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Top 5 Priority Interventions to get Infection Control to the Next Level
Infection Prevention and Control (IPC) in healthcare settings relies heavily on training, proper infrastructure, and equipment. For Ukrainian hospitals conflict conflict-affected areas, maintaining these essential systems presents significant challenges.

High costs, equipment scarcity, and limited technical expertise create barriers to adequate IPC implementation. This article explores five critical infrastructural interventions that humanitarian and development agencies can support to strengthen IPC capacity in Ukrainian health facilities.

1. Ventilation Assessment and Maintenance

Air in hospitals must meet far stricter standards than in most other places, and for several important reasons:
- There is a higher risk of airborne spread of pathogens, including through aerosols generated from the lungs.
- The are usually more people with infectious diseases in the hospitals.
- Some medical conditions make patients much more vulnerable.
- The procedures performed in the hospitals might raise the quality standards to the highest level possible.
- There are not that many alternatives for the patients. They cannot simply change the ward or go outside to catch some fresh air, because they are concerned. They are in the hospital for a reason, and usually those reasons might prevent them from being fully mobile or expirience life fully.
Considering all the above, it might seem odd that the ventilation in hospitals is often neglected and overlooked. In Ukrainian hospitals, properly maintained ventilation is more like an exception than a rule. This high bears a significant risk, specifically for patients in these departments:
- Burn treatment units,
- Operating theaters or a surgery room,
- Stroke units and rehabilitation facilities,
- Chemotherapy units.
Ukrainian health facilities face substantial obstacles in maintaining ventilation systems. The costs associated with professional assessment, routine maintenance, and equipment upgrades often exceed available budgets.

Despite regulatory requirements outlined in sanitation norms for health facilities, many hospitals lack the resources to ensure compliance.

Vintilation maintenance is an extremely challenging task that requires both expertise, special equipment, and an investment

Key barriers: High maintenance costs, lack of specialized assessment equipment, and limited technical expertise.

Target facilities: Surgical departments, burn units, operating theaters, and intensive care units.

Implementation considerations: Agencies should engage ventilation specialists to conduct baseline assessments, establish maintenance schedules, and provide training to facility staff on basic monitoring techniques.

2. Biological Safety Cabinet Validation

Biological safety cabinets serve as essential protective barriers in clinical laboratories and TB treatment facilities. These wardrobes prevent hazardous material from escaping, protecting both healthcare workers and patients from exposure to infectious agents. Without proper maintenance, the cabinets may fail to contain infected material from contaminating the environment.

The primary challenge lies in validation costs and technical requirements. Specialized equipment and trained technicians are needed to verify that cabinets maintain proper airflow patterns and containment capabilities.

Many Ukrainian laboratories, particularly those in primary and specialist care settings, cannot afford regular validation services.

Essential maintenance activities:
- HEPA filter replacement at recommended intervals
- Electronic component inspection and calibration
- Airflow pattern verification
- Containment testing
Target facilities: Clinical laboratories, TB hospitals (first and second grade), infectious disease departments

Potential agency support: Agencies can subsidize or fully cover validation costs, establish maintenance contracts with qualified service providers, or support the procurement of validation equipment for regional laboratory networks.

3. Provisions of Radiometers

Ultraviolet germicidal irradiation (UVGI) lamps play an important role in reducing airborne bacterial contamination in healthcare settings. However, without proper monitoring, facilities cannot verify whether these systems function effectively.

Radiometers help to determine whether the UV output, produced by the germicidal lamps, is enough to kill all the germs.

This intervention represents a relatively low-hanging fruit for agencies seeking to improve IPC infrastructure:
- The equipment is widely available on the market
- It is portable – you don’t need to install it
- It usually comes with a decent warranty > 2 years
But there is a catch – there are some basics you have a learn. And by basics mean not only an operational manual or some “features” of the particular model. Most of our medical staff have never used it before, so they should be familiar with how to read the numbers.

Implementation approach:
- Distribute radiometers to facilities using UVGI systems
- Conduct training sessions on proper measurement techniques
- Establish protocols for regular lamp output monitoring
- Connect facilities with sector experts for technical guidance
Target facilities: Primary care clinics, specialist care hospitals, and any facility using UV bactericidal lamps

Agency advantage: This intervention requires minimal ongoing costs after initial distribution and training, making it sustainable for facilities to continue independently.

