As a medical student, Shir Diner has dedicated herself to helping others.
WATERTOWN — Two weeks after returning from Poland in a whirlwind trip to aid adrift Ukrainian refugees, Milagros “Milly” C. Smith treasured a newfound sense of appreciation for the way she makes a living here.
“It was a very fulfilling and humbling experience,” said Mrs. Smith, chief physician assistant and practice manager at QuikMed Urgent Care, 727 Washington St. “I actually came back home and said to my husband, ‘I can’t believe I make money off what I do.’”
Mrs. Smith is spouse of Watertown Mayor Jeffrey M. Smith, who co-owns and operates QuikMed Urgent Care with his wife.
“Obviously, I have to make a living,” Mrs. Smith said. “But for me to deliver care and for it to be so easy for me to be around people that were just so genuinely grateful and humbled by the fact I was there. They felt like, ‘Wow! You came here to help us. All the way from the United States.’”
Mrs. Smith spent a week in Poland — Oct. 17 to 22 — as part of a 12-member volunteer team through the organization Lev Echad (One Heart), an Israeli volunteer humanitarian crisis relief group.
Mrs. Smith, the only non-Jew in the group, said her trip was the third contingent of ones Lev Echad has organized to help Ukrainian refugees fleeing to Poland following the February invasion of Ukraine by Russia. The groups mainly consist of medical providers.
“This group originated in New York City,” Mrs. Smith said. “I have a friend there and they had a delegation.”
The participants pay their own way — a $2,000 donation — to participate. Air fare is not included. The donation also covers such matters as hotel accommodations and meals.
“The next delegation they’re trying to put together is for January, in the middle of winter,” Mrs. Smith said. “They figure people are going to need a lot of help.”
Mrs. Smith said she found herself in high demand with her delegation because it consisted mainly of specialists in surgical fields and that she was the only primary care provider on the team.
“I ended up doing a ton of work because most of what the Ukrainian people and the Ukrainian refugees needed was primary care service,” she said.
Mrs. Smith estimated that she saw approximately 200 patients of all ages. Most were women and children.
“It was masses of people lining up,” she said. “When they heard we were American, they were even more infatuated.”
She was asked why she thought that was. “I think they felt that they were getting better care. And they did. Some of the people said they were going to some of the clinics and nobody was listening to them.”
According to UNICEF, Poland has welcomed more Ukrainian refugees than any other country.
In a July news release, Felipe González Morales, the United Nations’ special rapporteur on the human rights of migrants said, “I’m impressed by the government of Poland for providing significant support to a huge number of refugees fleeing Ukraine in such an intense period. At the same time, we must pay tribute to Polish citizens who have shown solidarity and generosity to Ukrainian refugees. Over 2 million refugees currently stay in Poland and most of them are hosted as guests in private homes by Polish people.”
On Tuesday, the New York Times , in a story headlined, “In Poland, Warm Welcome for Ukrainian Refugees Wobbles,” reported: “Around 20,000 people now arrive in Poland each day from Ukraine, a number sometimes matched or exceeded by those going in the opposite direction.”
A non-stop mission
For Mrs. Smith and her team, their work was non-stop, except for about five hours of sleep each night. After arriving in Krakow at 1 p.m. Oct. 17, Mrs. Smith and the Lev Echad team leader, Shir Diner, headed for a refugee home on the Ukraine border, in Rzeszów — the largest city in southeastern Poland. It was a 2½-hour train trip to get there and the destination ended up being two refugee homes. Each had several families — moms with their children.
“By the time I saw everybody, it was 9 at night,” Mrs. Smith said. The team spent the night in a hotel near the refugee home. At 5:30 the next morning, they woke to catch a train back to Krakow.
Mrs. Smith was impressed by the fortitude of the mothers she treated.
“They’re resilient,” she said. “If they lose their spouse, yes, obviously emotionally it’s going to be devastating. They’ll survive. They’re all survivors.”
But Mrs. Smith said she saw many sad cases involving children. One involved a young boy with a questionable tumor on his brain.
“He was scheduled to have a follow-up, and there was none,” Mrs. Smith said. “The mom was trying to communicate this, and obviously very concerned, saying her husband was at war, she had cervical cancer and now she had this 12-year-old who was developmentally delayed and didn’t know how to access the resources to care for her child.”
The team communicated with their Ukrainian patients and Polish hosts through translators and phone apps that translated voices and documents.
“It was really sad to see that the population was uprooted from their communities and who fled to Polish soil,” Mrs. Smith said. “They were uprooted to a land where they didn’t know the landscape, the language, they didn’t know how to navigate with resources. So many of them were sick and they didn’t know how to get hold of a doctor. And when they did go to a clinic, they couldn’t communicate.”
The Lev Echad team went to designated refugee homes and refugee centers.
