Ukrainian children face burns because of technology, infrastructure

Dr. David Brown, a plastic surgeon from the University of Michigan, left,

Dr. David Brown, a plastic surgeon from the University of Michigan, left, helps to screen Matievi Lepinin, 10, who is joined by his mother, Yana Lepinina, 33, lower left, of the Mykolaiv region of Ukraine, as he confers with Doctors Collaborating to Help Children colleague Dr. Brian Kelley, a plastic surgeon at the University of Texas at Austin Dell Medical School, on Lepinin's hotel patio in Leczna, Poland, on Sunday, May 14, 2023. Lepinin was burned at age 2 after a kettle of hot water scalded his legs and feet. Mandi Wright, Detroit Free Press

LECZNA, Poland — These Ukrainian children aren't featured in news stories about the war. They were scalded by boiling water or suffered burns when they got too close to a live wire in a nation with an outdated electrical grid that has sustained heavy damage by Russian attacks. Or they were caught in house fires sparked by faulty wiring or use of a space heater.

"A lot of the burns we see in Ukraine are related to hot water," said Dr. Jeremi Mountjoy, an anesthesiologist from Massachusetts General Hospital who traveled to Poland in mid-May with the first team of U.S. doctors to treat Ukrainian children in that country since the war began. "A lot of homes don't have a domestic hot water system, so they boil the water in the kitchen and bring boiling water to the bathtub to bathe their children. So there's an increased risk that they’ll get injured by hot water.

"And now, with all the destruction of the infrastructure in Ukraine, we certainly worry that there could be increased risk there. The war also makes it more likely children could be injured by electrical burns. There's a lot of cobbled-together infrastructure as people try to make repairs and whatnot to keep going on with life, not to mention all the war injuries directly."

Dr. Maxim Savenko, a plastic surgeon from Dnipro State University in Dnipro, Ukraine, sees those war injuries in his work every day.

His hospital has treated more than 200 children injured since the Russian invasion began in February 2022. Most, he said, have been shrapnel injuries, "along with other trauma, amputations, brain and head injuries and abdominal injuries from explosions," he said.

Burns accompany most of them. Children who recover from acute burn injuries require ongoing surgeries because the scarred skin tends to be thick and inflexible. It contracts as children grow, causing deformities and limiting their ability to move.

More: US doctors travel to edge of war zone to care for burned Ukrainian children

Repeat treatments are costly and difficult to get even when there isn't a war, when hospitals aren't being shelled, when physicians aren't already overwhelmed caring for the sick and injured. And the need for help is only likely to grow, Savenko said, as the ranks of war wounded rise.

Since Russian forces invaded Ukraine in late February 2022, more than 500 children have been killed, and at least 1,000 have been injured, according to the United Nations Human Rights Office of the High Commissioner, which is tracking civilian casualties.

Aside from war injuries, Ukrainian children are continuing to get burns from other sources, too.

"Many of the children who were burned, their mothers are really young and they didn't know anything about burn prevention or first aid," Mountjoy said.

"We created burn education materials in Ukrainian and disseminated them on social media. … Burn prevention is everything because then the next wave of kids is smaller, hopefully."

The Free Press traveled with the U.S. doctors to this Polish town 20 miles from the Ukraine border and met 20 Ukrainian children being treated. Here are a few of their stories:

Matviei Lepinin wore a red Spiderman hoodie zipped to his chin and a stoic look on his face.

He glanced at his mother, Yana Lepinina, seeking comfort in her eyes as she spoke with a team of doctors about his next surgery.

"What if that went away?" asked Dr. David Brown, a plastic surgeon at the University of Michigan, pointing at the third toe on Matviei's right foot. "What if it just wasn't there?"

Matviei, 10, appeared to be on the verge of tears, even though it was clear that his toe jutted so far out of alignment, it was difficult for the boy to wear regular shoes.

When Matviei was a toddler, a kettle of hot water fell on him, scalding his legs and feet, Lepinina said. As he grew, the burn scars contracted, pulling his toes up.

"The first year after the burn, he couldn't walk on straight legs," said Lepinina, who lives in Ochakiv, Ukraine, in the Mykolaiv region by the Black Sea. "And then, in 2016, as if by chance, we ended up on the mission of Dr. Gennadiy Fuzaylov."