4. Closed System Drug Transfer Devices

Certain medications, particularly chemotherapy agents, are better not to leak into the environment. Exposure to them, even in the smallest amounts, with inhalation or skin contact, can lead to significant health issues, specifically for those staff working with them for years.

Closed system drug transfer devices (CSTDs) can contain those medications safely and safeguard health workers and patients.

Procurement of these systems for each individual patient can be a serious financial burden for hospitals with oncology, hematology, or transplantation departments.

Primary beneficiaries:
- Oncology departments
- Hematology units
- Emergency departments handling chemotherapy patients
- Surgery and transplantology departments
- Pharmacy compounding areas
Implementation requirements. Agencies must work closely with facilities to assess current practices, identify appropriate CSTD systems for their workflows, and provide comprehensive training on proper use. This intervention works best when integrated into broader programs supporting oncology or specialty care.

5. Sharp Container Distribution

Sometimes the simplest interventions address the most persistent needs. Sharps containers prevent needlestick injuries and the transmission of bloodborne pathogens, including HIV, hepatitis B, and hepatitis C.

While often taken for granted in well-resourced settings, Ukrainian health facilities continue to experience shortages of these basic safety supplies, particularly as the ongoing conflict disrupts supply chains and strains budgets.

This intervention suits both humanitarian and development actors across all levels of care. The need is universal, implementation is straightforward, and the impact on healthcare worker safety is immediate and measurable.

Why this remains critical:
- Ongoing conflict disrupts regular supply chains
- Budget constraints force facilities to prioritize clinical supplies over safety equipment
- High staff turnover necessitates continuous availability of safety supplies
- Prevention of occupational exposure protects an already strained healthcare workforce
Implementation flexibility: Sharp container distribution can stand alone as a quick-impact intervention or integrate into comprehensive waste management programs. Agencies can combine distribution with training on safe injection practices, waste segregation protocols, and occupational health monitoring.

Target facilities: All levels of care, from primary health centers to tertiary hospitals

Conclusion

Infrastructure-based IPC interventions offer agencies tangible ways to improve patient and healthcare worker safety in Ukrainian health facilities. While some interventions require significant technical expertise and resources, others provide accessible entry points for organizations of varying capacities.

When selecting interventions, agencies should consider their technical expertise, financial capacity, and existing relationships with health facilities. Ventilation and biological safety cabinet programs demand specialized knowledge and sustained funding. Radiometer distribution and sharps container provision offer more accessible options that still deliver meaningful IPC improvements.

Regardless of the chosen intervention, success depends on collaborative planning with health facilities, engagement of technical experts, and commitment to both initial implementation and ongoing support. In the context of Ukraine’s protracted conflict, these infrastructure investments protect not only individual patients but also the healthcare workforce upon which the entire health system depends.
December 3, 2025
4 Tools to assess an Inclusive Design in Institutions in Ukraine
In today’s article, I want to present the team’s effort of developing a tool for the assessment of the infrastructure of institutions (health and educational facilities, boarding houses, village clubs, etc.) for core principles and norms of universal design and inclusivity.
The Global Movement Toward Universal Design

In 2007, the United Nations ratified a convention that would become a watershed moment in the global disability rights movement. On a single day, 82 countries signed the Convention on the Rights of Persons with Disabilities, setting a record for the highest number of signatories on an opening day for any UN convention.

This landmark treaty became the fastest-negotiated human rights convention in UN history, reflecting unprecedented international consensus on disability rights. On July 30, 2009, the US became the 142nd country to sign, followed by Monaco on September 23 as the 143rd signatory. Today, three-fourths of countries worldwide have signed this transformative convention, marking a fundamental shift in how societies understand and address disability.

Ukraine was one of the first countries to sign and ratify this convention.

Over the past half-century, the concept of disability has undergone a dramatic transformation. Universal design and inclusive design have evolved substantially, both as legislative frameworks and as practical design concepts.

An ageing population is a main driver for inclusive design

This evolution began for many countries with the realization of their aging populations. Advances in medicine meant that people who previously would have died from various conditions were now surviving and participating in society. Additionally, returning veterans from conflicts, including World War II and the Korean War, brought the needs of people with disabilities into sharp focus, catalyzing significant changes in civil rights movements.