“We ran a different clinic every day of the week we were there,” Mrs. Smith said, and that she helped to run clinics for senior citizens, a pediatric clinic, and a disabled children’s clinic; the latter which was particularly “heart-breaking,” she said.
“These were orphaned children from Kyiv, and they were removed because of the war and transposed into a new rehab center in Krakow,” she said.
At another clinic, she said a 74-year-old woman arrived and shortly collapsed and that it took 40 minutes for an ambulance to arrive. The woman had gone into cardiac arrhythmia, she said.
“When she fled Lviv into Krakow, she couldn’t get refills on her medications,” Mrs. Smith said. “She had a heart condition that required daily medication and she had been out of it for three weeks.”
Mrs. Smith grew amazed that the ailments her patients suffered from were very well documented.
“They all had folders of their medical information that they brought with them,” she said. The documents included lists of medications.
“We can’t even get that here,” Mrs. Smith said. “So many times I see patients and it’s ‘I don’t know.’ They have no idea what they’re on.”
Diagnosing and deciphering
The evidence of lives and daily routines suddenly being turned upside down for the refugees was plentiful. Mrs. Smith gave two examples she said she experienced.
“We had someone with cervical cancer who was scheduled for surgery. We had to find somebody for her,” she said.
Another patient arrived at a clinic with a “very obvious melanoma on her arm.”
“It was flagrant,” Mrs. Smith said. “And she was supposed to see a dermatologist in Ukraine and it never happened. So we had to scurry and find somebody. We thought this is really bad because there’s no way this hasn’t spread yet. We had some grave illnesses that we had to scramble to find some kind of connections for them so they could get the follow-up care they needed.”
But most cases with the older population, she said, involved common morbidities such as diabetes, hypertension and high cholesterol.
“We had one person who was very concerned about all of a sudden he gained a lot of weight,” Mrs. Smith said. “We looked at his labs and he clearly had hypothyroid (underactive thyroid) and no one had ever told him.”
In that man’s case, it was a prescription for levothyroxine. But Mrs. Smith said she saw many patients who were bewildered about their prescriptions.
“A lot of people came in and said, ‘This is my list for medications. I don’t know why I take them. Could you explain them to me?’”
Mrs. Smith said the team also discovered that many of the drugs go by different names in Eastern Europe.
“The only way we could decipher that they were the same was by looking at the active ingredients,” she said. “Plus there was a handful of medications they use that we had never heard of. But when we looked it up, it was — ‘Oh! That’s the same as this.’ So, it took a lot of digging to try to help people with their meds.”
Many patients had an urgency to return to their homeland in Ukraine.
“We had two people who were going back to Lviv to see their doctors to get their medication,” Mrs. Smith said. “It’s still accessible, but most people who fled to Poland are just afraid. Their husbands are at war and they don’t want to be at home by themselves.”
In a small village near Krakow, Mrs. Smith and team members were posted one day at an orphanage, a refurbished rehab center, containing handicapped children.
“These children were very limited,” Mrs. Smith said. “Some were non-verbal, most of them had cerebral palsy.”
The children were very well taken care of, Mrs. Smith said, but the Lev Echad volunteers had trouble when it came time to get medications dispensed. “In Poland, they don’t honor international medical licenses,” she said, and that pharmacies didn’t want to dispense medications to any of the volunteers.
But a small pharmacy was found near Krakow, Mrs. Smith said, and after some persuasion, success was achieved.
“I went to the pharmacy and just said, ‘I’m a medical provider in the U.S. doing some mission work here,’” Mrs. Smith said. “They knew the rehab center, knew the children were limited there and they did dispense the medications I needed. I worked really hard with the other two doctors I was with and said, ‘These children need this medication.’ We’re going to take it back.’”
Mrs. Smith said she had promised the house mother of the rehab center such success when she left for the pharmacy.
“She didn’t think we were coming back,” she said. “When we did, she started crying and said, ‘Do you know how many people come here and say they going to come back and help us, and they never come back?’ I felt so bad for them.”
“I gave her the bag of medicine,” Mrs. Smith said. “We sat down, went through every single kid that needed some medicine and she wrote it all down. They were just so grateful, just so humbling. They hugged and kissed us and gave us traditional Ukrainian bread that they bake, saying ‘Please take this.’”
But Mrs. Smith took away something much more.
“It was just so …” she said, before pausing to find the words to put the situation in perspective.
“You know, here, I run this urgent care and people get pissed off because they’re waiting five extra minutes, or because you tell them they have to wear a mask or because you didn’t give them the medicine that they want. It’s just so different when you’re put in a position where people actually appreciate medical care. That, for them, it was golden that we were there.”
Since she returned, the delegation leader, Ms. Diner, has been in regular contact with Mrs. Smith, who has appreciated what she has heard.
“So far,” she said, “all the people that I took care of have gotten the follow-up that they needed.”
Thank you for your care and contributions, Ms. Smith.
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