"This disaster has its own specifics": the doctor - about the treatment of victims in Beirut, the nature of the injuries and the assistance of Rossotrudnichestvo

- Please tell us how you help the Lebanese side cope with the consequences of the disaster?

- Today is only the second day, yesterday we arrived. Yesterday was spent on organizational issues of interaction, together with the staff of the Ministry of Emergencies and the hospital. And today we are already directly engaged in our work: this is consulting the victims who are in hospitals in the city of Beirut. Today we managed to bypass five hospitals, examine patients, identify the most severe ones and outline further treatment for patients who are in intensive care. And I would especially like to note that operations have already been scheduled for three of them, the type of these operations has been defined, and they will be performed in the near future by our team's employees.

- You say you've already visited five hospitals in Beirut. What is the general picture now, what are the main injuries in people you are facing?

- This disaster has its own specifics, the overwhelming majority of the victims have superficial, relatively superficial, and some deep wounds from glass fragments. These fragments are actually secondary shells that are formed when the glass of window openings and display glass are destroyed.

Well, the specificity in Beirut is such that the outer wall of many buildings is represented entirely by glass. And, depending on what kind of glass it is and what kind of fragments, the victims receive injuries of one depth or another. In another group of victims, it is less numerous, injuries from heavy objects. Among them, most of all, we identified severe craniocerebral trauma and craniofacial, so-called, trauma - fractures of the bones of the facial skull. They actually require jewelry neurosurgical operations, restoration of the integrity of the bones of the facial skull, bones that make up the orbits where the eyes are. Of these patients, whom we have consulted today, three of them are scheduled for recovery operations.

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- When you talk about these jewelry manipulations, which should be performed with the facial bones of the victim, who will perform these operations? Will it be your team, the Lebanese side, or together?

- The specificity of our team is such that we form it from specialists of various profiles. The current team consists of two surgeons, pediatric surgeons, specialists in the treatment of extensive wounds, extensive injuries, and severe open fractures. Of two traumatologists who know absolutely all modern methods of osteosynthesis. Two anesthesiologists who administer anesthesia and intensive care. And a neurosurgeon. He is a highly qualified specialist who performs almost all operations: for spinal cord injury, for severe traumatic brain injury, and for such a craniofacial trauma. Therefore, these operations will be performed by our neurosurgeon together with Lebanese colleagues. 

- In many materials about your department, his profile is indicated as a child's.

- Since 1986 I have been working at the Vishnevsky Institute of Surgery (now the Vishnevsky National Medical Research Center of Surgery). In the department of wounds and wound infections. This department was unique in the Soviet Union. And the team of this department, headed by Professor Kostyuchenko and Academician Kuzin, at that time, the director of the institute, built a coherent theory of active surgical treatment of wounds, the principle of which we spread throughout the Soviet Union, and according to the principles of which all surgeons, including military surgeons, work helping the victims in the fighting. From a certain period I started working at the Institute of Emergency Pediatric Surgery and Traumatology. At the request of Leonid Mikhailovich Roshal, he organized a department of wounds and wound infections, in fact, a department of purulent surgery, already for children. And so, the employees of this institute just transferred all these principles developed in the adult segment to children. 

The second side is that, starting in 1988, when there was a catastrophic earthquake in Armenia, Leonid Mikhailovich Roshal formed a team of pediatric surgeons.

Not all adult surgeons understand the specifics of the child's body. It is necessary that the affected children be treated by pediatric surgeons who know exactly this specificity. Leonid Mikhailovich created a unique team of pediatric surgeons, the only one in the world, we call it Roshal's pediatric team, which subsequently worked in many foci of natural and man-made disasters, including in the centers of local military conflicts.

Today, this team has a wealth of experience, it continues to exist. We work together with Leonid Mikhailovich, we are in touch with him every day. He also created the International Fund for Assistance to Children Affected by Disasters and Wars, which provides assistance to our team. Therefore, it turns out that it seems like adults, like children. This has a positive feature: working with children in different countries, we help adults too. Because we cannot help only children in isolation, seeing that there are seriously injured adults. This helps to provide all-round assistance to the population who find themselves in such foci of defeat. 

- How did you decide on your direction to Beirut?

- It was on behalf of the RF Ministry of Health and the Moscow City Health Department. I would like to emphasize that in all previous trips it was not possible to arrange so as to take off immediately. Between the moment of the disaster and the time of our departure, it took from four to five to 10 days.

And now, thanks to Rossotrudnichestvo, which was recently headed by Yevgeny Alexandrovich Primakov, and thanks to our close cooperation, for the first time we managed to fly out literally the next day, actually after this catastrophe.

And many thanks to Evgeny Primakov and his team. They worked for 24 hours without interruption in order to make it all work out. And naturally, a big thanks to the Ministry of Emergency Situations, which provided the opportunity to fly to Beirut.

I want to note one more feature. There is a very large diaspora in Lebanon, let us call it that, graduates of Soviet and Russian universities, and especially graduates of the Peoples' Friendship University of Russia. More precisely, the Medical Institute of the Peoples' Friendship University of Russia. And the director of the institute, professor Abramov Aleksey Yurievich, helped us a lot in this. He put us in touch with alumni who are helping us. For them it is a native element, but for us it is an opportunity to work immediately, from the first hours, in normal conditions. Peoples' Friendship University of Russia, in close contact with Rossotrudnichestvo, also helps us in this process. They have amazing cohesion here. They know each other. And at the first call they provide us with assistants so that we do not feel any restrictions.

- How does the coronavirus pandemic affect your work?

- This, of course, is an aggravating condition. You have already felt what the weather is like here, what the temperature is. And with this high temperature and high humidity, it is necessary to wear some kind of restrictive devices that make breathing difficult, which make it difficult to care. Naturally, without these infectious moments it would be much easier to work. Nevertheless, you have to do your job. And I think that we will fulfill it, as we did in other countries.