Currently, Ukraine is facing both a mounting number of victims of war and an ageing population, so developing an inclusive environment is critical on both community, institutional, and political levels.

The Evolution of Accessibility Standards

The accessibility movement in the United States gained particular momentum in the realm of education. The landmark 1954 Brown v. Board of Education case established the principle that “separate is not equal,” initially applied to racial segregation but later extended to broader inclusion concepts.

By 1961, the US had developed the first specifications for making buildings and facilities accessible for people with handicaps, published by ANSI (American National Standards Institute). The Civil Rights Act of 1964 represented another landmark achievement, responding to demands from civil society movements during a period of rapid economic growth.

One of the first comprehensive checklists of inclusive design was developed by ANSI in 1961

The Minimum Guidelines and Requirements for Accessible Design were published in 1981, followed by the Americans with Disabilities Act (ADA) guidelines in 1991, which remain one of the primary prescriptive frameworks in the United States today. These developments reflected a growing understanding that accessibility was not merely a matter of accommodation but a fundamental right.

Ukraine’s Commitment to Inclusive Design

Ukraine was among the signatories of the UN Convention on the Rights of Persons with Disabilities, demonstrating its commitment to international standards of accessibility and inclusion. The most prescriptive concepts of universal design were incorporated into Ukraine’s DBN (Derzhavni Budivelni Normy), or state construction norms. The latest revision of these norms occurred in 2018, with a strong focus on inclusive design principles.

Building on this legislative foundation, our team developed four comprehensive tools to assess the accessibility and universality of infrastructure integration in Ukrainian institutions. The development process involved dividing our team into four groups, each bringing expertise in engineering and humanitarian design principles.

All team members had at least two years of experience working in international organizations and had been implementing WASH (Water, Sanitation, and Hygiene) programs for two years, ensuring they possessed the practical experience necessary for this work.

Core Principles Underlying the Assessment Tools

All four assessment tools share a fundamental approach centered on the user journey. Our primary persona is a person with restrictive mobility, which includes:
- wheelchair users,
- parents with small babies,
- elderly,
- people with temporary disabilities (after surgery, injury, etc.),
- those using other assistive devices (walkers, crutches, etc.).
Personas for the user journey for our assessment tools

Each assessment tool visualizes and models the complete user experience, from entering the facility compound to using washrooms, elevators, and physicians’ offices.

This comprehensive approach ensures that no aspect of accessibility is overlooked.

The foundation of these tools rests on core principles of Design for All (DfA), which state that products and services must be:
1. Demonstrably suitable for most potential users without any modifications.
2. Easily adaptable to different users through adaptable or customizable interfaces.
3. Capable of being accessed by specialized user interaction devices and assistive technologies.
4. Developed with the involvement of potential users in all phases of development.
Tool 1: The Binary Assessment Tool

The first tool in our suite is the Binary Assessment Tool, designed by Igor Onyshchenko and tested by Olga Shtepa in one of Ukraine’s clinics. This tool features 64 yes/no questions, making it straightforward and user-friendly with a minimal learning curve required.

During field testing, the team successfully assessed a clinic and determined it was 92% ready in terms of accessibility compliance. The

Binary Tool’s strength lies in its simplicity and clarity. Each question can be answered definitively, allowing for quick assessments that provide a clear percentage-based understanding of an institution’s accessibility status.

This tool is ideal for organizations conducting initial accessibility audits or for teams without extensive technical expertise in accessibility standards. Its straightforward approach removes ambiguity and enables rapid deployment in field conditions.

Download binary tool

Tool 2: The Automation-Based Assessment Tool

The second tool represents a more sophisticated approach, incorporating software automation to streamline the assessment process. This tool is designed to reflect the model of the WASH FIT (Water and Sanitation for Health Facility Improvement Tool) assessment framework, using a three-point scale of 0, 1, and 2 to evaluate accessibility features.

With over 25 questions for comprehensive assessment across all categories outlined for the assessment tools, this instrument requires more experience to use effectively. However, it offers significant advantages in return for this complexity. The tool utilizes elaborate Excel formulas to automatically calculate scores, reducing manual computation errors and saving time. Notably, it includes an integrated slope calculator, which proves invaluable for rapidly evaluating ramp compliance with accessibility standards.

