Wartime Pathology
How Ukrainian pathologists and laboratory medicine professionals are serving their patients – even during a war
Ivan Damjanov interviews Oleksandr Dudin and Oksana Sulaieva
A photograph taken from the window of Medical Laboratory CSD.
Tell us about your laboratory…
Medical Laboratory CSD (“Care and Safe Diagnostics”) was established in 2010 to focus primarily on anatomical pathology but expanded in 2013 to add cytology and molecular pathology services. In 2020, despite COVID-19 and pandemic restrictions, the Clinical Pathology Union was launched. Michal Michal and our Czech colleagues at the Bioptická Laboratoř, Plzen, contributed significantly to CSD Lab’s development and its alignment with international standards.
Now, CSD Lab is one of the largest laboratories in Ukraine, with unique expertise in clinical and anatomic pathology. Combining diagnostics with research, CSD collaborates actively with more than 700 hospitals and many universities in Ukraine and abroad. It occupies over 3,000 square meters of space and is equipped to provide modern histopathology, immunohistochemistry, molecular pathology, and clinical pathology services.
Before the war, CSD Lab had two hubs of diagnostic activity: anatomic pathology and clinical pathology. The central laboratory is (or was) located near the center of Kyiv, but we operate 60 laboratory points throughout Ukraine for sample collection and handling; it allows us to be close to people in every part of the country, providing them with fast, accurate diagnostics.
A military checkpoint in Kyiv.
How has the Russian invasion affected pathology practice in Ukraine?
Russian aggression has broken many aspects of the health system and heavily affected laboratory practice. The war and continuous bombing of Kyiv and many other Ukrainian cities halted the activities of many health care institutions, including laboratories. Two of CSD Lab’s sites were damaged during the bombing.
Unfortunately, Russian rockets also destroyed many living spaces, administrative buildings, childcare facilities, universities, and hospitals. People with small children spent days and nights in underground shelters to survive.
Due to the imminent danger from Russian bombardment, we have transferred our entire operation to Lviv with the support and financial assistance of our friend and colleague Michal Michal. By now, we are fully operational in our new location and have resumed the pathology services our clinicians need.
Ukrainian air force shooting down a Russian plane over Kyiv.
Are you still functioning exclusively as pathologists or have you taken up other duties?
Oleksandr Dudin, CSD Lab’s chief executive officer, supported Ukraine’s armed forces and participated in defending Kyiv’s boundaries – as did many pathologists. Others volunteered to support the defenders or work at blood transfusion stations.
Many pathologists now combine their usual functions with the work of laboratory technicians and administrators because of the shortage of resources and people. Despite all the challenges of the war, we keep working for Ukrainians and supporting our most vulnerable, including oncological patients and children.
A column of Russian tanks stopped and burned out by Ukrainian defenders 20 meters from Kyiv.
What are the most pressing challenges faced by pathologists?
The first days of the war, with their frequent air raid alarms and explosions, induced fear and panic. Many people could not believe they were living in such a reality. Some lost their homes and had to find shelters. The main challenge we faced was supporting and protecting our staff – and continuing our laboratory’s work for the Ukrainians who need us. And that’s why, when the situation in Kyiv became critical, we made the decision to evacuate our staff and part of our facilities.
Due to extensive migration, most cities in western Ukraine are overcrowded, so it was difficult to find a place for the lab, make logistical arrangements, and rent living spaces there – but our staff joined forces to get us to Lviv. Colleagues and friends who are residents of Lviv and other western regions of Ukraine provided support to refugees, sharing their homes with those who had lost their own.
The main building of the CSD laboratory – 3,000 m² – now empty.
How have medical schools been affected by the war?
By now, most universities in Central, Southern, and Eastern Ukraine have halted all activities because of the danger to the lives of students and teachers. Many international students have been evacuated to Western Ukraine or abroad. Some are trying to continue their education online, but not all have Internet access and the opportunity to study.
Moving the CSD laboratory from Kyiv to Lviv.
What can pathologists in other parts of the world do to help their Ukrainian colleagues?
We feel and appreciate the support of pathologists and researchers from all over the world. In addition, some associations have provided free memberships and offered positions in laboratories.
It is difficult to imagine what further actions pathologists could take to support Ukraine now, but perhaps it would have an impact if sanctions against Russia were extended to every health care institution and professional society.
The time when we will need the most help is after the war – to restore our facilities, research, and diagnostic activities. We hope we will be able to call on our friends and colleagues for support then.
We believe in Ukraine and Ukrainians. Our country has become a symbol of freedom and dignity. We believe that humanity and critical thinking will overcome Russia’s unreasonable aggression. We believe in our victory. We believe in peace!
Oleksandr Dudin is CEO at Medical Laboratory CSD.
Oksana Sulaieva is Medical Director at Medical Laboratory CSD, Kyiv, Ukraine.
Professor Emeritus of Pathology at the University of Kansas, Kansas City, USA.
