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An Island in the Storm


“Go to Vietnam and find a solution for child malnutrition in the 10,000 plus impoverished villages there. Oh, and by the way Jerry, you have 6 months to show results.”

This was the challenge given to Jerry Sternin back in 1990. Fast forward 20 years and now millions of children in Vietnam run around in flowing rice fields, seemingly with enough energy to last them all week. How did he do it you ask, by looking for bigger, more well fed kids, the bright spots in the villages, and creating a space where their moms could share their secret recipes with the moms of malnourished kids in village led cooking groups.

Launching a stroke project in a country with a nationwide recanalization procedure rate of less than 1% is no less daunting. For many patients in Ukraine, a stroke is a fatal diagnosis. Even with recent efforts to improve the awareness and treatment of stroke, the level of care is still wildly inconsistent. That is except for in one small city 260km south-west of Kyiv called Vinnytsia.

Approaching the hospital feels like stepping into an old sixties James Bond movie, but move inside to the stroke unit and you will find a beacon of hope. The stroke team under the leadership of Prof. Sergii Moskovko is able to treat in excess of 20% of their patients. In fact they treat more patients with recanalization therapy than all other stroke ready hospitals in Ukraine combined. It is no wonder then that when the Angels Initiative consultants started their activities in the field the first place they went to learn was Prof. Moskovko’s clinic.

In our experience from implementing Angels in other low – and middle income countries we’ve learned that there are often a thousand different reasons for why the situation is what it is and why it is impossible to change. It’s not that those issues did not exist in Vinnytsia, it’s just that they were considered TBU – True But Useless. There was no challenge that was not solvable with a practical local solution.

With a bag full of tried and tested local solutions, a mentor in Prof. Moskovko and renewed motivation that maybe, just maybe this time we can make a lasting difference, the Angels Initiative was launched in Ukriane. It was attended by 700 strokeologists from all regions of the country, including prominent experts like former Minister of Health and President of the Ukrainian Anti-Stroke Association - Prof. Mykola Polishchuk, Chief neurologist - Prof. Tamara Mischenko, Chief neurosurgeon - Prof. Eugen Pedachenko, Chief internist - Prof. Vasyl Netiazhenko, and of course, Prof. Moskovko, who had now become the National Coordinator of the Angels Initiative in Ukraine.

Since then the initiative; now with a distinct Vinnytsia flavour, is busy being implemented across the country and has caused quite a stir. It has been officially endorsed by the Ukrainian Anti-Stroke Association; the Society of Neurologists, Psychiatrists and Narcologists of Ukraine; the Association of Internal Medicine Doctors of Ukraine and the Ukrainian Association of Neurosurgeons.

It is very early in our journey, but the Angels Initiative in Ukraine has gained a momentum never before experienced in the country. From a standing start and with the motivation of Prof. Moskovko and the endorsement of the entire Ukrainian medical profession, the Angels network goes beyond simply adding value. It is proving that no matter what the situation, a solution is often only one bright spot away.