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Prytulak   InfoUkes Posting   02-Oct-1997   Re: Friends of Ukraine (The 17 surgeons)
Date:  Thu, 02 Oct 1997 23:34:10 -0700
To:  [email protected]
From:  Lubomyr Prytulak
Subject:  Re: Friends of Ukraine (The 17 surgeons)
I do have a comment on the 17-member team of U.S. surgeons from the U.S. that performed 37 operations in Kyiv, as reported in RLChomiak's posting which I reproduce below.

I am reluctant to say anything negative about this American project, because it's better than nothing and I know I'm going to seem guilty of ingratitude and of being incapable of being satisfied.  However, this instance of aid amounts to helping a small number of Ukrainians a little bit, which is inferior to helping Ukrainians on their feet so that they can help themselves � so that many of them can help themselves a lot.

The grand total of the people helped in this one project is 37!  In the larger scheme of things, that is less than a drop in the bucket.  It is not going to make a dent in Ukraine's annual report, either in the economic bottom lines, or in the demographic.  The 37 people were possibly predominantly elderly, so that the net effect might be that following the efforts of the American surgeons, 37 predominantly elderly people were freer from pain and enjoyed greater freedom of motion � yes, I don't deny that that is wonderful, but isn't our goal to get the big statistics reversed, the rising mortality and alcoholism and smoking and drug abuse, the falling life expectancy, the 200,000 people who are in need of such knee and hip surgery, and so on � and this project did not make a dent on that big picture, and even the same project carried over four years and operating on 133 patients did not make a dent on that big picture either.

Also, the number of Ukrainian physicians trained during the two weeks of this project will have been small, and the degree of their training will have been superficial.  Will the Ukrainian physicians now be able to continue operating on additional patients after the Americans leave?  I doubt it � the parts that are used in such replacement operations are probably prohibitively expensive.  Thus, perhaps there will not be much more than 37 patients helped.

What strikes me as being the case is the Americans have picked a type of aid which will not leave the Ukrainians able to compete with them, and which will not bring dollars into Ukraine � for example, a rich Saudi Arabian will still go to the U.S. for his hip replacement, not to Ukraine.

Now deprecating the efforts of this team of surgeons is justifiable only if I have in mind some alternative aid that could have been given Ukraine which would have cost the Ameicans no greater effort and which would have had a larger impact.  And I do have in mind alternative projects that would have helped Ukraine more.  For example, perhaps for the same outlay, the U.S. could have brought a team of Ukrainian surgeons for more extensive training in the United States � say a year � and then equipped them with parts such that when they returned home they could over the course of their lifetimes treat many thousands of patients.

But much better even than that would have been to support Ukraine's textile industry.  The reason that I pick the textile industry is that it is already competitive, such that with a little encouragement, it could be a grand international success.  Thus, if the U.S. removed all tariffs and quotas on Ukrainian textiles, and if the U.S. could have sent a team of 17 experts on textile manufacturing and design and marketing to Ukraine, then the cumulative effect might be that Ukraine earned hundreds of millions of dollars more each year than it does now.  Anybody who saw the Ukrainian fashion show at the Pacific National Exhibition in Vancouver a few years ago will not find it hard to believe that Ukraine could become a leading player in the related field of fashion as well � the clothing, the models, the music, and the choreography made this a fashion show not only that was world class, but miles better than anything that one sees from the leading fashion houses of the world, and I think I am speaking objectively here, not as an over-eager Ukraine.

And some of those hundreds of millions coming from textiles and fashion would then become available to pay Ukrainian surgeons to learn hip and knee replacement, and to pay for modern operating rooms and for the expensive parts needed in the operations, such that thousands of operations could be performed annually over many years into the future instead of only 133 over four years, and such that ultimately the rich Saudi Arabian would come to Ukraine for his knee replacement, not only because Ukraine was closer, but because the quality of the surgery was better.  So, my argument collapsed down to the most critical conclusion is that with planning whose primary motivation was to help Ukraine, the U.S. with the same expenditure of energy could have helped tens of thousands of more knee and hip sufferers than it in fact did.

