OU Health's program followed Russia's full-scale invasion of Ukraine in February 2022. Dr. Mark Mims, an OU Health facial and plastic reconstructive surgeon, said members of the American Academy of Facial Plastic and Reconstructive Surgery started to serve Ukrainians with one-week medical mission trips. But, it couldn't meet the demand of patients requiring reconstructive surgeries.

"Most of their injured civilians and soldiers have received some sort of mine blast, rocket blast, missile attack, bomb, and so there is a large area of soft tissue and bone that is missing for these patients," Mims said. "Unfortunately, the medical training in Ukraine does not have the tools capable for treating these types of patients on a large scale."

In September 2022, the academy put out a call for anyone who wanted to create a training program in the U.S. for Ukrainian reconstructive surgeons to learn reconstruction techniques.

Enter OU Health's Operation Ukraine.

The nonprofit was created to financially support a one-month observership in head and neck reconstruction or advanced neurosurgery. Mims said he always felt a calling to help people beyond the U.S., so he became the program's director.

Since its first cohort in May 2023, Operation Ukraine has trained 15 physicians from cities like Kyiv and Lviv. The goal is to recruit surgeons from places that will have a high impact in the field of reconstruction.

"When the patients are injured in Ukraine, typically, this is on the Eastern Front, where the active war zone is," Mims said. "Those patients get stabilized, and then they arrive by train every two to three days to one of three main tertiary referral centers: Kyiv, which is their capital city, Lviv, which is on the far western area of Ukraine, near the Polish border, and Kharkiv, which is in the northeastern part of the country."

Dr. Andrii Kopchak is the chief of oral and maxillofacial surgery for the Kyiv Regional Hospital and part of the program's fourth cohort, which began their work in August. He said the techniques they're learning are unavailable at home due to resource and training gaps. That includes cadaver work, which is illegal there.

Mims said the primary techniques they're learning involve free tissue transfer, which includes taking a part of the body from one area and moving it to another part that needs to be repaired. The most common need in Ukraine is to recreate a jaw using a leg bone and its overlying skin.

Kopchak said 13% of the wounded who come into his department need complex microvascular reconstruction. It will take them years to get to everyone.

He's seen patients who have lost their jaws, eyes, noses, ears and, sometimes, their whole faces.

"They are extremely complex, and they are not commonly done in a regular manner in our peacetime conditions. But with the war, we need to learn and to study these techniques very quickly," Kopchak said.

Dr. Tetiana Pavlychuk is also an oral and maxillofacial surgeon. Following Russia's invasion, she and other staff lived at their hospital for two months. She said conditions at the Kyiv Regional Hospital have been impossible to live in.

While the unimaginable occurs back home, OU Health provides a safe place to train.

"Sometimes when we start a surgery we can hear rocket attacks somewhere," Pavlychuk said. "Sometimes, when we come to work ... our electricity [is] off. It's OK, because our hospital [has] a generator. We can work. We can continue our surgeries. ... It's absolutely 100% not like before."

Surgeons also learn in the operating room, where they observe and assist with surgeries on OU Health's advanced-stage cancer patients who require reconstruction after the removal of cancerous tissues. Other advanced technologies include smart glasses, which allow Ukrainians to call surgeons from OU for real-time consultations once they're home.

"You know, they're not obliged to help us at all, but nurses, all the staff are deeply involved," interventional neurologist Dr. Olexy Mykhailov said.

Mykhailov works with the National Military Medical Hospital in Kyiv. He left his service to become one of the first to participate in Operation Ukraine's new advanced neurosurgical training. It teaches advanced approaches to brain and spinal tumors, and interventional neurology, which treats aneurysms and strokes.

Mykhailov said these cases are an invisible threat.

"The beauty of the approach is that in [comparison] to the regular operation, that person ... could be discharged home or back to service. I mean, that's really [a] miracle," Mykhailov said.

Mykhailov said he's seen a lot of unpredictable health issues and death in his work, especially among the country's young and middle-aged men. But he said he has the strength to keep going because "the job is fruitful."

"The doctor [needs] to somehow split his or her behavior during the service because whenever you [become] emotional in each and every patient, you will be dead in [a] few weeks," Mykhailov said.

Working at OU Health has given Mykhailov a better idea of what an ideal setup of nurses and equipment looks like. He said it will help him figure out how to work with what he has in Ukraine and potentially help fill in the gaps later.

"Maybe we could address, even to some high level, basically, what our needs are, and, to sort that out. ... [We] absolutely understand what [needs] to be moved, and we will try definitely to do that when we're back," Mykhailov said.

Until then, Mykhailov said he is bringing back whatever neurosurgery books he can fit into his luggage and knowledge that could improve the lives of his community. He's also bringing back professional and personal connections.

Mykhailov said he was moved by Mims' hospitality and investment in the program. When the air conditioning went out in the place they were staying, Mims invited physicians to stay with his family until it was fixed. They even shared some of his wife's birthday cake.

"He is unbelievably good in engagement, if I may put it so," Mykhailov said.

As they return home, Kopchak said he is impressed with the high-quality training he received. A few of his colleagues back home have trained through Operation Ukraine, and together, they're building on the hospital's ability to meet the needs of their community.

Eventually, Mims said it's OU Health's goal to no longer be necessary because it will have prepared enough surgeons to provide care regularly. He said it's the honor of his professional career to work with the members of each cohort, and he's humbled by the knowledge and experiences he's gained from them.

Information on donating to Operation Ukraine is available on its giving page.