On the night of Wednesday 3 March, Critical Care Doctor James Tooley was on call for paediatric retrieval. His phone buzzed, but what met his eyes was a WhatsApp message asking him to attend a very different type of call-out, one to help support getting some very sick children out of Ukraine.

Preparing to help

The children were receiving treatment for advanced stages of cancer. An effort was underway to try and move them from a hospital basement in Kharkiv to the Ukraine/Poland border. They had already moved twice following shellings to their shelter and they’d experienced periods of no water and electricity. On top of all this, they were running out of chemotherapy drugs.

James had been contacted seven days into the war for his paediatric expertise. His initial response was, “Of course, I will.” James also realised this mission very much fitted the pre-hospital work of Great Western Air Ambulance Charity (GWAAC) so he put out a call to the crew for help. Within ten seconds, Medical Director and Doctor Ed Valentine responded to say, “I’m in.”

Discussions then followed around how this mission might happen. And on the Friday, during a shift with GWAAC, he got the call to say it’s happening and asked if he could come as soon as possible.

With the backing of GWAAC, they were able to collect drugs and equipment, and be ready to fly out two days later on Sunday.

According to Doctor Ed, “The challenge was not having much time to prepare. Part of the problem was we had no idea what state these children would be in when we got to them, so it was hard to work out what kit to take.”

The doctors had to consider all sorts of factors including the type of journey the children would face. It could take two or three days at best and there was the problem of roadblocks, diversions, missing signposts, and the potential of being caught up in military action. The doctors would be meeting very sick children with lots of medical needs and potential trauma injuries.

“We didn’t quite know what to expect or what kit to take, what drugs, and how much. And we didn’t know how to get it onto a commercial airplane through customs. We were quite limited; we couldn’t take the drugs we’d normally carry in the air ambulance because they’re controlled drugs and can’t be taken out of the country, and we also couldn’t take blood across borders.”

Critical Care Doctor, Ed Valentine

They ended up taking lots of bags to cover all scenarios. They staggered to Stanstead with about sixteen different bags to meet their contact – a military medic from the Israeli Special Forces.

Arriving in Poland

Doctor James and Doctor Ed flew to Krakow in Poland, picked up a hire car, and booked into a hotel. Krakow is about two hours from the Poland/Ukraine border but hotel accommodation nearer to the border was fully booked.

More planning ensued over the next couple of days. They drove to the border to work out where the children could be taken as there are multiple border crossings. There was also the possibility that if things went wrong in the extrication, the children could be diverted to the Slovakian border or Moldova border, and James and Ed would have to travel down to meet them.

Following a drive around with guide Gregor, they formed a plan for getting to the relevant crossings at the border and they prepared the kit so it was ready to go. The frustration came with the realisation that any intentions of going into Ukraine to help transport or meet the children would be too risky and uncertain.

The updates coming through were very changeable: one day they’d have contact with the children, the next day they’d lose contact. And the biggest dilemma was that if they went in, there was no guarantee they’d be able to get back out quickly and safely. There were four-day delays to get back across the border into Moldova. And even the Ukraine/Poland border had 24-hour delays.

It was all very unknown and the delays across the border added to the uncertainty of the children even starting the journey. A lengthy delay at a border crossing on top of grueling travel would be very serious for such sick children. Doctors James and Ed made a compromise — they decided that if they heard the children were definitely on route, they would hop across the border and try and get them to a safe place with local intelligence.

It’s about the process, not the outcome

Sadly, the decision to move the children looked less and less likely. Doctor James and Doctor Ed were hearing reports that the Kharkiv Hospital doctors and nurses were having doubts about moving some of the very sickest children. They were concerned about the delays in travel and the worst-case scenario of having to turn back; their fear was the sickest children would not make it. The group was starting to fragment; there were stories of parents borrowing vehicles in attempts to move their own children out of the hospital and out of Ukraine.

Doctor James said, “Another prime concern of ours was not to add to the drama over there. The border was saturated with people. People have tried to help by bringing kit and supplies but there’s nowhere to stay and so they end up sleeping in the refugee camps and eating the hot soup and tea which we all really want to go to the refugees.”

For James and Ed, it was about doing their very best to help without adding any extra burden to the situation.

After spending a few days with poor information and no signs of the children starting the journey, the Critical Care Doctors decided it would be best to return home — a hard decision to make.

Doctor James, who’s been a consultant for over twenty years said, “I’m the first person to say that success shouldn’t be judged on the outcome but on the process. As a Critical Care Doctor for GWAAC, I know that the important thing is the process of giving someone the best chance of survival.”

Despite knowing this, both Doctors felt like they’d left a job half-finished. Doctor Ed said, “We had a huge desire to go out and help and we’re both bitterly disappointed we didn’t achieve what we wanted to. But a positive is we’ve made some connections which means we might get other requests to help in the future.”

More to do

Doctor James and Doctor Ed feel that there’s more they can do to help — they’ll be keeping their ears to the ground for other opportunities. Sadly, it’s now too dangerous to go into Ukraine but another option could be helping transfer sick and injured babies and children out of Poland to surrounding countries.

Doctors James and Ed were part of a huge and ongoing effort to help the people and children of Ukraine. Their particular mission was a privately funded independent exercise. The generous benefactors offered the Critical Care Doctors a daily wage but James and Ed knew that by donating their wages to Ukrainian charities they could make an indirect difference to the children of Ukraine.

Video messages from children of a local orphanage saying, “Thank you Doctor James and Doctor Ed for our new shoes” certainly brought a smile to the doctors’ faces.

Find out more about our lifesaving work with children