In Ukraine, doctors are working to continue giving quality care to patients with inflammatory bowel disease. Mount Sinai has stepped in to help by offering courses over Zoom with more than 250 doctors.
Amid the ongoing war in Ukraine, doctors are desperate to continue giving quality care to patients with inflammatory bowel disease (IBD), a condition that causes chronic inflammation of the gastrointestinal tract. Determined to help, Jean-Frederic Colombel, MD, and his team created the “Mount Sinai IBD Course for Ukraine,” a series of remote courses that support IBD doctors in the country. “As soon as I was aware that there was a need, I immediately said ‘yes,’” says Dr. Colombel, Director of the Susan and Leonard Feinstein IBD Clinical Center and the Leona M. and Harry B. Helmsley Charitable Trust IBD Center at Mount Sinai, and Professor of Medicine (Gastroenterology). “Also, because I’m European, I’m very emotional about what’s going on in Ukraine, because I know several of these doctors.”
Jean-Frederic Colombel, MD
As an IBD specialist who practiced in his home country of France before joining Mount Sinai in 2013, and who served as President of the European Crohn´s and Colitis Organisation from 2008 to 2010, Dr. Colombel was in a unique position to help. Working closely with his network of colleagues both within and outside of Mount Sinai, Dr. Colombel and his team organized the series of courses over Zoom. In all, three courses have been held since August so far, with up to 250 Ukrainian doctors attending both live and recorded video sessions. Dr. Oleksandr (Alex) Shumeiko, a Ukrainian gastroenterologist currently undergoing training at the University of Cincinnati, worked closely with Dr. Colombel to organize the courses and helped spread awareness among colleagues in his home country.
Ukraine is a leader among Eastern European countries in the field of IBD. However, the war has forced many doctors there to rethink how they treat patients—using minimal resources, rather than the latest developments and innovations in their field. “Because of the war, it was back to some basics, and how to deal with that,” Dr. Colombel explains.
Since the war began a year ago last February, patients and doctors have faced multiple dilemmas— disruption of logistics, the closure of hospitals under constant shelling, damage to energy grids—all of which makes it almost impossible to provide quality diagnoses and treatments for patients. Many health care workers and patients have become refugees or were displaced, partially or completely unable to access IBD treatment. Before the war, Ukrainian centers were tightly involved in clinical trials for IBD, providing opportunities for advanced therapies and cutting-edge medical care. Now, those trials have closed and many hospitals have lost resources to provide adequate IBD care. As a result, most patients are relying on humanitarian efforts to receive treatment.
As the war continues to disrupt health care systems, Mount Sinai’s IBD Course for Ukraine is helping Ukrainian physicians support IBD patients with minimal resources. For example, one course trained doctors in the management of long-term use of steroids for patients with IBD. While not recommended under normal circumstances, Dr. Colombel says the treatment is necessary for patients in Ukraine. “Because the typical biologics prescribed to IBD patients are not available due to the war, Ukrainian doctors wanted to learn how to minimize the side effects of steroids, which was sometimes the only treatment option,” Dr. Colombel says.
In fact, a majority of the courses have focused on practical topics, such as managing stomas following surgery, optimizing nutrition, treating IBD during pregnancy, caring for children with IBD, surgical options for IBD patients, and more. When Dr. Colombel asked Mount Sinai colleagues with IBD expertise to participate, many were eager to help. “This was extra work for all of them, but everybody was very enthusiastic. And actually, we had almost too many people who wanted to participate.”
The courses “perfectly align” with Mount Sinai’s core values of creativity, empathy, and teamwork in times of crisis, he says, because they offer “the best education for doctors in the Ukraine to provide the best care for all their patients, rather than a select group of patients who are the most wealthy.”
While organizing the courses over Zoom was relatively simple, Dr. Colombel says it was “very emotional,” because some doctors attended a live course in Kharkiv while missiles struck the city. He imagined what it would be like to provide care to patients under similar circumstances. “This would be a heartbreaker,” he says. “Very often, we don’t think about the consequences for doctors and patients to be at war like that. It is not like Ukraine is a country that never had access to the best care—they had access to very good care before, and then, suddenly, boom—nothing. So this is a big deal.”
Aside from helping doctors in Ukraine access the knowledge they need to treat patients, Dr. Colombel says it was just as important for them to see that their colleagues outside Ukraine were willing to help.
“Any sign of solidarity that you can bring for them, psychologically, is very important,” he says.
A damaged operating room inside a Ukrainian IBD center.
Ukranian IBD doctors examine an image together
Ukranian doctors meet for training on how to use diesel generators