On Feb. 24, Michael Mizwa was traveling abroad at Baylor College of Medicine Children’s Foundation – Malawi when Russia invaded Ukraine.

In less than 10 days, he flew to Romania, a country that borders Ukraine, to coordinate relief for Ukrainian refugees at Baylor Black Sea Foundation, part of Baylor College of Medicine International Pediatric AIDS initiative (BIPAI) at Texas Children’s Hospital.

“We started seeing the situation develop with refugees fleeing Ukraine into a lot of different neighboring countries, specifically Moldova, Hungary, Poland and Romania,” said Mizwa, director of Global Health at Texas Children’s and CEO of BIPAI. “The southern part of Ukraine is about a seven-hour drive from the border of Romania. We all anticipated and started to see people coming into Romania, fleeing into the area.”

To evaluate the influx of people, Dr. Michael Belfort, chair of the Department of Obstetrics and Gynecology at Baylor and gynecologist-in-chief at Texas Children’s, and Mizwa conducted a rapid in-country needs assessment for the clinic in Constanța, Romania. Mizwa and Belfort spent a week meeting with partners, including the U.S. embassy, UNICEF and Romania’s health minister to determine the medical needs and gaps for refugee children, as well as any pregnant people, and whether infrastructure and logistics existed to transport very sick patients to Texas Children’s.

“Essentially, what would be the logistical challenges of us getting aid to Romania to support the refugees – medicine, medical supplies and humanitarian aid?” he said. “We came up with a multi-pronged plan for Texas Children’s to help address some of these critical situations.”

The Baylor Black Sea Foundation clinic is the longest-operated BIPAI clinic, opening in April 2001. The clinic has operated an outpatient Clinical Center of Excellence, or the Romanian-American Children’s Center, in partnership with Baylor and Texas Children’s.

Overall, the TCH/BIPAI Global Health Network extends to 12 countries in Africa, South America, North America and Eastern Europe.

“There aren’t many institutions that have built infrastructure and support with local nongovernmental affiliates like we have,” Mizwa said. “We’re not in the business of crisis-response; however, our infrastructure and partnerships in Romania allow us to respond in this situation.”

The Romanian clinic needs supplies to serve a different population on top of its mission to care and treat people through medicine, education and research. Ukrainians have come to the Constanța region for medical care before. The clinic typically serves more than 1,000 patients who have been diagnosed with HIV/AIDS, and 4,000 people with Hepatitis B and C from the region, according to TCH Global Health.

Nearly 1% of Ukraine’s population is currently living with HIV, according to the World Health Organization. From 2015-2019, the proportion of people older than 50 diagnosed with HIV in Ukraine rose to nearly 15%.

“We’re the source of care in this region, and we just hired a pediatrician at the Baylor Black Sea Foundation to see sick kids in the Ukraine/Romania border region of Tulcea, regardless of nationality,” Mizwa said. “We’re all about access to care regardless of boundaries, and we want to address health inequities that are being put in the spotlight as a result of this war.”

Mizwa doesn’t see the clinic’s work as crisis intervention, but an obligation to Baylor and Texas Children’s global health’s mission to do what it does best: provide quality maternal and pediatric care to whoever needs it. During the recent needs assessment, Butterfly iQ+ portable ultrasounds were delivered by Dr. Belfort to the Romanian clinic that can connect to smartphones through Bluetooth, which means more pregnant people can be treated at a time.

In the month since the Russian invasion of Ukraine, Mizwa has seen people come to the clinic with everything they can fit in a suitcase or carry in their arms, including children and pets. Language barriers and cultural differences can often slow down patient intake but everyone is eventually seen, he said.

Mizwa tries to put himself in their shoes. What he has witnessed first-hand is different from what is portrayed in U.S. news coverage, he said.

“They’ve been transported to a foreign land with only a suitcase,” he said. “You have to trust you and your family’s health, safety and well-being in the hands of strangers. It’s hard to fathom that until you see it.”

To learn more about the Baylor Black Sea Foundation, or to support the cause, visit Texas Children’s Global Health.

By Julie Garcia