Beyond Bombs: Rebuilding Ukraine's Human Infrastructure, One Surgery at a Time

LVIV, UKRAINE – November 27, 2025 – While conversations about rebuilding Ukraine often center on bridges, power grids, and digital networks, a more fundamental form of infrastructure is being painstakingly reconstructed in the quiet, focused intensity of operating rooms. This fall, for the first time since the 2022 full-scale invasion, a team of Canadian medical specialists returned to Ukrainian soil, not just to mend bodies shattered by war, but to reinforce the very foundation of the nation's healthcare resilience.

The Canada Ukraine Surgical Aid Program (CUSAP), a humanitarian initiative of the Canada-Ukraine Foundation (CUF), completed its 18th mission, moving its operations from the relative safety of Poland back into western Ukraine. This return is more than a logistical milestone; it's a powerful signal of progress and trust, demonstrating that the critical work of building long-term medical capacity can and must continue, even amidst the uncertainties of conflict. It underscores a crucial truth: before smart cities can rise, the human infrastructure—the health, well-being, and expertise of a nation’s people—must be secured.

A Mission of Precision and Resilience

Operating in partnership with Ukrainian hospitals in Lviv and Lutsk, the multidisciplinary Canadian team brought specialists in orthopedics, neurosurgery, and complex plastic and craniofacial reconstruction. The statistics from their 12-day mission are a testament to their efficiency and focus: 52 major reconstructive operations and 88 consultations. Among these were nine highly complex microsurgical free flaps, procedures where tissue, along with its blood supply, is transferred from one part of thebody to another to reconstruct devastating facial or limb injuries.

“To be back on Ukrainian soil, working side by side with our colleagues again, was profoundly meaningful,” said Dr. Oleh Antonyshyn, CUSAP’s founder and surgical lead. He described it as their “most efficient and cohesive mission to date,” a result of the deep integration between the Canadian and Ukrainian medical teams. This cohesion is a form of resilient, decentralized infrastructure in itself. Operating in a country where power outages can disrupt schedules and damaged supply chains can delay critical supplies for months, CUSAP’s self-sufficient model—bringing its own staff, surgical hardware, and supplies—is a vital adaptation to the logistical realities of a war zone.

These missions navigate immense challenges. The threat of missile strikes remains a constant, and the logistical hurdles of moving personnel and equipment are significant. The success of this mission is a case study in humanitarian logistics, requiring seamless coordination to ensure that the vital work of healing can proceed uninterrupted.

The Staggering Scale of Need

The return to Ukraine is driven by a need that can only be described as staggering. The full-scale invasion has not only created a massive number of casualties with complex trauma but has also severely disrupted Ukraine's own medical training systems. The United Nations projects that nearly 13 million people in Ukraine will require humanitarian aid in 2025, placing an unprecedented strain on a healthcare system under constant attack.

“The need for orthopedic and reconstructive expertise is staggering,” stated Dr. Michelle Hladunewich, a physician involved with the program. The injuries of modern warfare—blast trauma from shelling, high-velocity wounds, and severe burns—require a level of sub-specialized care that the war has made both more necessary and harder to provide. Patients often face delayed treatment, leading to complications that make reconstruction even more challenging. Stories like that of Oleksandr, a soldier who lost his mandible and lower face in a tank shelling, illustrate the profound impact of this work. His journey through multiple CUSAP missions, involving complex jaw reconstruction, has given him a future that was nearly erased.

More Than a Mission: Building Sustainable Capacity

While the immediate surgical results are life-altering, the strategic core of CUSAP’s work is its focus on long-term sustainability. This is not just about providing aid; it's about knowledge transfer. Every mission is an intensive educational bootcamp. Since the program's educational component began, over 40 Ukrainian surgeons and physicians have been embedded with the CUSAP teams, participating in every stage of patient care, from pre-operative planning to assisting in surgery and managing post-operative recovery. Some reports indicate that, more broadly, over 3,000 Ukrainian medical professionals have received some form of specialized training through CUSAP's various educational initiatives since 2014.

Dr. Antonyshyn emphasizes that the ultimate goal is to build self-sufficiency, empowering local surgeons to perform these advanced procedures independently. This transfer of expertise is the most durable form of infrastructure imaginable. It ensures that the capacity to heal remains in Ukraine, growing and adapting long after the visiting teams have returned home. It’s an investment that will pay dividends for thousands of future patients, strengthening the entire healthcare network from within and laying the groundwork for a robust, post-war medical system.

A Lifeline of Support

This ambitious undertaking is powered by a transatlantic lifeline of support. A recent national fundraising campaign led by the Canada-Ukraine Foundation raised over $1,000,000 CAD, funds that will directly enable future missions to address the backlog of craniofacial and extremity deformities. According to Charity Intelligence, an independent evaluator, CUF operates with extremely low overheads, ensuring that 99 cents of every dollar donated are available for the cause.

“CUSAP missions demonstrate what Canadian support makes possible,” said Valeriy Kostyuk, Executive Director of the Canada-Ukraine Foundation. “Returning CUSAP to Ukraine signals both trust and progress, proof that our collective efforts are helping rebuild the country’s medical resilience.” This return is a vote of confidence in the partner hospitals, like the Unbroken Centre in Lviv, and in Ukraine's ability to secure and facilitate these complex operations.

Ultimately, the work of CUSAP is a profound reminder that the future of a nation is built on the health of its people. Before any discussion of 5G networks, autonomous transport, or smart grids, there must be a resilient social fabric and the human capacity to thrive. By reconstructing faces and limbs, these medical teams are also reconstructing hope, and by transferring their skills, they are laying the most critical foundation of all: a nation’s ability to heal itself.