A Boston-based physician and founder of Doctors Collaborating to Help Children, Fuzaylov has organized annual mission trips for more than a decade to Ukraine. His team of physicians provide complex plastic and reconstructive surgeries to severely burned children to improve the quality of their lives.

Fuzaylov, whose own family fled the former Soviet Union decades ago, arranges everything — from travel plans to hospital care for the families. In mid-May, he brought a team of U.S. physicians to Poland, rather than Ukraine, for the first time to ensure the safety of the doctors and the children.

Fuzaylov played the role of translator, too.

"Mom says she wants to keep (the toe)," Fuzaylov told Brown. "She is afraid if there are pins, he won't be able to walk."

The last time Matviei had surgery on the foot, it included skin grafts and pins to straighten his toes. Afterward, he had to wear a cast and have a repeat surgery to remove the pins. He couldn't put weight on it for two months.

Brown examined the boy's foot again.

"Those straightened out very well," Brown said of the other four toes on Matviei's foot. "If we take this one off, it will look much better. There will just be a little extra space right there. … We don't have to do any pins. No pins this time. No cast. Is that OK?"

They agree, and Matviei high-fived Brown.

It’ll be Matviei's sixth operation by the team of U.S. doctors and their allies since 2016. Lepinina said she trusts no one else.

"I no longer feel any kind of worry or distress because I know that everything will be great, everything will be all right," Lepinina said. "I trust this team 100%."

Lepinina was less confident about their safety when they return home.

"Our city, Ochakiv, and the territory where the Russian troops are sitting are 9 kilometers apart across the sea in Tendra Spit," Lepinina said. "Therefore, there are shellings every day, four or five times a day. There are periods of calm, but sometimes this nightmare goes on all day and night."

About 70% of the houses in her small town have been destroyed, she said, "but people live in such conditions."

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When the Russians first invaded in February 2022, Lepinina and Matviei left Ochakiv. They moved temporarily to Lviv, in western Ukraine. Though not immune to the violence of the war, Lviv is farther from the frontlines, farther from the heavy shelling. It felt a little safer.

They stayed there for nine months before returning to Ochakiv.

"The children wanted to go home," Lepinina said. "They could not adapt in another city. This is our house. We cannot leave it. We have relatives there, a grandmother. We can't just leave them."

But there's little peace in Ochakiv.

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Ukrainian boy receives sixth operation by team of U.S. doctors and their allies since 2016

Burned by a kettle of hot water at three years old, Matviei Lepinin receives sixth operation by the team of U.S. doctors and their allies since 2016.

"This morning, the city has already been shelled," Lepinina said on the day of Matviei's surgery. "We are monitoring this all the time. We are anxious," though there were no casualties this time.

"We are trying to live."

Tears filled Lepinina's eyes.

"I'm for Ukraine," she said. "We are waiting for victory in our country, for our children to live peacefully in a world without war. Ukrainian children deserve to live in a world without war."

Hanna Sokolova will never forget the day when her son nearly died.

It was June 27, 2022 — three months into the Russian invasion of her homeland.

Artem Sokolov was with friends on a playground near their home in Kharkiv, Ukraine, when cluster bombs rained down around them. To her horror, she watched as a small bomb landed at Artem's feet.

"The explosion ripped off a part of his arm," she said with her hands clasped in front of her as if in prayer.

Neither she nor Artem's friends were hurt — at least not physically — but the shelling struck courtyards throughout the area. Six Ukrainians died in the attack and many others were injured, Sokolova said.

She found her boy unconscious.

Though it was obvious that Artem's left arm had been badly injured in the blast, Sokolova, 38, soon realized her son also was wounded in ways she couldn't see.

"He was in coma," she said. "He had to be resuscitated. His internal organs were severely damaged."

Because cluster bombs release explosives as they fall, showering grenade-like bomblets across hundreds of feet, humanitarian groups say using them against civilians is a war crime. More than 100 countries have joined a convention banning the use of cluster bombs — though neither Russia nor Ukraine have joined that convention. The U.S. hasn't, either.

Artem underwent several surgeries, Sokolova said, and was transferred to a hospital in Lviv, in the far western part of Ukraine, where he was hospitalized for three months.

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Doctors told her they could "save his life, but not his arm," she said. "That hand turned out to be nonworking and remained so."

It wasn't until the end of September that Artem was well enough to return home to Kharkiv.