This automation-based tool is extremely powerful but requires users who can interpret Ukraine’s state construction norms and make nuanced judgments about partial compliance.

It is designed for people with previous expirience in inclusive design. The tool’s open-ended nature allows for more detailed evaluation of complex situations, though this same flexibility demands greater expertise to use accurately. Designed by Dmytro Meroniuk and tested by Roman Kolos, this tool represents a significant advancement in balancing comprehensiveness with usability.

Download Automation tool

Tool 3: The Humanitarian-Focused Assessment Tool

The third tool may be the most strategically valuable for humanitarian organizations operating in crisis contexts, as it not only assesses accessibility but prioritizes interventions based on criticality. This tool employs a four-point scale: fully implemented, partially implemented, not implemented, and not applicable. What distinguishes this tool is its integration of criticality categorization for each indicator.

The assessment framework assumes three levels of criticality:
- completely critical (marked in red),
- intermediate priority,
- lower priority (green)
Based on these categorizations, different scores are assigned, creating a weighted assessment that reflects real-world impact on users. An experienced assessor can use this tool to design immediate humanitarian implementation plans, creating a matrix of interventions prioritized by criticality.

This approach offers the shortest lead time from assessment to intervention, making it particularly valuable for humanitarian actors who must make rapid decisions about resource allocation. The tool clearly identifies the most critical gaps, explains why these gaps present the greatest barriers to accessibility, and generates actionable results. For organizations working in emergency or resource-constrained environments, this prioritization function is invaluable.

Designed by Yurii Usenko and tested by Tetiana Klymenchuk, this humanitarian-focused tool bridges the gap between assessment and action.

Download Humanitarian inclusive tool

Tool 4: The Evidence-Based Comprehensive Assessment Tool

The fourth and final tool represents the most structured and scientifically rigorous approach in our suite of inclusive assessment instruments. Designed by Nadia Marchenko and tested by rehab specialist Andrii Gavrylenko, this tool was built on the foundation of previous research and tool development experiences, truly standing on the shoulders of giants in the accessibility assessment field.

This tool is exceptionally well-designed, well-structured, and scientifically approached. It incorporates safety indicators, reflecting the expertise of one of Ukraine’s strongest infection prevention and control (IPC) specialists and epidemiologists. The tool is beginner-friendly while remaining comprehensive and structured, making it accessible to newer practitioners while providing the depth required for thorough assessment.

What makes this tool particularly valuable is its evidence-based nature. It incorporates previous experiences in developing similar assessment instruments, grounding its methodology in tested approaches.

The tool is built primarily around Ukraine’s DBN state construction norms but also integrates sanitary norms and infection prevention and control protocols, creating an innovative intersection of accessibility and health safety standards.

This represents one of the most scientifically proven and evidence-based assessment scales in our collection. It is the ideal choice for organizations seeking a reliable tool built on previous research experiences in Ukraine, for those who need an instrument that has been validated through prior implementations and assessments, and for practitioners who want assurance that their assessment methodology is grounded in established best practices.

Download Scientific Assesment tool

Choosing the Right Tool for Your Context

Each of these four tools serves distinct purposes and suits different organizational needs and contexts. The Binary Tool offers simplicity and speed for quick assessments. The Automation-Based Tool provides depth and computational power for experienced assessors. The Humanitarian-Focused Tool prioritizes action through criticality weighting, perfect for emergency contexts. The Evidence-Based Comprehensive Tool offers scientific rigor and validation for organizations requiring documented methodologies.

Together, these tools represent Ukraine’s commitment to implementing the principles of the UN Convention on the Rights of Persons with Disabilities in practical, contextualized ways. They reflect an understanding that accessibility is not a one-size-fits-all proposition but rather requires flexible approaches that can adapt to different institutional contexts, organizational capacities, and urgency levels.

Moving Forward: From Assessment to Inclusion

As Ukraine continues to align its infrastructure with international accessibility standards, these assessment tools provide essential mechanisms for measuring progress and identifying gaps. They transform abstract principles of universal design into concrete, measurable criteria that can guide institutional improvements.

