Ukrainian Loss and legacy – Amanda Howe reports


A visit to the Ukrainian Association of Family Medicine (UAFM)

Professor Grygorii Lysenko was a famous Ukrainian scientist, a gifted teacher and organizer, the Director of the first Institute of Family Medicine of National Medical Academy of Postgraduate Education (NMAPE), Head of the first Department of Family Medicine, and the President of the Ukrainian Association of Family Medicine until his death in October 2013. He was a founder of family medicine in Ukraine; his life was dedicated to development of medical science and family medicine, and the improvement of the system of postgraduate medical education of family physicians in Ukraine.
Professor Lysenko was a highly intelligent person, talented mentor and teacher, who with many of his students and colleagues successfully worked on the development of family medicine. He was a really wise, highly respected teacher and doctor, and a friendly and sincere person.

Under his leadership, the first Faculty of Family Medicine was established within the Institute, and the speciality was formally recognized in 2010, although the UAFM has existed for 15 years and FM started 25 years ago. Prof Lysenko worked tirelessly to bring together academic and community leaders and organizations for the effective implementation of family medicine in Ukraine, and was active in WONCA for the informing and supporting of the development of FM in his beloved country. More about Prof Lysenko.

It was at his invitation prior to his death, and therefore with both pleasure and sorrow, that I visited Ukraine from 22-24 October to speak at the UAFM national conference. I was also able to visit a family medicine clinic, and was hosted for meetings with the Institute (NMAPE) and the Ministry of Health. I would like to report the following good news: reforms in the health system of Ukraine which support the development and prioritization of primary health care are now under way in four pilot regions, and there was a clear commitment to the establishment of family medicine and modernization of primary care across the whole country over the next phase leading up to 2020.

The conference itself was impressive, with 1300 registered participants, and centres all over the country being linked into the plenaries (video-connection registered about 10 000 participants by internet) – we could see halls full of delegates and hear their local FM leads speaking and asking questions! This was through interactive connection with six universities. The Minister of Health connected by video on the second day of the conference. (Note the WONCA editor is reliably informed that the Minster of Health spoke about Prof. Amanda Howe’s positive attitude towards local health reforms in the evening news on TV).

Both Prof Janko Kersnik (President of EURACT) and I were present, and were delighted to hear WONCA mentioned positively and repeatedly by other plenary speakers. In spite of the loss of Prof Lysenko, spirits were good and the Ministry were clearly backing the Family Medicine Association.

However challenges remain, and the UAFM Council had a list of recommendations from 2012 which remain to be actioned, which include issues around training capacity, support for FM CPD, FM exposure in basic medical school training, and a number of other issues. The numbers of FM practitioners are expected to more than double, so while these are exciting developments the challenge for the existing FM faculty is great. It will be really important to support Ukrainian family medicine in what is a crucial era.

Prof Lysenko left a huge legacy of good work and goodwill, but, as in so many countries, the expectations of family medicine are huge, and lack of resources or effective stabilisation of the new primary care reforms could undermine what otherwise would be a strong and effective model of care that is sorely needed by the Ukrainian population.

It was a great honour to be at the meeting, and to be hosted there. My particular thanks to Associate Professor Dr Victoria Tkachenko (pictured with Prof Amanda Howe), WONCA Council representative for Ukraine, who was a wonderful host and role model for the younger doctors. Prof Lysenko should be proud.