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US doctors help Ukrainian boy injured by Russian bomb

US doctors took nerve tissue from a Ukrainian boy's leg to restore function to his bomb-damaged left arm.

"We wanted to go home," Sokolova said — even though the city is about 10 miles from the border with Russia, even though it faced ongoing attacks.

"I have an older daughter there," Sokolova said. "All of our family is in Kharkiv. Our part of city is not so heavily bombed."

Artem began rehabilitation to improve function in his left hand and arm, but, she said, "doctors suggested that the process is pointless. … Artem needs a surgery."

Doctors and the family had little hope for surgery for Artem in Ukraine, however, as the war dragged on.

It was through a chain of acquaintances, friends and doctors that Sokolova said she heard about the work of Dr. Gennadiy Fuzaylov, a Boston-based physician and philanthropist who founded Doctors Collaborating to Help Children, and his mission trips to help children like Artem.

For more than a decade, the nonprofit organization has provided plastic and reconstructive surgery during annual trips to Ukraine to provide plastic and reconstructive surgery to children who’ve been severely burned or have congenital anomalies that affect their ability to function. Not only do they provide procedures that are not available in Ukraine; the American physicians also offer training and education in collaboration with Ukrainian doctors.

When the war started, Fuzaylov said he could not risk a mission trip in a nation under siege. So instead, a medical team of 10 U.S. physicians and a certified nurse anesthetist traveled to eastern Poland, and Ukrainian children like Artem were brought across the border for surgeries spanning five days in mid-May.

Artem's procedure took place May 15 at the Independent Public Health Care Facility in Leczna, a 400-bed hospital with one of the largest burn treatment centers in Poland.

In addition to thick scar tissue on his forearm, Artem also had nerve damage.

A group of plastic surgeons — Dr. Shawn Diamond, a plastic surgeon with Texas Tech Physicians of El Paso; Dr. Alfred Yoon, a chief resident from the University of Michigan; Dr. Brian Kelley of the University of Texas at Austin Dell Medical Center, and Dr. Eric Wenzinger, a senior medical resident from Massachusetts General Hospital — examined Artem's injured arm. They agreed to take nerve tissue from his lower left leg and graft into his arm.

"We need to reconstruct the nerves," Diamond said, to help Artem regain function in his left hand. They formed two teams to complete the work.

Yoon marked some spots above Artem's left ankle, where he later would make an incision to remove nerve tissue for the graft.

"One team is doing a revision of the forearm. … The other team is harvesting the sural nerve on the leg," said Dr. Tomasz Korzeniowski, vice chair of plastic surgery at the Polish hospital.

It took nearly three hours to complete the procedure. Two days later, Artem was well enough to join friends at a hotel near the hospital, where he and other Ukrainian families stayed while in recovery.

His arm and leg were bandaged, but he still managed to play games on a smartphone with three other boys in the hotel lounge.

"He is feeling OK," his mother said. "His arm is a bit in pain, but, overall, he feels fine."

The best part: With proper rehabilitation, doctors told her, "the arm should be operating within six months."

Evheniia Ukhvatova comes from a long line of nezlamni people, which means "unbreakable" in Ukrainian.

Her grandfather volunteered to join the battle against Russia. Her uncles work in territorial defense. And her great-grandmother, Valentina Ukhvatova, 75, of Dnipro, is an aerospace engineer who refuses to give up on a free Ukraine or on Evheniia.

"We will handle this," Ukhvatova said. "Glory to the heroes! Having children like Evheniia, we can do anything."

The little girl with brown hair and curious brown eyes fell facedown as she fled a house fire on Sept. 4, 2020, Ukhvatova said. The backs of her feet and legs were severely burned. Her heart and kidneys also were affected.

As she grows, Evheniia's scarred skin isn't stretching with her, causing painful and disabling contractures that make it difficult for her to walk.

As her country fights for autonomy from invading Russian forces, the Ukrainian medical system can't provide plastic and reconstructive surgery for children like Evheniia. Their focus now is keeping people with critical injuries alive.

Seeing the need, a team of U.S. doctors traveled to Poland in May and evacuated 17 Ukrainian children from the war-torn country for cosmetic and reconstructive surgery at a Polish hospital as part of a historic mission. Three other children who are living as refugees in Poland and the Netherlands also were brought for treatment to a hospital in Leczna, near Poland's eastern border.

