The Ukraine surgeon championing cleft surgeries in the midst of war

Dr. Natalia Tetruieva recently performed surgery on a 2-year-old child whose face had to be reconstructed after suffering injuries from the explosion of a leftover bomb in the city of Chernigov in northeastern Ukraine, which suffered heavy bombing by Russian forces for months early in the year.

When the war broke out in February, Tetruieva initially focused on providing emergency care for wounded soldiers and civilians. But she has since resumed performing maxillofacial surgeries for children, including cleft lip and palate surgeries, amid evacuation sirens, power outages, and bomb explosions — work that has earned her an award in October as one of 17 outstanding women in global health.

“Dr. Tetruieva’s work in Ukraine has been incredibly important before, but especially during, the war,” Olga Kudamanova, Smile Train’s program manager for Europe, told Devex in an email.

Tetruieva, who lives in Kyiv, is one of Ukraine’s leading maxillofacial surgeons. She leads a team of surgeons at OHMATDIT, a specialized hospital for children in the country, and one of the few standing operating facilities in Ukraine where surgeries for children with cleft lip and palate still continue. Such operating facilities in other parts of Ukraine such as Dnipro, Kharkiv, and Odesa have shut down.

She goes to work every day, even amid Russia’s ongoing war in Ukraine.

“It’s important because [cleft lip and palate] could cause feeding distortions, delay in speech development, and even affect a child’s facial development,” she told Devex from Kyiv.

Dr. Roopa Dhatt, the co-founder and executive director of Women in Global Health, said that Tetruieva “exemplifies the resilience and commitment of women leaders in global health.”

She has an “understated, no-nonsense approach to her work as a surgeon in the conflict in Ukraine,” Dhatt told Devex in a statement, adding, “She has chosen to stay in her country serving her people, children, and adults.”

It started with a wish

Tetruieva trained in cleft surgery in Germany. When she returned to Ukraine, she reestablished a cleft program at OHMATDIT and partnered with Smile Train in 2009 to help more children receive free cleft lip and palate care.

“Despite bureaucratic and other challenges, Dr. Tetruieva has succeeded in building and mentoring a comprehensive cleft care team, which, in addition to surgery, provides patients with orthodontic and speech treatment that is often necessary afterwards,” Kudamanova wrote.

During the interview, Tetruieva lit up whenever she spoke of her patients who have now grown up, some of whom are now in university, also pursuing medicine.

But her decision to pursue cleft surgeries came early in her medical career, when, while working with children with different health issues, a child with a cleft palate shared with her his wish of becoming “normal.”

“One of the children with clefts once told me that he made a wish that he would be normal just like everyone else. That made me pursue [a] career in the field of cleft because really these patients who are born with clefts can be and deserve the rights to become absolutely normal [looking] and sound just like everyone else and become proper members of the society,” she said.

But the war has opened up other needs, including emergency surgeries for children casualties of the war, such as from leftover, unexploded bombs.

“It was like … a situation that we had after the Second World War when children were playing outside and a mine was exploding,” said Natasha, Tetruieva’s daughter.

There were also cases when Tetruieva had to operate on civilians in Kyiv who were just having breakfast when a rocket explosion smashed their glass windows, leaving them with facial injuries.

Keeping at it at 74

Tetruieva said that the work at the hospital keeps her sane and serves as a distraction from “what's happening for now outside of the hospital.” But her daughter also underscored the mental toll doctors such as her mother had to deal with daily.

Many hospitals and health facilities have closed down or have been rendered inoperable from bombing. One of those included a children’s hospital and maternity ward in the city of Mariupol in March that grabbed international headlines. The World Health Organization surveillance has to date recorded 663 attacks on health care in Ukraine, and according to UNICEF in August, nearly 1,000 children have been killed or injured since February in Ukraine, with the true number likely much higher.

Two days before her interview with Devex, one of Tetruieva’s colleagues, Dr. Oksana Leontyeva, a child cancer surgeon, died after a Russian missile hit her car while she was on the way to work.

Tetruieva herself was just nearby when the explosion took place. But instead of going back home, her daughter said “she just walked [down] another street to work.”

But it illustrates the dangers health professionals face in Ukraine, and the difficulties they face in continuing their work.

“I think it's very important to understand that [explosions] can happen anytime. That can happen anytime they are in the operation, that can happen when they go to work. It can happen while they are on the bus, on a car. There is no … stability in the system,” Natasha said.

None of that deters Tetruieva, however, who, at 74, doesn’t see herself retiring any time soon.

“Sometimes I forget that I am 74 because I have many tasks which I would like to resolve,” she said. That includes teaching Ukraine’s young doctors on how to perform maxillofacial surgeries.

“I think it's my future to teach our young doctors to do what I do and to do it better,” she added.