Ukraine is indeed a geopolitically diverse nation. There is much history and understandable thirst for true freedom and servant leadership. Ukrainians haven’t had much of that kind of leadership. Consider the Holodomor in 1932–1933 when Stalin starved millions to death in Ukraine over a squabble with Ukraine’s farmers; the many more millions who died in World War II, their own Holocaust, and the deaths caused by not only Hitler but by Stalin; and Stalin deporting the Crimean Tatars en masse to Central Asia after World War II and Russians put in Crimea in their place. The list goes on and on.

It is a tribute to the human spirit and to Ukrainians that they stand strong to try to unify their country, whether Ukraine-centric or Russian-centric, in achieving true freedom. Allegiances can be mixed, but desire for freedom will triumph. Last November, their President, Viktor Yanukovych, was anticipated to sign an agreement to a path to joining the European Union. However, when he arrived in Vilnius, Lithuania for the meeting, it all changed when he declined to sign the EU membership agreement. That reversal and decision instead to accept a $15 billion loan promise and 30 percent reduction in natural gas costs extended by Russian President Vladimir Putin is what set off the current mass protests at the Maidan  (a rallying site in downtown Kyiv for protesters) and in other cities in central and western Ukraine. Many in Ukraine resist the notion of becoming a modern-day version of a Soviet republic.

The degree to which President Yanukovych and his son and their friends have plundered Ukraine’s limited wealth and used it for themselves is astounding. Regardless of what else might happen, we should all hope and pray that Ukraine achieves true freedom and finds true servant leaders. It deserves nothing less.

A Complex and Dangerous Situation

As this is written, Putin is occupying Crimea with some 18,000 troops and many armaments. The average Ukrainian is very worried about Putin’s ambition and aggressiveness, according to Sergei Bolyukh, MD, a friend and general surgeon in Vinnytsa, Ukraine. There is fear that Putin will move even further into Ukraine under the pretense of protecting Russian-centric Ukrainians from the temporary Ukrainian government appointed by the Rada (parliament) upon former President Yanukovych’s departure from Kyiv to Russia. There is, per Sergei and the international media, no evidence that the Russian-centric Ukrainians are in any peril of any kind. In fact, with the call for a new presidential election to take place May 25, the hope of the majority of Ukrainians is to continue a path to true freedom and unity. Unity is stressed and is key to Sergei and to Ukraine. This is not to the exclusion of a peaceful relationship with neighboring Russia but specifically to include that relationship, but in a way that respects established internationally recognized borders.

When Sergei and I spoke on Feb. 20, and he told me that his son, a neurosurgeon, had been manning a medical tent at the Maidan and that his son was in tears, I knew things had really worsened … To hear Sergei ask for my prayers and those of my family …well, I cried, too.

It is understood that Putin is keen to maintain the Russian Black Sea fleet in Russia’s only warm seaport, Sevastopol, which Russia has leased until 2042. Ukraine may need to extend that indefinitely as part of any accord moving forward. However, the blunt truth, per Sergei and others in Ukraine with whom I have spoken, is that they feel like Putin is being allowed to “rape us.” They feel the EU and the United States are being too slow and not harsh enough with sanctions and in isolating Putin. The Russian people in Russia have a long tradition of powerful leaders who they seldom stand up to, even if they are unsure of their leader’s wisdom. At this moment, Ukrainians live in fear for their future as a free country.

It is one thing to watch the news on TV, to have numerous Facebook posts shared with you, to watch the Internet news and various TV reporting. Today everything is so “out there,” so different from Sergei’s and my younger years. But when Sergei and I spoke on Feb. 20, and he told me that his son, a neurosurgeon, had been manning a medical tent at the Maidan and that his son was in tears, I knew things had really worsened. Sergei himself had been manning such a medical tent for weeks before. His son told Sergei of the brutal snipers killing dozens of unarmed protesters and his painful witness to the death, helplessness, and agony, with hundreds of others injured. To hear Sergei ask for my prayers and those of my family … well, I cried, too.

How Ukraine Became Important to Me

In April 1996, long before the ACEP International Section launched the Ambassador Program to facilitate international emergency medicine collaboration worldwide, I made my first trip to Ukraine. My wife, Catherine, and I had experienced a spiritual awakening, and our church was sending a family to live in Vinnytsa, Ukraine. The link was a family having moved from Vinnytsa to Franklin, Tenn., and sharing with their new church in America, where my wife and I are members, the needs of Ukraine as the nation was emerging from the Soviet era as a newly independent nation (as of 1991). I distinctly remember stepping off the airplane in Kyiv that first trip and feeling like I had landed in enemy territory, not because of the people—they were warm, although initially guarded—but because, after all, my sixth-grade class was repeatedly marched to the fallout shelter because of the Cuban Missile Crisis. So going to a part of the former Soviet Union was a mixture of anticipation, excitement, and some concern.

But my concerns were replaced by warmth when I met Sergei and his family. Over the years, Sergei has met my family, too, and visited our home. He is a graduate of Pirogov Medical University in Vinnytsa, and was the first surgeon in Vinnytsa Oblast to agree to operate on known HIV-positive patients. Since we first met in 1996, he has developed a strong outreach to poor patients and HIV-positive patients and those recovering from alcohol and/or drug addiction.