The development of these tools reflects a broader understanding that true inclusion requires not just good intentions but systematic approaches to identifying and addressing barriers. By providing multiple pathways for assessment—from simple binary evaluations to complex, evidence-based frameworks—we ensure that organizations at various stages of accessibility maturity can engage meaningfully with the challenge of creating truly inclusive institutions.

The journey toward universal accessibility is ongoing, and these tools represent important milestones in that journey for Ukraine. As we continue to learn from implementation experiences and international best practices, these instruments will evolve, incorporating new insights and adapting to changing contexts. What remains constant is the commitment to ensuring that all individuals, regardless of their abilities, can access and participate fully in institutional life—a commitment enshrined in international law and increasingly embedded in Ukrainian practice.
November 29, 2025
How Cash for Medical Transportation is Transforming Healthcare Access in Conflict-Affected Ukraine
In the newly liberated regions of Ukraine, receiving a medical referral is only half the battle. For patients in remote, conflict-affected communities, the journey to specialized care can be as challenging as the health condition itself. Our experience deploying mobile health teams revealed a stark reality: even when we eliminated service costs and facilitated quality referrals, nearly half of patients still couldn’t access the care they needed.

The missing piece? Transportation.

The Problem: A 50% Gap in Healthcare Access

When we launched our integrated mobile health teams in December 2022, starting in Kharkiv oblast and rapidly expanding to Zaporizhia, Kherson, and Mykolaiv, we built what we thought was a comprehensive referral system.

Our teams— some of them comprising Ministry of Health medical personnel, psychologists, and social workers—were reaching remote communities through trusted local channels.

We mapped referral facilities across multiple categories: specialist consultations, diagnostic services, imaging, procedures, and hospitalization.

We implemented rigorous quality assurance protocols, including direct facility contact, appointment booking, and systematic follow-up.

Yet our positive referral rate stalled at 45-50%, far below our 70% target.

Diagnosing the Barrier

Through bottleneck analysis, we identified two primary obstacles preventing patients from accessing referred services:

Service costs were the first barrier. Many patients simply couldn’t afford the medical services they needed, even when clinically necessary. Our solution was to integrate with the Ukrainian’s government Medical

Information System (MIS) to facilitate e-referrals, channeling patients through the medical guarantees program that covers service costs. We automated the process through SharePoint Lists and Power Automate, creating a seamless workflow from our mobile teams to government coverage.

The results were encouraging—positive referral rates climbed to 58-60% for e-referrals. But that still left 40% of patients unable to access care, even when services were completely free.

Transportation costs emerged as the persistent, critical barrier. In remote, conflict-affected areas, public transportation is often nonexistent. Private transportation comes at a cost many families cannot bear, particularly when facing the compounding pressures of displacement, loss of income, and ongoing insecurity.

The Solution: Cash for Medical Transportation

Understanding that financial barriers required financial solutions, we developed a targeted cash transfer program specifically for medical transportation. The program was designed with several key principles:

Evidence-Based Calculations

Rather than arbitrary amounts, we built a distance-based calculation model:
- Assumption: 12 liters of fuel per 100 kilometers
- Costs factored: fuel, vehicle amortization, maintenance, plus a 10-15% buffer
- Coverage: round-trip transportation for the patient
- Maximum payment: 1,800 hryvnias (~$45 USD)
- Average payment: 1,100 hryvnias (~$27 USD)
We created a living matrix based on beneficiary location and referral site distance, updated every six months to reflect fuel price fluctuations.

Clear Eligibility Framework

Inclusion criteria focused on patients with clinically sound, evidence-based referrals that didn’t require regular, frequent visits—ensuring we addressed acute access barriers without creating long-term dependency.

Exclusion criteria prevented mission creep: no support for medicine procurement or ongoing treatments requiring weekly or monthly visits. Patients could receive cash support only once every six months, with rare exceptions.

Secure Transfer Modalities

We prioritized accountability through formal transfer channels—bank transfers or UkrPoshta (postal service)—rather than cash-in-hand. While this added a 1.5-month lead time, it ensured traceability and reduced risks.

The Results: A 30-Point Increase in Access

The impact was clear and consistent. You can dive into the numbers in the page dedicated to the program analysis.

