Bob Downs, a physician assistant from Lake City, Colorado, returned in June from his fifth medical mission to Ukraine. Downs has been volunteering in the war-torn country through the organization Global Care Force. He spoke with Laura Palmisano about his experience.
Laura Palmisano: Why do you keep going back?
Bob Downs: I guess early on I was drawn to do some mission work, but never really had the time in my career, and then Ukraine came up. I was able to do a little bit of research, found an organization, Global Care Force. I was very interested in what they were doing and what caught my attention is the fact that they were going back on a monthly, if not every other month basis, specifically for continuity in taking care of patients with primary care issues in Ukraine, and that certainly caught my attention because I feel as a medical provider, continuity of care is very important. Why I decided to keep going back…I will admit, the first trip I was mildly apprehensive about it, but learned very quickly that things there were fairly safe for the most part.
It was nice to get to work with the Ukrainian part of our team as well as the Americans on our team, and I got to know those folks. And of course, after completing my fifth mission, I count many of the Ukrainians that I've worked with on our team there as friends, and we still communicate when I'm not in the country or on these trips.
Palmisano: What have you seen change from your first medical mission now to your fifth?
Downs: The first medical mission, we were in a different part of the country in the far eastern part of the country, which now is actively involved in the conflict, and we haven't been able to get back there since. But the last four missions have been in the south of the country and we were based out of Mykolaiv, visiting villages somewhat to the east of Mykolaiv.
I've had the opportunity to go back to several of those villages multiple times now. I've gotten to see some of the same patients that I saw in some of those other visits. Again, the continuity I was talking about earlier. What I've found is the roads are still badly pocked marked from the times that those villages were occupied and in the south of the country most of those villages that were occupied, were occupied for up to seven months. And if they weren't occupied, they certainly were contested over. In other words, there was fighting in and around those villages, which affected the agricultural areas, and it made it difficult for people to actually work and plant the fields.
A lot of the fields were mined. There weren't a lot of fields planted on some of those earlier trips. On this last trip, I noticed that a lot more fields had been de-mined and were planted. And things are starting to get better. I noticed some of the clinics we functioned in which were badly damaged and now are starting to be repaired.
I think things are starting to get a little bit better. I can't say that the conflict itself is getting better, but at least in these occupied areas, folks are getting back to their normal lives. Although there's still a lot of post-traumatic stress I'm seeing in these villages as well.
Palmisano: What kind of medical care are you providing to patients in these villages?
Downs: The primary care that we're providing is basically hypertension management, type 2 diabetes management, some mental health management. A lot of these folks are not sleeping well, that sort of thing. And they aren't able to actually get into the bigger cities where they can get to a pharmacy to get their medications.
And that's one of the things Global Care Force does, is we actually bring medicines to them. We work from a formulary. We're able to provide up to 60 days worth of their medications for them. There are other aid groups that are going into these villages, but our impression is that they probably aren't bringing the medications with them.
And if patients have no way of getting into these bigger cities to a pharmacy, they're not getting the medicines that they need. Traveling to some of these villages is difficult. For example, in Mykolaiv, we're traveling up to an hour and a half to two hours on a daily basis just to go 50 kilometers, 20 kilometers to some of these villages because the roads are in such bad shape.
Palmisano: How are the Ukrainian people you're treating holding up?
Downs: Well, they're resilient people. They're very happy that we're still coming to see them. In fact, on each of the last two or three trips I've seen patients that I'd seen on previous visits, and they just were so grateful that we'd be willing to come back and that we haven't forgotten about them.
Generally speaking, their healthcare, I think, is improving slightly, but again, there's still a great deal of stress because they don't know what their future holds.
Palmisano: What are some experiences that stand out to you in your five medical missions that you've completed?
Downs: The last mission, we returned to a clinic we'd been to before and there was a woman coming in to be seen, and one of my colleagues was available to see a new patient, we were still finishing up with a patient. And as she was walking in the room, she exclaimed something and my translator kind of stopped what he was doing and chuckled. He says, she looked over here and said, 'you're my doctor. I'm gonna wait to see you.' And she went back down and sat down for us to finish so we could see her.
Palmisano: How are you and the medical providers staying safe?
Downs: We have a pretty good network on the Ukrainian side. We've been invited to be there as an NGO by the government of Ukraine. They know when we are there and there are members on our team that keep in close contact with other governmental contacts to know if the areas we're going to be working in are safe.
Since I learned that after my first trip, I'm very, very comfortable and I feel like we're fairly safe, at least as safe as you can be. I mean, let's be realistic, life has risks.
Palmisano: How many patients are you seeing on average in a day?
Downs: Generally speaking, most of the clinics are AM and PM clinics. We're seeing about 30 to 50 patients, depending.
I know on the last trip over the five days, 10 villages we visited, we saw 335 patients.
Palmisano: Is there anything else you'd like our listeners to know?
Downs: I think it's very important to know that this conflict is still going on. There's still a great need in Ukraine, and I think it's very important to continue to support organizations like Global Care Force who are providing primary care to the people of Ukraine during this difficult time.
Palmisano: Is that a Ukrainian flag on your porch?
Downs: Yes, it is. I got that the last time I was in Ukraine, that Ukrainian flag with blue on the top and the yellow on the bottom represents a wheat field as the yellow and the blue sky of Ukraine. We think of our flag and what it represents with the 13 stripes and the 50 stars. It's interesting, their flag represents something very important to them as well.
Palmisano: I see you're flying the Colorado flag, the U.S. flag, and the Ukrainian flag. What do those mean to you?
Downs: It's right near the 4th of July, and I would always fly the American flag, and of course, I'm very proud to be in Colorado now as well. And the Ukrainian flag is just sort of my way of trying to remind people of what's going on and how people in Ukraine are suffering right now.
Copyright 2025 KVNF - Mountain Grown Community Radio
