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At the start of the war in Ukraine in February 2022, roughly 80 percent of oncologists fled the country even as thousands of cancer patients remained. That’s according to Stan Polozov of Mission Kharkiv, an organization that was formed to connect these patients and others with critical medications they needed.
As doctors were leaving, patients still had medical needs, and an estimated 139,000 Ukrainians were living with newly diagnosed cancer before the full-scale invasion. And lack of medical professionals was just the beginning of the unprecedented challenges ahead.
In the city and region of Kharkiv, which borders Russia in the east of the country, conditions were especially dire immediately after the conflict began. The Ministry of Health-run cancer center was destroyed, leaving the Grigoriev Institute for Medical Radiology and Oncology, or GIMRO, a public research center operating on a tight budget in normal times, as the only hospital in the oblast where cancer patients could get the full spectrum of diagnostics and treatment.
“Despite the attempts to evacuate the majority of the cancer patient population deeper into Ukraine and abroad, many still decided not to leave their homes and so continued living in Kharkiv. And given the circumstances, for the first three months after the beginning of the invasion, I had to live in the Institute. So I left my home and slept there,” Dr. Artukh Sergii, an oncologist at GIMRO, told Direct Relief.
And some patients were forced to live at the Institute as well during this time.
“Some patients left Lugansk suburbs before the Russian forces entered the city and occupied it. They didn’t have a way home because of their houses had been occupied or entirely destroyed. So about 30 patients stayed for some period of time in the Institute before they could finally be evacuated or found a temporary place for them to make their living,” he said.
On top of these challenges, patients also relied on the Institute for food, so GIMRO’s staff went to the market and bought food for patients with their savings. Then the cancer medicines they had in storage were gone after a few weeks.
“The basic medications like infusion solutions, some paracetamol, and some antibiotics had been supplied in the first weeks and months of war, all thanks to the volunteers and humanitarian organizations. But in the first six months of the war, we had no cancer medication supply,” said Dr. Artukh.
At this time, logistics companies were afraid to risk themselves by trucking medications to the east. In the west, there were huge chemotherapy shortages as well as patients moved west and overwhelmed cancer clinics in that part of the country. On top of that, in Kharkiv and other oblasts in red zones (those deemed the most dangerous), the electricity infrastructure was bombed, and suppliers couldn’t guarantee the security of the cold chain, which was a big issue as many cancer therapies require refrigeration.
Mission Kharkiv is born
In mid-March 2022, Stan Polozov, a Ukrainian oncologist and biomedical researcher, was flooded with a massive wave of requests for cancer medications from across Kharkiv, including from GIMRO.
In 2017, Polozov moved from Kharkiv to Great Britain for school and then started a biotech company called HQ Science. However, right before the conflict broke out, he was temporarily back in his hometown to lead a clinical study with the Institute for Inherited Incidence of Medical Radiology and Oncology. When Russia invaded, the research was paused.
“So I sat down and thought, okay, what can I really do?” Polozov said. “And then I said directly to the oncologists I’ve been in touch with in Kharkiv, ‘Okay, I’ll try to activate all my network to find the potential donor entity and to find a way to actually manage a humanitarian program.’”
Polozov was soon introduced to Ross Filippenko, a fellow Kharkiv native and mathematician who had started a volunteer medicine distribution project. They teamed up, set up an NGO called Mission Kharkiv, which now has several health-related programs. Polozov became the director of its oncology program, which fields requests from oncologists and patients in Kharkiv, Ukraine, and uses a thorough vetting and tracking process to fill cancer medicine and treatment needs.
Mission Kharkiv has so far been able to provide 700 cancer patients with the treatments they need, and the organization has been able to support over 30 patients who needed to travel outside Ukraine for treatment (providing connections and funding for housing for the patient and family members, transportation, and treatment). In mid-February, they also completed the construction of an underground cold room, which is equipped with backup power and ensures that medicines will be preserved in the event of shelling.
The majority of cancer patients in Ukraine can receive treatment in-country now, as 60 to 80 percent of Ukrainian oncologists have returned home in recent months, according to Polozov. He shared that “now most clinics we work with… work under full operational capacities. I’ve even seen new faces [of young doctors coming on board], which is kind of nice.” And with the recent donations from Direct Relief, Mission Kharkiv currently has enough of the medication used to treat non-Hodgkin’s lymphoma and chronic lymphocytic leukemia for all the patients in need in Kharkiv through the end of the year, and so their team is expanding distribution to other regions in Ukraine as well.
“In a year of collaboration with the Mission Kharkiv, hundreds of cancer patients have received the necessary chemotherapy and supportive therapy during a difficult time when Kharkiv is under constant rocket fire, experiences blackouts, and faces significant logistical problems, including medicine shortages,” said Dr. Artukh.
Challenges and opportunities Remain
While the treatment pipeline has been strengthened, cancer care challenges in Ukraine remain. Certain medications continue to be very limited. “There are extreme shortages for some of the positions,” Polozov shared. “Extreme shortages is one of the reasons that we have observed enormously high prices, which most cancer patients won’t be able to afford.”
Also, the hospitals in Mission Kharkiv’s network have backup generators, but fuel prices remain sky-high. Dr. Artukh mentioned that, like food in the first few months of the conflict, fuel is being purchased out of pocket by the Institute staff.
However, on the whole, Polozov remains hopeful. Continued international support seems likely, and he sees a potential silver lining: the situation may precipitate systemic improvement in cancer patient diagnosis and treatment.
“The Mission Kharkiv protocol [for medicine distribution] is an example showing that it’s possible to make everything digitalized and make patients follow the path,” he said.
Since February 2022, Direct Relief has shipped over 2.45 million defined daily doses of cancer medications to Mission Kharkiv and other partner organizations in Ukraine, totaling over $113 million in product value.
In total, Direct Relief has sent over 271.7 million defined daily doses of medicine worth $930.5 million to Ukraine since the start of the war.