With cash support:
- E-referrals: 80-82% positive referral rate
- Standard referrals: 78% positive referral rate
Without cash support (control group):
- E-referrals: 58% positive referral rate
- Standard referrals: 55% positive referral rate
Cash for medical transportation increased successful referral completion by approximately 25-30 percentage points. Critically, it worked across both groups, whether or not service costs were covered through e-referrals. This confirmed that transportation represents an independent, addressable barrier to healthcare access.

Lessons Learned: Continuous Improvement

No program is perfect from launch. As we’ve scaled, we’ve identified areas for improvement:

Multi-Tiered Communication

UkrPoshta cash delivery, while secure, isn’t foolproof. SMS notifications fail, patients don’t answer calls, or network coverage is spotty. We developed a three-tiered follow-up protocol:
- Plan A: Direct contact from nurses and doctors;
- Plan B: Community health workers provide in-person notification, leveraging local trust and presence.
- Plan C: potential Viber or a text messaging upon the transfer of cash.
This approach ensures accountability to affected populations even when standard channels fail.

Enhanced Data Collection

We currently lack systematic data on negative referrals where cash support was provided. Understanding why patients who received funds still didn’t access services is critical for continued improvement. We’re exploring ways to shift this data collection to office staff, reducing the burden on our mobile teams whose capacity is fully occupied with clinical duties.

Statistical Rigor

While our trends are encouraging, we’re working to strengthen our analytical foundation with larger sample sizes and longer observation periods to draw more definitive conclusions about program effectiveness.

Implications for the Humanitarian Response

Our experience offers several insights for humanitarian actors working in conflict-affected settings:

1. Multifaceted barriers require multifaceted solutions. Healthcare access isn’t just about clinical capacity or service availability. Financial barriers—both service costs and transportation costs—can independently prevent care access. Comprehensive programs must address all three.

2. Cash transfers are effective tools in health programming. While often associated with food security or livelihoods, well-designed cash interventions can directly improve health outcomes by removing financial barriers to care-seeking.

3. Digital systems enable accountability and learning. Our transition from Excel sheets to SharePoint Lists with Power Automate wasn’t just about efficiency—it enabled systematic tracking, follow-up, and evidence generation that informed program adaptation.

4. Integration with government systems amplifies impact. By connecting our mobile health teams to Ukraine’s MIS system through e-referrals, we leveraged existing resources and ensured sustainability beyond our direct intervention.

5. Local engagement strengthens last-mile delivery. Community health workers proved essential for ensuring cash notifications reached beneficiaries when formal systems failed—a reminder that humanitarian innovation must include, not replace, community-based approaches.

Looking Ahead

As we continue refining this model, we’re exploring how to support patients who need more frequent access to referred services—those with ongoing treatments requiring monthly or bi-weekly visits. Can we integrate with public transportation systems where they exist? Should we consider recurring compensation models for chronic conditions? These questions will shape the next evolution of our approach.

The conflict in Ukraine has created immense healthcare challenges, particularly in newly liberated areas where infrastructure has been damaged or destroyed. But it has also created space for innovation—for testing models that combine humanitarian cash programming with health system strengthening in ways that could have applications far beyond Ukraine.

Transportation may seem like a mundane barrier compared to the dramatic challenges of conflict-affected healthcare delivery. But for the 78-82% of patients who now successfully access referred services—up from just 50% before cash support—that journey to care has become possible.

Sometimes breaking barriers is about building roads. Sometimes it’s about removing the financial obstacles standing in the way of the roads that already exist.
November 19, 2025
Facilitating WASH FIT in Kharkiv, an Exciting Collaboration between the two Agencies

Our team of WASH experts decided to give back to the amazing WASH community in Kharkiv by collaborating with WeWorld to empower the local heroes on the front lines of healthcare. In early November, we had the privilege of facilitating a WASH FIT training, bringing together two vital local health facilities to strengthen their water, sanitation, and hygiene practices.

It was an incredible three days of learning, collaboration, and practical action. We were joined by six dedicated staff members from the Pechinihy Primary Health Care (PHC) Center in the Chuhuiv Raion and the fantastic team from the Slobozhanske hospital. The energy and commitment in the room were palpable from the start.