Ultimately, it's all about money.  The best aid is the aid that teaches, or allows, Ukrainians to earn foreign capital.  Anything else is just window dressing.  Put a dollar amount on the aid Ukraine did receive from this one visit � 37 operations at say $5,000 per operation gives $185 thousand, and the benefit of say a dozen Ukrainian surgeons receiving a two-week introduction to knee and hip surgery, valued at say $5,000 per surgeon gives another $60 thousand, for a grand total of $245 thousand in benefits received.  That's nice, but a similar degree of effort on the part of the United States to upgrade and untrammel Ukraine's textile and fashion industries could have enabled Ukraine to earn a $100 million more each and every year into the indefinite future.

What I am pointing out is that when the Americans were deciding how to allocate a given amount of money for aid to Ukraine, they appear not to have calculated how to spend that money so as to maximally aid Ukraine � they seem to have been guided by considerations of public relations, by the need to provide the sort of aid which offered good photo opportunities, by a desire to earn a Mother Theresa reputation for feeling compassion for the unfortunate.  They do not seem to have been guided by a desire to make Ukraine independent and competitive.

Lubomyr Prytulak


At 12:35 AM 10/3/1997 -0400, RLChomiak wrote:

On Sept. 30 Lubomyr asked:

Did you know that 13 thousand Ukrainian children had passed through Cuba?

Yes.  Every time a group of kids left for Cuba or returned from Cuba it was covered on Ukrainian TV and in the print media.  (I guess it's Cuba's way of saying thanks.  Between 1961 and 1991 Ukrainian taxpayers have supported Cuba financially and through their skills.)

And here's something that was in my e-mail file right after Lubomyr's harangue against the paltry American aid to Ukraine:

- Donations Aided Effort to Perform Joint-Replacement Surgeries -
TOPEKA, Kan., Sept. 30 /PRNewswire/ � A 17-member team of U.S. orthopedic surgeons and other health care professionals recently returned from its fourth annual humanitarian mission to Ukraine to provide free hip and knee replacement surgery.  The team, led by Kenneth Gimple, MD, of the Orthopedic Clinic of Topeka and supported by donations from such organizations as the pharmaceutical company Rhone-Poulenc Rorer (NYSE: RPR), performed 37 successful hip or knee replacement surgeries during its two-week mission to the Ukrainian city of Enakievo in July.

"We went to Ukraine to share the benefits of new and important medical techniques," said Dr. Gimple.  "Hip and knee replacements are still not very common in Ukraine."  The Ukrainian medical community is partnering with physicians from other countries to enhance its knowledge and update its technological resources.  Vitaliy Lobos, MD, President of the Medical University at Donetsk, and Boris Stinsky, MD, Chief of Orthopedics at Trauma Hospital in Enakievo, invited Dr. Gimple and his colleagues to assist in total hip and knee replacement surgeries at local hospitals.

This recent mission and others before it would not be possible, Dr. Gimple pointed out, without the generosity of a variety of companies and hospitals that donated funding and supplies.  For example, Rhone-Poulenc Rorer, a global pharmaceutical company based in Collegeville, Pa., donated its low-molecular-weight heparin Lovenox(R) (enoxaparin sodium) Injection, which was administered to all surgery patients.

Thanks to the team's effort, 133 patients have undergone total hip or knee replacement surgery in the past four years.  However, the situation in Ukraine remains somber for people in need of total joint-replacement surgery.  "Imagine 200,000 people in line to get tickets for a movie theater that only holds 100 people," said Dr. Gimple.  "The demand is simply greater than our annual visits can accommodate."  The team's fifth trip is scheduled for June 1998.
The person who wrote the Novy Shliakh article quoted by Lubomyr has to be Marian Kots, a resident of Lexington, NY, who has donated a lot of his own money to various projects in Ukraine since independence.

RLChomiak
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