Doctors of the Russian Children’s
We are very often involved in fundraising for bone marrow donor search and activation. Transplantation is very often considered the only possible way of treatment for our patients. When at last we have enough money to pay for donor search, the donor is found, very little we have to do is to bring the bone marrow to the patient.
The best bone marrow container is its owner, a human being. In any other type of container, even if it is made of pure gold or other precious material, blood cells live for 48 hours. It is not always possible, and in majority of cases impossible, to bring the donor to Russia and there are hundreds of reasons for it. So a hospital doctor goes abroad to deliver bone marrow.
Doctors from the Russian Children’s Clinical Hospital go to different parts of the world. They are to take the precious container and rush back to Moscow where a boy or a girl and their family are waiting for them in trepidation. To be as quick as it is only possible our doctors ask for help of local fire engines and ambulances, planes wait for them at the airports and land in extreme conditions.
For about two years Aeroflot has been presenting our heroic doctors with ‘Charity Miles’. It means our doctors can have free VIP class tickets. They need them not for extra comfort and luxury. VIP ticket holders must be given a place in any plane for any flight which is absolutely essential in such unpredictable trips as bone marrow delivery.
Words cannot express how much doctors, kids and their families, volunteers and hospital support staff appreciate such kind and noble actions. We all remember too well how things were before this Charity programme was initiated.
This is what doctors say about bone marrow transplantation and how it happens.
Mikhail Maschan, Head of Hematology Department #1, the Russian Children’s Clinical Hospital
Bone marrow transplantation is considered to be an effective way of treatment for leukemia and other blood diseases and the only possible way of getting over relapse. Unfortunately, Russia is lagging behind some developed countries in bone marrow transplantation – for example we started using unrelated donors only 5-6 years ago. About 50% of unrelated transplantations are a success which is not bad at all taking into consideration our short experience and complicated cases we deal with here at hospital.
As we do not yet have a donor data bank in Russia, Stefan Morsch foundation in Germany is currently giving us its helping hand. Morsch foundation is one of the biggest registries in Europe with the opportunities for donor search throughout the world.
If our patient needs bone marrow transplantation we do a special DNA test here in Moscow and send the patient’s DNA to Germany. For the donor search to start the test results must coincide in two independent laboratories. Donor search may take one week or eternity and some patients have to wait for the results for a year.
The donor found, the transplantation date is to be appointed. It depends on a lot of factors but in any case it takes 4 weeks minimum to activate the donor. What we need here is perfect coordination between the Foundation in Germany, Hematology Department in Moscow which prepares the patient for the transplantation and a local hospital which makes bone marrow ready for delivery to Russia. The day of marrow donation is the day for a Russian doctor to start their trip.
The doctor gets to the hospital at the appointed time and takes the bone marrow container. This is where the most difficult part of the job begins as there are only 48 hours at our disposal.
My last trip was to Germany, and the planned flight was to be from Munich and I was expected to come back to Moscow early in the morning after an 8-hour wait at Munich airport. Thanks to my VIP class ticket I was able to change my flight hours and arrive in Moscow 10 hours earlier.
I should say the first marrow delivery experience causes, in some way, an intensive adrenalin flow. When it is your tenth time it becomes a routine. Still, it is two days off work which a rare doctor can afford, to say nothing about Head of Department. That is why we are now trying to involve more doctors in marrow delivery.
Before charity foundations started to help us our patients’ parents had to pay for the marrow delivery. We booked the cheapest tickets and never knew if we would be able to come back in time. We were saving money and putting children’s lives at risk. When Aeroflot and Transaero companies started to help us we had a lot of problems solved. The company representatives always give us assistance in document preparation and tickets booking and changing in case of necessity.
There are different situations and you never know where you would depart from and when you will land in Moscow. Sometimes we are able to bring the precious container to the hospital 10 or 12 hours earlier. That is why we desperately need the opportunity to change place and time of departure.
There is something very nice in this joint effort as this cooperation of doctors, donors, volunteers, air companies and people donating their Charity Miles is not a personal matter of a sick child or their family but the whole country issue. We are very much supported by the thought of two biggest national air companies giving us their helping hand.
Marina Persiantseva, Doctor of Marrow Transplantation Department
We have 48 hours at our disposal. I have been involved in marrow delivery since 2003 when unrelated donor transplantation programme was initiated. By now more than 80 marrow transportations have been organized.
Germany is the most frequent place to visit as Germans are quite close to Russians genetically. At the same time donors for Russian children sometimes are found in the USA, the Czech Republic, Italy, France, etc. I am very sorry to say that the cost of these marrow deliveries is not covered by the state and every time we have to address charity organizations.
In February 2005 I was to bring bone marrow from Germany for 3 children. There was a snowstorm in Frankfurt and all flights were delayed. I saw I had no chance of coming back to Moscow in time. I contacted the Head of the air company telling him that 3 children were going to die without bone marrow transplantation. The Head thought carefully considering our chances and ordered a take-off. Fortunately, everything turned out nice and the kids got their transplants.
If it was an extreme take-off in Frankfurt there was also an extreme landing in Moscow. The plane was due to land in St.Petersburg instead of Moscow because of poor weather conditions and it was a disaster for 2 kids waiting in hospital for their transplants to arrive. The Captain of the plane crew decided to land in Moscow in spite of the weather, the storm and God knows what else.
In my first trips I was trembling like a leaf. It all reminded me of a dream when you try to reach some point and cannot move or move in a wrong direction. And this direction is not a bad wizard but a real child’s life. It is not bone marrow but somebody’s life in the container and I have no right to be late or make a mistake.
Now I feel more comfortable as I know for sure there are a lot of people ready to help.
People are usually very glad to take part in saving somebody’s life. I have never been refused any kind of assistance. People manage to find a way out of any situation and this is very much appreciated by our patients and their families.
Pavel Trachtman, Doctor of Marrow Transplantation Department
I delivered bone marrow more than 20 times, the majority of my trips were to Germany. The most difficult journey was to Japan to bring bone marrow for 6-year-old Valeria. The way back took 24 hours.
The most difficult thing in bone marrow delivery is limited time. You only have 48 hours and the worst worry is to be late for your flight. That is why it really matters if a doctor has an opportunity to have the time of their flight changed.
My first experience is bone marrow delivery for a small girl in 2003. It was the third unrelated transplantation in Russia. I am very glad to say that the girl then recovered and is now OK!
Larissa Shelikhova, Doctor of Hematology Department #2, the Russian Children’s Clinical Hospital
I brought bone marrow for 3 children from Verona, Hamburg and a small town near Munich. I will not say much about going to the airport in an ambulance and a fire engine with pedestrians and cars rushing aside. The trip to Hamburg was more or less easy which I would not say about Verona and Munich.
The most difficult thing is that bone marrow cannot be X-rayed at the airport and sometimes a doctor is considered to be a terrorist refusing to display the container at the customs office. We have to bring piles of documents and, fortunately, they do help.
Olga Makarova, Doctor of Hematology Department #3, the Russian Children’s Clinical Hospital
I brought bone marrow from Germany 3 times for leukemia children aged from 4 to 16. On the first trip I was very nervous and afraid of being late or doing the wrong thing. Usually doctors do not walk but run in such trips. In Tubingen I used two local trains with the time gap of 3 minutes between them.
The best time to arrive in Moscow is at night as there are no traffic jams.
A great pleasure is to meet our patients after they undergo transplantation and begin their way to recovery.