Day 1: Getting Down to Basics

Our first day was a deep dive into the “why” and “how” of top-notch WASH in healthcare.

Our experts, Nadiia, Yurii, and Victoriia covered the latest updates in infection prevention and control (IPC), inclusive Health infrastructure, and navigated the newest Ministry of Health guidelines and Government construction norms (DBN).

Our trainers, Nadiia and Yurii, are performing the test for residual chlorine

It was all about building a strong foundation and getting everyone on the same page.

Day 2: Rolling Up Our Sleeves

Theory is great, but practice is everything. For our second day, the wonderful team at Slobozhanske hospital opened its doors and became our real-world classroom.

Equipped with the WASH FIT assessment tool, our participants went on-site to analyze the hospital’s main building. It was a hands-on opportunity to see the concepts we’d discussed in action, identifying potential risks and pinpointing areas for improvement.

This practical experience is what turns knowledge into lasting change.

Day 3: Planning for a Safer Future

The final day was all about turning our findings into a concrete plan. We gathered to reflect on the assessment results from Slobozhanske. It was a dynamic session of brainstorming and strategizing, where the teams began outlining improvement plans to tackle the most critical risks.

You could feel the ownership and excitement as they contemplated the future steps to make their facilities safer for every patient and staff member.

A True Team Effort

This training wouldn’t have been possible without incredible teamwork. We’re extremely grateful to our partners at WeWorld, whose organization of the event was absolutely top-notch. From hosting us at one of the hotels in Kharkiv to making sure every single test and supply for our practical sessions was procured and ready, they made sure everything ran smoothly.

We were also thrilled to be joined by representatives from the Health Cluster, Oleksandr and Valeria, and a representative from the RCC. Their participation shows the wide-ranging support for strengthening our healthcare systems.

Most importantly, a huge thank you to the healthcare professionals from Pechenihy PHC and Slobozhanske hospital. Your active participation and enthusiasm are what made this training a success. We are confident that you will take what you’ve learned and continue to make a powerful, positive impact on the health and well-being of the Kharkiv community.

November 18, 2025
Rothman’s Community Change Models

Jack Rothman, an influential American social work scholar active from the 1960s onward, developed one of the most widely referenced frameworks for understanding community intervention. His work emerged during a period of significant social transformation in the United States, including the civil rights movement, the War on Poverty, and the rise of community action programs. In this context, Rothman introduced a structured typology of community change strategies—first published in the mid-1960s—that remains foundational in community development, social work practice, and public health today.

Community Action Model

There are three models of community change, and the first one is the community action model. This model is quite radical, aiming to redistribute resources in a significant way. When implemented, it redirects power toward more inclusive participation of community members in economic and health activities, expanding access to healthcare and other social benefits. Overall, it connects strongly with efforts to strengthen democracy, promote social justice, and broaden access to essential resources across the community.

Social Planning (or Social Policy) Model

The second model is the social planning or social policy model. This is a more deliberate, long-term, and technically oriented process of problem solving. It may involve the community to varying degrees—sometimes community participation is central, and sometimes it is limited. The model focuses on rational decision-making, the use of experts, and systematic planning to address complex social issues.

Community Development Model

The third model is the community development model. This approach assumes that sustainable change emerges from building the capacity of the community itself. It emphasizes empowerment, local leadership, skills development, and strengthening social networks. By fostering community capabilities, the model seeks to enable residents to take charge of their own development and shape the solutions that affect their lives.

Our project has been utilizing this model with our community health work.

November 9, 2025
The Tragedy That Transformed Medicine: The Legacy of the Tylenol Murders
Discovery of Tylenol

Acetaminophen—known as paracetamol in the Old World—was rediscovered not once, but three times.

First by French scientist Gerhard in 1852, who hasn’t found it useful.

Acetoaminophen got a second chance in 1873 in a laboratory of an American chemist, Harmon Northrop Morse, now considered the father of acetaminophen.

Harmon Northrop Morse is considered a “father of acetaminophen”

This time paracetamol has been tested as a potential safer alternative to its cousin acetanilid, which caused methemoglobinemia, a condition of a reduced capacity of a red blood cell to bind and transfer oxygen. Tests on humans showed a mild to moderate tendency to cause methemoglobinemia and acetaminophen was shelved for almost eight decades.

