July 17, 2014 was a bad day for Andre Usach.
The 33-year-old soldier was hit by a shell while in a bunker at the airport in the eastern Ukrainian city of Luhansk.
Badly wounded and knocked out, he could not be safely evacuated and had to remain there for two weeks, unconscious, without any medical treatment more complex than tourniquets provided by his comrades.
Dr. Oleh Antonyshyn, who would meet the soldier months later, fills in the details:
"When they did finally get him to a medical facility, his wounds were infected, resulting in the amputation of his leg. He (had) a very significant injury to his arm – he (couldn't) use his arm – and in addition to that, he had a multi-fragment fracture of his jaw, with an open wound to his jaw, and all of that was infected as well.
"When the primary physicians got ahold of him, they completed the amputation and treated his wounds, but he was still battered, with a major defect of the jaw – it was split in two, from left to right. He was unable to eat and was unable to speak normally."
Photo: Dr. Kimit Rai (centre-left) performs surgery on a patient.
The wounds, and their long-lasting effects, were the results of the unrest that began in the Ukrainian capital of Kiev in the late fall of 2013.
The anti-government protests would lead to the ousting of President Viktor Yanukovych on Feb. 14, 2014, but not before heavy fighting in Maidan Nezalezhnosti – the city's central square – that left more than 100 killed and many more wounded, to be followed by many thousands more dead and injured in the eastern part of the country as Russia became more involved in the conflict throughout the year.
The plight of the wounded would attract the attention of Canadian medical professionals, some of whom volunteered to bring their reconstructive surgery skills to Ukrainians.
The first-ever Canada Ukraine Foundation and Operation Rainbow Medical Mission arrived on Nov. 6, 2014: One neurosurgeon, four plastic surgeons (one a hand specialist, the others face and general), two plastic surgery residents, one general surgeon, three anesthesiologists, 10 nurses, and a support team of six.
While the majority were from Ontario (and one nurse from Edmonton), six of the volunteers were from B.C., including team leader Dr. Kimit Rai and Surrey videographer Gary Hanney, a retired Global TV cameraman who documented 37 surgeries performed over nearly 10 days.
Billeted at the Kiev Hilton, the team – which came with its own medical equipment – performed surgeries in the Main Clinic Military Hospital, built in 1775 (which locals like to say is older than the United States).
Dr. Rai said that most of the bullet wounds and explosives injuries were a few months old, and included broken jaws, noses and cheekbones, and scarred and distorted upper extremities.
In Andre Usach's case, Dr. Antonyshyn used a titanium mesh and a bone graft from the patient's thigh to put his jaw back together.
Usach wouldn't be the first to thank a visiting doctor.
Photo: The military hospital in Kiev was built in 1775.
Ontario plastic surgeon Dr. Tara Stewart would get a big hug after doing surgery on 35-year-old patient Roman Bertash.
Via email, Stewart explains how Bertash witnessed his friend being shot by a sniper during battle, only to be shot by the same sniper while he was attempting to get his friend to safety.
The bullet ripped through the left side of Bertash’s face, destroying his orbital bone and blowing his left eye out of his socket.
His friend did not survive.
"One time he looked me in the eyes he said – and this left me humbled by his strength – 'Don’t worry though, I got the sniper!' After being shot, he circled around and with only one eye, and eliminated the sniper."
There would be 35 other surgeries during this medical mission, all with unique stories.
One young man lost an eye after opening up an explosives-laden package inside a medical station in the Maidan ("Square") during the protests.
One had such bad scar tissue under his arm that he couldn't raise it.
Another patient who got reconstructive surgery from the Canadian team wore a bullet previously removed from his head as an amulet around his neck.
Photo: Surrey videographer Gary Hanney, on his fourth Operation Rainbow mission.
Antonyshyn said that while Ukrainian doctors are perfectly capable of performing reconstructive and cosmetic surgery, the surgical tools and materials are expensive and difficult to obtain.
The idea of a mission by the volunteers with the Canada Ukraine Foundation seemed daunting at first, so Antonyshyn sought the advice of someone more experienced.
"I didn't know how to go about (organizing) that," he admits.
Operation Rainbow Canada did – it has provided reconstructive/cosmetic surgery to more than 2,000 children in 20 years during missions to India, China, Mexico, Lebanon, Cambodia and other countries.
Antonyshyn says he knew of Rai's reputation – his experience, infrastructure and knowledge in taking teams to other countries in often harsh conditions.
This time, their patients had battle wounds, scars and burns, rather than cleft plates like the children they usually treat during Operation Rainbow missions.
Despite the complexities, and "a lot of bone grafts," Rai says the outcomes were all good, with no complications or infections.
Hanney witnessed and recorded much of the activity, and spent his afternoons in the hospital (each surgery was usually four to five hours long), and the following mornings edited the videos to send to CBC TV stations in Toronto and B.C., as well as Global BC.
Photo: Dr. Tara Stewart with 35-year-old patient Ukrainian patient Roman Bertash following his surgery.
Hanney said he was too busy working to be truly affected by what he saw in the hospital – including the interaction between Dr. Stewart and Roman Bertash, and the big smile on the patient's face.
"It didn't hit me until I saw the CBC footage."
It was Hanney's fourth mission with Operation Rainbow as a videographer.
"The patients are very grateful," says Rai. "It's been very emotionally charged and it feels good to help them."
All-volunteer and non-profit Operation Rainbow relies on donations. Visit http://www.operationrainbowcanada.com. For more information about the Canada Ukraine Foundation, visit http://www.cufoundation.ca/
– with files from CBC (video a special edit of footage by Gary Hanney.)
OF THE 37 SURGERIES:
• 7 skull reconstructions
• 10 bony reconstructions of the facial skeleton
• 9 soft tissue reconstructions of the eyelids, nose and lips
• 6 upper extremity reconstructions
• 5 burn and scar revisions