Bob Downs has worked as a physician assistant in the tiny mountain town of Lake City for the past decade.
The 66-year-old retired from full-time practice in February. Then in March, he went to Ukraine on a medical mission with Global Care Force, a nonprofit organization.
Downs needed to raise $6,500 to go on the trip. He surpassed that goal in a matter of days with a majority of his funding coming from the Lake City community.
Laura Palmisano spoke with Downs about his experiences in war-torn Ukraine.
Laura Palmisano: You retired in February, then in March, you headed to Ukraine. What were you doing in Ukraine?
Bob Downs: I was with a group called Global Care Force. They're a group that's been there since the conflict started about two years ago, and they are providing mobile clinics to provide primary care for folks that need it, (who) are either are displaced or they don't have any electricity or water, that sort of thing, and they'll go in and actually take care of their blood pressure, their diabetes, and all of their medical needs that are primary care needs, and they'll refill their prescriptions for 60 days at a time until they can get back and see them again.
In fact, that was one of the reasons I liked this group. There's continuity to what they're doing. They're not just going in one time, taking care of things, and then leaving. They actually are there on a continual basis, trying to get back to the same villages to run a clinic every 60 days.
Palmisano: Where in Ukraine did you go?
Downs: Getting to Kiev was the toughest part. We flew into Krakow, Poland, took an overnight train into Kiev, and then our first clinic was at a Nazarene church in Kiev where there are a lot of refugees. The church is helping those folks resettle there because they've been displaced. And we actually ran an all-day clinic there and saw about 77 patients that day.
And then the next day, we went out to do remote villages, the northern suburbs of Kiev, actually very near the Belarus border, probably within 50 kilometers of the Belarus border. We did two clinics, an AM and a PM clinic there, again, taking care of a lot of their primary care needs. Both of those villages were villages though that were occupied by the Russians during the initial push toward Kiev.
In fact, they pointed out a couple of buildings and a couple of the residents even discussed the fact that they actually were held prisoner in a basement of an apartment building there for about 40 days.
Palmisano: How long did you go? What did you see?
Downs: Most of these trips are planned out to be about 14 or 15 days. Again, it takes three days to get into the country. It takes three days to get out of the country. That leaves you with travel in the country, about seven clinic days. Basically, we left the first week in March on around the fourth. I actually arrived in Kiev around the seventh and we did our first clinic that day.
And then we left the country on the 17th as we made our way back to Kiev. Some of the clinics were in the far Eastern part of the country near Kharkiv. And some of the rural villages we worked in were actually north of Kharkiv, right along the Russian border. In fact, going into the first of those villages, we were within two kilometers of the Russian border, although the village itself was actually more like five to seven kilometers away from the Russian border. We actually could hear mortar and artillery fire that day.
Palmisano: You went to Ukraine and it's at war. Why did you do that?
Downs: Initially, I don't think we realized we were going to be that close because we were in an area that even our medical director said was considered a grey zone. When we were doing clinics in that part of the country, we actually were accompanied by a government ambulance, mostly to help us get through checkpoints and that sort of thing, and hoping that we wouldn't be fired upon, although again, I don't think we're at great risk at that point in time anyway.
Palmisano: When people came to your clinic, what were you treating?
Downs: Mostly ongoing chronic illnesses, a lot of diabetes care, we would check their blood glucose, make sure their diabetes medicine was still working and make sure that we could refill that medication. A lot of hypertension, we would double check their blood pressure, double check the medicines that they were on and adjust them if needed, otherwise we would just refill the medicines that they were in need of. Those sorts of things.
I did get to do one home visit. With a diabetic, an amputee, he was homebound, basically. And I got to take care of him, we checked his blood glucose, and we made some adjustment on his medication as well.
Palmisano: How many medical providers were in your group and where did they come from?
Downs: The American side of our team, the U.S. team, we were basically a group of six. There were two nurses, and then we had three providers, a physician who is an internal medicine specialist, and then two PAs, of which I was one of those. And then, of course, we had a behavioral health specialist, who was a specialist in post traumatic stress, as well as domestic violence.
Palmisano: What was it like being in Ukraine for you?
Downs: I found the Ukrainian people to be extremely friendly. All of the patients we saw in clinic were exceptionally appreciative of the care we were providing. I was very impressed with the resilience of the Ukrainian people too, especially when we were in Kiev, as well, as in Kiev life kind of went on.
I mean, people were doing the things that they would ordinarily do. They were going to work. They were shopping the way they needed to. Yes, there are a lot of buildings that are boarded up and yes, there still are under threat of missile attack, that sort of thing. But they seem to be going on with their life.
In fact, it struck me as having lived through 9/11, what we felt like maybe the week or two after 9/11, you know, we will not be terrorized, life goes on, and I sort of felt that way when I was there, and that was the impression I got from both the Ukrainians on our team as well as the folks we encountered in clinic.
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