Acetaminophen finally found its way to the market

In 1953, acetaminophen was finally entered the market as a safer alternative to aspirin for kids and adults with GI ulcers. Thankfully, to the Food, Drug, and Cosmetic Act, a pharma should provide both efficacy and safety to the FDA before medications enter the market.

Two companies at the same decided to market acetoamiphen:
- Tylenol – by McNeil
- Panadol – by Heleon plc
Chicago murders and Tylenol

For almost three decades, McNeil and its parent company Johnson and Johnson (J&J) have enjoyed a steady growth of market share of their paracetamol brand.

The success story took a sudden turn in 1982 when Tylenol was undisputed leader of the consumer market with 35% of sales of acetaminophen in the US. Nothing is too big to fail, specifically when it comes to patient safety.

In 1982, multiple people in Chicago lost their lives after consuming Tylenol Extra laced with cyanide. “An infamous painkiller delivered a painful demise to unsuspecting victims,” read the shocking headlines, sparking unprecedented fear among consumers. As panic spread, Tylenol’s market share plummeted to just 8%.

J&J reacted immediately by recalling over 30 million bottles of Tylenol. An R&D department of a pharmaceutical giant came up with a quick solution – a nice rounded seal on top of the, which became de facto an industry standard for anti-tampering.

With a fast and transparent approach to the problem, the manufacturer was able to win public trust again and everything lost was soon regained. Now J&J recall is a successful case study for many MBA courses around the globe.

Fortunately, J&J hasn’t settled with alterations to the packaging and soon came up with an alternative excipient formula for Tylenol giving a pill recemblence to jelly pop candy. Those candies are incredibly difficult to tamper with, making it nearly impossible to insert or introduce any foreign substances..

Food and Drug Act 1983

In 1983, the Food and Drug Act classified tampering as a federal offense, significantly increasing the penalties for offenders. One such opportunist from NYC attempted to blackmail J&J, demanding $1 million in ransom to halt the cyanide poisonings. However, the court sentenced him to 20 years in prison for extortion—a daring scheme met with dire consequences.
March 1, 2025
Diethylene Glycol: The Deadly Molecule That Changed Medicine Forever

You can’t expect more from this small molecule of Diethylene glycol (DEG). Having a humbling origins of an ether of an antifreeze (CH₂OH)₂, the DEG is one of the dozens interim substances in the process of manufacturing of polyester raisins.

If only not a single blunder and a corporate greed that put it in the spotlight of as “Elixir Sulfanilamide”, DEG would be one million other molecules used in organic polymer synthesis.

Elixir Sulfanilamide

A year 1938, sulfa drugs, that miraculously cured a bad pneumonia of Winston Churchill in few days are now available for everyone who can swallow a pill. Prominent scientists of this era are struggling with a challenge of getting a potion for those who still cannot gulp a whole tablet.

One of those griddling with the task is Harold Cole Watkins. Working as a chief chemist at Messengil, he decided to use Diethylene glycol as a dissolvent, which on paper and in vitro was a brilliant idea.

Flavored with a raspberry it was ready to hit the market as “Sulfanilamide elixir”, which by mid 1938 started selling countrywide – an extreme case for a new drug today, it was absolute reality of that time – you don’t need to prove neither efficacy no safety of the remedies you producing. By the Food and Drug Act of 1906 your medication needs to be “original”, period.

Diethylene Glycol. Remedy for disaster

It was of the most tragic launches in history. One third, more than 100 kids died of renal failure, caused by the dissolvent writher than antibacterials itself.

Once consumed, DEG quickly enters the bloodstream and turns to liver. Having not one but two OH groups it provides an excellent substrate for liver to practice oxydation – the process of adding more oxygen. The result is 2-hydroxyethoxyacetic acid or HEAA, which accountable for the kidney and nervous system toxicity of Diethylene Glycol poisoning.

The reaction from public and lawmakers was almost immediate – in late 1938 Federal Food, Drug, and Cosmetic Act was born and enacted by Franklin D. Roosevelt.

US became first among developed nations to enact drug approval regulations, that helped the country to avoid infamous thalidomide tragedy.

February 26, 2025