Just because trauma, as I often say is a young person's sport. But when I got the phone call to go to Ukraine, it was time to, I dusted off my trauma of those days and it was time to head back.
Scott Webb: Yeah. And I watched a piece on you. And I know you do a lot of media and you're very good at this. So it always helps to have somebody on an expert on who's good at answering questions. But one of the things I learned from watching you and hearing you was that there certainly are doctors in Ukraine, but a lot of them are family doctors, like primary care physicians who aren't necessarily trained, don't have that same background that you have.
And so that's one of the things you've been doing right. Is working with them, trying to bring them up to speed as quickly as you can and unfortunately the situation that they're in. To help them with the trauma cases, with the cases that are inherent in this type of conflict, right?
Dr. Mark Alain Déry: Yeah, a hundred percent. So when we got Ukraine initially was to do evacuating individuals from the parts of the country that are affected by conflict. And that was the original purpose. And to a large degree still is for the entity that sent me out there, which is the Swiss foundation for innovation. But when we got there, the ministry of health was very clear to us that while transportation and evacuation was still a main priority, especially for civilians, and injured civilians.
It became very clear that their trauma doctors were busy managing trauma and what they needed help with was trauma physicians, teaching other healthcare workers, other non-trauma based physicians, nurses, medical students, nursing students, whoever, all hands on deck. The basics of trauma and a large part of this is born out of the necessity that civilian installations are being directly. Targeted in this war. It's not just the Russian Federation are targeting the Ukrainian military.
It's not that at all. These are in fact war crimes and, and I've documented. And the majority of this is certainly reporters who do this for a living of documented this as well. And. Those war crimes will be adjudicated at another time. I'm certain, but the fact that civilian installations are being directly targeted here has made it such that physicians are finding themselves maybe next door to a building that has been missile and collapsed.
And everybody's looking at that doctor to do something. And that Doctor maybe a psychiatrist or maybe a pediatrician. They somebody who's never, or a pathologist. Somebody who's never done anything like this. And fortunately trauma, there's some very basic things that you can do. that can save lives. If somebody's bleeding, you stop the bleed. Well, how do you stop the bleed? There are tricks that you can do to do that.
How do you make sure that somebody's cervical spine remains intact after they may have fallen, let's say, in the building that was missile or what happens if somebody's shot? So there are these basic things that we can do in terms of training individuals. And what we did is we set up a course called the armed conflict trauma training course. And the idea was to teach physicians all across Ukraine, using zoom the basic skills of pre-hospital medicine and how to save lives in the setting of armed conflict.
Scott Webb: Obviously education is a big component here, and maybe you can talk about the three components, really the inspiration, what you're trying to achieve, what all of you're trying to achieve besides obviously independence and all of that. But for you, for the doctors, you know, the frontline sort of healthcare workers there, what are the goals?
Dr. Mark Alain Déry: Yeah the goals were essentially was to take a bit of the learning that they've done because a majority of the clinicians probably have taken some form of advanced trauma life support. And in that advanced trauma life support, they may have remembered kind of these basics, that we all learn in medical school, whatever, which is A, B, C right. Airway, breathing, circulation. So if physician comes upon somebody who is injured, And they start focusing on, they're like, oh, what do I do?
ABC airway. But if they're bleeding, the bleeding actually takes the priority on top of that airway. So one of the main things that we are trying to do was show them that the advanced trauma life support is good, but that's just really a foundation to build new information upon in the setting of armed conflict. So it was stop the bleeding, it's remove a weapon from somebody if they have it, basic things that doctors don't think about, because we're not trained in the military.
We're not trained in the setting of armed conflict, but one of the things, and one of the suppositions that we are considering is that we will probably be seeing more armed conflict as we move forward in time. I mean, Climate change is gonna probably force migrations of people around the world water shortages, food shortages, and we're gonna probably see some destabilization more and more as time goes on. And so the development of this class into something that's more standardized is a huge goal for us.