Evheniia's great-grandmother accompanied her because the child's mom is caring for her four other kids at home. "I believed in myself that I could do that, help her and put her on her feet," Ukhvatova said.

The small girl looked frightened as she was wheeled on a stretcher May 15 into the third-floor operating room at the Independent Public Health Care Facility. Then her eyes met a familiar face, and her demeanor changed.

"That's my patient!" declared Dr. Artem Posunko, a plastic surgeon from the Regional Medical Center of Family Health in Dnipro; he was among the Ukrainian physicians traveling with the families.

In that moment, it was if he claimed Evheniia, 6, not only as his patient, but as a daughter of Ukraine; his presence seemed to calm her.

Posunko stood by while Dr. Justin Knittel, an anesthesiologist from Washington University in St. Louis, and Whitney Roberts, a certified nurse anesthetist from Boston Children's Hospital, worked to sedate Evheniia.

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Soon after, a team of plastic surgeons — led by Dr. David Brown from the University of Michigan and assisted by U-M chief resident Dr. Gina Sacks, as well as Posunko and a Polish doctor — began cutting healthy skin from Evheniia's back to graft onto her scarred legs.

She had laser treatment, too, which breaks down and thins scar tissue, leaving more flexible skin with a better texture.

A couple of hours later, Ukhvatova waited for her in the recovery room. As the anesthesia wore off, Evheniia cried and thrashed in her bed.

"I have to be strong," Ukhvatova said, maintaining her composure. "I can't complain, cry or be emotional. Evheniia deserves to see me strong, confident, smiling."

By the next morning, Evheniia, too, was smiling as she sat on the edge of her hospital bed; Ukhvatova spooned oatmeal into her mouth.

And the day after that: "You can't even imagine! She walks!" Ukhvatova said. "Within a month, she should start rehabilitation. We will continue to heal in Dnipro."

Even though Ukhvatova believes it's dangerous to continue living in Dnipro during the ongoing war — just after the families returned from Poland, Reuters reported an air strike in the region destroyed several buildings and injured eight people — she isn't willing to flee.

"I have children, grandchildren and eight small great-grandchildren," she said. "I can't leave them behind."

Instead, Ukhvatova stays, and she fights in any way she can. This trip was for Evheniia.

"I would like to thank everyone who supports us, and helps us in a moral, emotional, physical way, and sends weapons. … I am grateful that American surgeons came here."

Karolina Petrenko was with her older brother, Zhenia, and a friend at a cargo train station in Ukraine when she pulled out her cellphone and did what many teenagers do multiple times a day: She took a selfie.

That ordinary act had a disastrous outcome. As a train passed nearby, an electrical current arced to her phone, sending 25,000 volts of electricity through her 13-year-old body.

"She caught on fire," said her mother, Vitalina Petrenko, 38. "Zhenia ripped off her burning clothes and shoes. At the beginning she was in shock. … Then she lost consciousness. While falling to the ground, she hit her head on a stone.

"Seventy-five percent of her body was burned, 25% of which were severe burns."

In many ways, Sept. 9, 2019, was the worst day of their lives. But it also set them on a new, unexpected path.

Standing beside her daughter's hospital bed in eastern Poland last month, Vitalina Petrenko pushed up the sleeves of her pink sweater, showing the tattoos on her forearms. On the right is the phoenix, rising from the ashes. On the left, the images of fierce creatures — a dragon and a wolf — are tattooed above the infinity symbol.

"Infinite love, which inspires and saves, which conquers everything," she said. "My tattoos resemble what I have been through. … We went through everything imaginable. We even ended up on the streets one day, but as you can see, we do not give up. We fight!"

Petrenko is raising her children alone — Zhenia, 18; Karolina, now 16, and Anhelina, 11. It's been very difficult financially, she said. When Russia invaded Ukraine, Petrenko said she knew the family couldn't stay in Cherkasy, where Karolina was burned.

They fled to Poland, and settled in Warsaw, where Petrenko and Zhenia now have jobs; Karolina and Anhelina go to school.

"Since day one, I worked," Petrenko said. "Some refugees used free accommodations or food, but not us. No one supported us. No one funded our stay here. We paid for ourselves since the very start."