We had both had a spiritual awakening not long before we first met. He was born in 1949 and I in 1952. We were “Cold War” kids. He had been a leader of the Communist Party medical wing in Vinnytsa Oblast. I was a kid who grew up in a GM family, moving often until I settled outside Detroit in the early 1960s. Then I went on to university and medical school and to a relatively wealthy existence compared to Sergei’s. Could we have been more different? What were the odds that we would become best friends?

That was 32 trips ago. Having spent well over a year of my life in all areas of Ukraine, I can say that it is indeed my second home. Their emergency physicians ride on ambulances. They don’t work in the hospital as we do. What a fascination it has been to ride in ambulances with their doctors in cities across their nation. On one such ambulance run, the patient was a former Soviet army general with chest pain. He had never had an American in his home. He formerly commanded an Intercontinental Ballistic Missile facility where the missiles were all aimed at America. By the end of the visit we hugged. It’s a true joy to break down walls.

Medical collaboration over these 18 years has taken on many forms: the honor of speaking at Pirogov Medical University in 1996 on HIV emergencies; collaboration with that university and with teams of other American or Canadian doctors on educational programs; sponsoring Ukrainians needing heart surgery as their nation’s heart surgeons developed greater expertise; launching a program in 1998 for the use of high-dose ACE inhibitors for systolic heart failure; bringing Ukrainian doctors to Vanderbilt University School of Medicine, where they were welcomed by the dean and Department of Emergency Medicine; hosting Dr. Georgiy Roshchin of Ukraine’s Disaster Medicine Program in Denver at ACEP 2012; working with churches that run drug and alcohol rehab centers; assisting doctors and nurses in providing care at desolate orphanages; and sending more than 20 containers full of medical supplies and equipment to Ukraine through Project C.U.R.E. of Denver and Nashville. Well, you get the idea—this has been my passion.

Many in Ukraine resist the notion of becoming a modern-day version of a Soviet republic…Regardless of what else might happen, we should all hope and pray that Ukraine achieves true freedom and finds true servant leaders.

During the last several trips, it has been a treat to travel far and wide in Ukraine with a new friend, Vitaliy Krylyuk, MD, the chair of the Ukraine Resuscitation Society. Vitaliy ushered us from city to city across Ukraine as we presented “Highlights of ACLS, PALS, NALS, and ATLS.” The last trip in September 2013 took us from Kyiv to Ternopil, Lviv, Vinnytsa, Mohyliv-Podilskyi, and finally to Sudak in Crimea. Joining me were Sergei; our translator, Ruslan Tkachuk (who, along with his wife, runs a foster home in Nemia, Ukraine, on the Moldovan border); and American doctors Michelle Sergel, MD, of Cook County Chicago, Shannon Langston, MD, of Vanderbilt EM and a former international fellow there, and Mark McLean, MD, a fellow TeamHealth leader of Maury Regional EM in Columbia, Tenn (see photo). All of us have been in agony watching the recent events unfold, especially since we were so recently traveling through Crimea.

Dr. McMurray and colleagues during their September 2013 trip to Ukriane. Pictured, from left to right, are Dr. Gudma, the host in Ternopil; Dr. Shannon Langston of Vanderbilt EM; Dr. McMurray; Dr. Vitaliy Krylyuk of Kyiv; Dr. Sergei Bolyukh of Vinnitsa; Dr. Michelle Sergel of Cook County, Chicago; and Dr. Mark McLean of Maury Regional EM and Team Health, Tenn.

ACEP International

The roughly 10-year-old ACEP International Ambassador program is a wonderful opportunity to serve in international emergency medicine, whether it is in Ukraine or in numerous other countries around the world. The program was launched in 2004 as a means of organizing and further developing and coordinating many efforts already taking place among ACEP members in international emergency medicine. The field of international emergency medicine has since grown greatly in scope, with dozens of international emergency medicine fellowships now existing in the United States and abroad. ACEP’s international Emergency Medicine Section provides all forms of networking and leadership to deepen the work of collaboration worldwide. In this coming year, we will see the development of the international liaison physician program within our ambassador program. This will facilitate ACEP membership by EM physician leaders from other countries served by the ACEP Ambassador program.

I encourage all ACEP members to become members of the International Section and to find their niche. Look at our blog at www.ukrainemedicalmission.com to gain more insight on outreach to Ukraine. We anticipate our next trip to occur in September 2014. You might want to participate.

A friend of mine once told me that, in going to Ukraine to help others, he had learned the difference between success and significance. I encourage you to find out that difference firsthand for yourself.

Dr. McMurray is medical director of the Wayne Medical Center Emergency Department in Waynesboro, Tenn., and medical director of First Stop Urgent Care in Columbia, Tenn. He is the ACEP International Ambassador to Ukraine. Since 1996, he and his wife, Catherine, and their three daughters all have been to Ukraine, initially on trips focused on helping orphanages.