We really did have excellent buy-in. The American College of Emergency Physicians partnered with us, the Department of Defense partnered with us, the Harvard Humanitarian Initiative partnered with us as well. So we really had these amazing partners that really saw the big vision of the necessity to teach physicians how to manage themselves in a pre-hospital setting during armed conflict.
Scott Webb: What would you like Americans to know about the fighting there since you've been there? The goals ultimately of the Ukrainians in this conflict and how folks can get involved and help if they're moved to do so, which I'm sure they are?
Dr. Mark Alain Déry: Essentially the goals amongst Ukrainians are of course, to rid themselves of the Russian Federation, the Southern part of Ukraine borders, the black sea. I mean, so there's all. These thousands of little port cities and towns, and this is where all the refineries are. These are where all the major ports are. And this is how Ukraine is able to remain such as rich country, because they're able to transport goods in and out of the country. And of course the Russian Federation wants that.
That's what they're looking for. And so they're initially taking a little bit by little bit. In 2014 they took some of the Donska region what's called the Dombas, the Don Dombas. That's the Ukrainian word for region. They were able to take that region because there were still a lot of people there who were sympathetic toward the Russian Federation. But since February 24th, when the Russian Federation first invaded Ukraine they are now going into places, mostly the Eastern portion of the country.
And this is where you're seeing a majority of conflict occur. Because they do have ships in the Black Sea and because Belarus is friendly, what the Russian Federation, Russia is able to send rockets into central Ukraine as well as Northern Ukraine as well through Belarus or through the Black Sea. There was large regions of the country that we've been to that have been bombed as well, especially the capital city Kyiv, which initially the Russian Federation made an immediate B line for thinking They could take it.
One of the things that's the most surprising of all here is just how unprepared the Russian Federation is in terms of the military. I think that there was a sense that the Russian Federation had a strong military force and they probably do in numbers just because the country is so large that they're able to recruit anybody they want. But that doesn't necessarily mean that they're willing to fight, one. And two, they're just not prepared and that's largely due to the fact that they don't give real information to Putin.
Because We do know that Putin, if he gets information that he's not happy with, he will oftentimes take that out on the messenger rather than actually creating good military plan. And so what we are finding is that you have a David and Goliath situation, but goliath here, the monster here is the Russian Federation and they're grossly unprepared. They are grossly incompetent and you are fighting people on their own land. And when you're fighting people on their own land and you're putting people in a situation where they have nothing else to lose, they're going to fight aggressively.
And so what you're finding is fact, men and women are on the front, fighting aggressively, the entire country supports the Ukrainian military here. They have donation boxes everywhere, and it's really a DIY donation. I mean like the military is literally being funded by pennies or dimes at a time. It's pretty remarkable. And then of course the Ukranian president President Zalinsky who was the John Stewart of his time, playing in the John Stewart like TV program as a comedian knows how to tell stories. He knows how to inspire the Ukrainian people and he's done an amazing job, inspiring people.
So if people do wanna donate. Donating directly to the Ukrainian military is a great way to do it. And certainly the organization that sent me was the Swiss Foundation for Innovation, that Swiss Foundation for Innovation and that's sfi.org. And they are a tremendous organization. And you know that if you do donate to them, that money will go directly into the Ukrainian programming that they are doing currently right now, with respect to evacuating innocent civilians, who've been injured in the war.
Scott Webb: Well, It's been great to speak with you today. You always seem to be fighting the good fight, whether it's HIV, COVID Ukraine, you always seem to be on the front lines or certainly near them helping teaching. It's really amazing. So thanks so much for your time and your efforts and you stay well.
Dr. Mark Alain Déry: Thank you so much.
Host: And thank you for spending a little time with us today. We look forward to future podcasts where we'll continue to explore issues of importance to you. For additional information, please contact the ACOI directly at 1-800-327-5183. Or by visiting our website at acoi.org. You can also email us at acoi@acoi.org. And until next time, be well.