Karolina is an artist, though the burn scars on her hands have bent and twisted her fingers so it's difficult to hold her colored pencils. She loves to ride scooters, bicycles and roller skates, though the skin on much of her upper body is tight because it is contracting as she grows.

It was through a co-worker that Petrenko first heard Dr. Gennadiy Fuzaylov's name.

Fuzaylov, a Boston-based physician who founded Doctors Collaborating to Help Children, led a medical team of 10 U.S. physicians and a certified nurse anesthetist to eastern Poland in mid-May while 17 Ukrainian children were brought over the Polish border to meet the physicians at the Independent Public Health Care Facility in the city of Leczna. Three other Ukrainian children, including Karolina, also traveled to Leczna from other parts of Poland and the Netherlands, where they are living as refugees.

Karolina's turn for a long-awaited surgery came May 16. She was brought into the operating room on a stretcher, tucked beneath a metallic gold sheet to keep her warm. Dr. Jeremi Mountjoy, an anesthesiologist at Massachusetts General Hospital, and Dr. Christopher Bean, an anesthesiology medical resident at the same hospital, prepared her for surgery.

"Her hands have almost zero function," said Dr. Brian Kelley, a plastic surgeon from the University of Texas at Austin Dell Medical Center.

Music pumped into the operating room. Tina Turner's voice sang "What's love got to do with it?" as doctors worked, using grafting skin on Karolina's hands to allow her to fully open and close them again. They placed temporary pins into her fingers to straighten them while also releasing contractures in her hands, on her arms and neck, said Dr. Tomasz Korzeniowski, vice chair of plastic surgery at the Polish hospital.

Karolina also had laser treatments to soften and improve the appearance of her burn scars. The pins in her fingers will remain in place for two to three weeks, Kelley said, and will be removed after she returns to Warsaw.

When Karolina was brought into the surgical recovery room, Bean monitored her for any signs of distress.

He noticed Petrenko looking worried, standing by Karolina's bedside stroking her daughter's blond-tipped hair as the anesthesia wore off. Though they shared no common language and he couldn't offer consoling words, he brought her a stool so she could sit.

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US doctors aid Ukrainian teen who was badly burned taking a selfie

This family endures a freak accident that severely burned a teen daughter followed by Russia's invasion of their homeland.

In that moment, kindness transcended the language barrier.

Petrenko said she knows Karolina will need more surgeries to improve her quality of life, but, she said, "as long as I have strength, I will do everything possible to make my child healthy. … I fight alone. We go through problems together, me and the children. People used to tell me, ‘You are strong,’ but do I have any other option?"

Four-year-old Yelizaveta Nadolniak lives in a fantasy world, where she has been told the sounds of war in her homeland — bombs exploding, the air raid sirens — are simply the bass and timbre of rap music playing nearby.

The tiny Ukrainian girl with wispy blond hair asked her aunt, Ludmila Nativa, "Where is the music?" when they crossed the border earlier this month into eastern Poland, a country at peace, where the days and nights are quiet.

Yelizaveta, whose nickname is Liza, is among 20 children from Ukraine to undergo complex plastic and reconstructive surgery on burn scars, war trauma and congenital anomalies in mid-May in this small Polish town, about 20 miles from the border.

These surgeries can vastly improve the quality of the children's lives, restoring their ability to bend their arms and legs, use their hands and turn their heads and prevent crippling deformities. But because they’re not life-threatening injuries, the kids can't get treatment for them now in Ukraine.

A team of U.S. doctors from Michigan, Texas, Massachusetts, and Missouri traveled to Poland on a humanitarian mission to fill the medical void.

Liza doesn't remember much about the night of the fire, when she was burned across her torso, neck and both arms, Nativa said.

Her family lived in an older home in a small village near Mykolaiv, the southern Ukrainian city that has been heavily attacked by Russian forces. It was soon after the war began when faulty wiring sparked a blaze that caught the entire family unaware, Nativa said.

Liza's sister and another child were pulled out of the house before they could be badly burned, but when a window was opened to get the children to safety, it supplied more oxygen to the flames, she said.

"Tiny Liza was lying in bed at the time of the fire, so when they opened the window … the fire grew," Nativa said. "She lost consciousness and luckily does not remember most of what happened."

On May 16, Liza underwent surgery in Poland to release the contracting scars to make it easier for her to turn her neck and lift her arms, but she didn't know that's why she was there.

