November 10, 2000

Paul Shellito, MD, of MGH Surgery, considers his recent trip to Ternopil, Ukraine, an eye-opening experience. Since the country achieved independence from the Soviet Union in 1991, Ukraine has experienced an economic depression, which has affected all areas of life, particularly the way health care is provided. While on a weeklong visit sponsored by the Rotary Club International, Shellito witnessed a struggling health care system and saw first hand the poor conditions in which the Ukrainians live.

Shellito has been a member of the Rotary Club in Boston for 10 years and was selected by the club to visit the Ternopil Regional Center of Minimally Invasive Surgery (TRCMIS) to assess the needs of the clinic. Shellito, along with another Boston Rotarian, toured the city of Ternopil (population 230,000), visited two state hospitals, the clinic and two schools, met the city's mayor and stayed with a Ukrainian family. "I found the hospitals to be quite grim and poorly supplied," says Shellito. "The people I met there are trying very hard to work with very little. The trip was a moving experience."

Health care in Ukraine is supposed to be completely government supported and provided at no cost to residents, but because of the poor economy, hospitals and clinics are run on shoestring budgets. Physicians are seldom paid, equipment is outdated, and medicines and supplies are limited. According to Shellito, patients often must buy their own supplies and medicines and pay the doctors unofficially before receiving care. Because of the high cost, most people with serious illnesses do not get the care they need.

Shellito, on right, inspects an antiquated anesthesia machine in the clinic.

As a longtime member of the MGH surgical staff, Shellito's expertise was welcomed by the TRCMIS staff, who hope that their minimally invasive approach to surgery will help the clinic provide better care at a reduced cost to patients. The clinic is a nonprofit organization and the first private medical clinic in the region. With seven physicians on staff, the clinic performs approximately 300 operations a year, along with hundreds of other procedures such as endoscopies and colonoscopies.

Although the clinic aspires to be successful, it is struggling at best. It is in need of donations of any kind, especially anesthesia machines and monitors, ultrasound equipment and computers. While privatizing health care with clinics such as the TRCMIS might be part of a long-term solution to the ailing system, donations from organizations like the Rotary Club and interest from physicians like Shellito are what help the clinics survive.

"This was the first time I've made such a trip since I've been at the MGH," says Shellito. "It was an eye-opening experience, and I hope that I can continue to try to make a difference there."