"We didn't tell Liza she was having surgery today," Nativa said. "We told her that the doctor put ointment on her. … I didn't want to scare her that her skin would be cut."

When the nurses came to take Liza to the operating room, "I told her I lost my passport and had to look for it so that she would not be distressed with me leaving her side," Nativa said.

Whitney Roberts, a certified nurse anesthetist from Boston Children's Hospital, brought a bag of small toys for the Ukrainian children, and gave Liza a heap of stickers and crayons, a mini coloring book and a small blue knit octopi with little nubbins for tentacles.

The toys are a distraction, Roberts said, and help put kids at ease before surgery. It worked for Liza, who held the stickers gleefully. Within minutes, she was sedated and ready for surgery. And a couple of hours after that, Liza emerged from the operating room, curled up with her feathery blond hair askance and bandages from her belly to her neck. At the foot of her bed, the toys Roberts gave her were piled up, waiting for her to wake.

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Young girl seeks help in Poland after house fire caused severe burns

A young girl's family shelters her from realities of war and surgery even as U.S. doctors work to repair her severe burns.

Nativa rubbed Liza's back, speaking softly.

"When she asks why it is painful, we will explain to her that she has a scar, but soon we will go home — once it is better," Nativa said.

May 17 marked nine years since Volodymyr Bubela's accident, nine years since he was caught in a barn fire near Lviv, Ukraine, that engulfed his arms, legs, torso, neck and the side of his face in flames.

In the days after the fire, Volodymyr's injuries were so severe that Dr. Gennadiy Fuzaylov, a Boston-based physician and the founder of the nonprofit Doctors Collaborating to Help Children, coordinated a complex international effort to have him airlifted to the U.S. for lifesaving treatment by a team of doctors at Shriners Boston Children's.

Volodymyr stayed for six months, said his mother, Mariia Kit, and has needed repeated surgeries over the years as he has grown. Many of them, she said, were done in Ukraine, when Fuzaylov and his team of volunteer doctors traveled from the U.S. for annual medical missions.

"These doctors have had a huge influence on our lives," she said. "Dr. Fuzaylov, Dr. David Brown (a plastic surgeon from the University of Michigan), and the other doctors saved my child's life. … I am very grateful for that. Volodya was dying on the operating table, and they saved him.

"He is my only son," she said, eyes brimming with tears.

Volodymyr lost the fingers on his left hand and the external part of his right ear. Only a portion of the fingers on his right hand remain. Scars run up and down his arms, making it difficult to bend and straighten his elbows.

In the same week as the ninth anniversary of the fire that caused his injuries, Volodymyr, now 17, was on an operating room table again in eastern Poland, where Fuzaylov's team performed plastic surgery to ease the tightness and contractions in his burn scars.

"This is a difficult case," Brown said, as he examined an open wound on the back of Volodymyr's left leg. The medical team cleaned up the wound and bandaged it, and then turned the focus to his hands, arms and neck, trying to restore function.

Brown and two University of Michigan chief medical residents, Dr. Alfred Yoon and Dr. Gina Sacks, worked for about three hours on Volodymyr, along with Dr. Brian Kelley, a plastic surgeon from the University of Austin Dell Medical School, who previously trained with Brown at U-M; Dr. Shawn Diamond, a plastic surgeon with Texas Tech Physicians of El Paso, and Dr. Artem Posunko, a plastic surgeon from the Regional Medical Center of Family Health in Dnipro, Ukraine.

Volodymyr was released from the hospital the next day. At dinner, he sat by his mother, and was able to use his bandaged hand to lift a spoon and feed himself.

"I already see results of the surgery," Kit said. "He is moving his finger! Yesterday and this morning he was in pain, but in the afternoon he was able to use the spoon by himself.

"I want to say how important it is to have a possibility to turn to good doctors when your child is ill or in pain. Availability of the doctors, access to good medical care is very important."

Volodymyr said he has dreams of one day becoming a 3D designer, making 3-dimensional products from digital designs. He loves to play soccer with his friends.

"Yesterday, he was in a little pain," Kit said, "but he already danced today."

Zuza Nikitorowicz translated interviews for these stories. To contribute to Doctors Collaborating to Help Children, go to dctohc.org/donations.

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Ukrainian children face burns because of technology, infrastructure