Dr. Yaroslava Lopatina is AHF Ukraine’s Country Program Director. Her story is next in our “I Am AHF” series featuring remarkable staff, clients, and partners who are doing what’s right to save lives everyday. Interviewed by Diana Shpak, Knowledge Management Focal Point, AHF Europe.
What were you like as a child? What did you dream about? Who did you want to become?
I was a very happy child. But my dreams changed as quickly as the seasons. At first, I wanted to become a milkmaid. It seemed to me that this was the most wonderful job – sitting in warmth, milking cows, scratching them behind the ears, and hearing them “mooo” gratefully. Pure calmness.
Then it occurred to me that being a circus animal trainer would be much more exciting. After that, I became fascinated by the post office. This is where there was real magic. During my childhood, sending and receiving post packages was an entire procedure: filling out a form, waiting, and finally receiving a package. And what a joy it was to find gifts from different corners of the country inside. But my absolute favourite part was the wax seals. They seemed so special and extraordinary to me. Therefore, I dreamed of working as a post officer.
Wax seals are truly romantic! But how did you end up choosing medicine?
As I grew older, my parents, like all parents, started to worry about my future and suggested that I consider medical school. In high school, we had a career orientation program that allowed us to try out different professions through internships. Some of my classmates chose aviation, others went into maritime studies, and I decided to complete my internship in a hospital.
Did you like it right away?
Oh yes! Especially my time in the maternity hospital. I remember helping to swaddle newborns and bringing them to their mothers for feeding (back then, babies were kept separately from their mothers). One day, a neonatologist asked if I wanted to assist with newborn examinations. They gave me a lab coat, and the pediatrician trusted me to hold the babies while she examined them and treated their umbilical cords.
I desperately wanted to be like the doctors – to wear a medical uniform, speak in complex, mysterious terms, and work night shifts. It felt like belonging to a secret society, as if doctors possessed a special kind of knowledge—a hidden truth that was inaccessible to others.
Your parents suggested it, but you chose your profession yourself. Is that correct?
Exactly. They gave me their advice, but I embraced it wholeheartedly. I loved studying, and I prepared diligently for medical school, diving deep into biology and physics.
While still at university, my biggest interest was infectious diseases, and I joined a specialized student research group where we studied various illnesses in depth and prepared reports for student conferences. I spent hours in the library, unable to tear myself away from ancient manuscripts that described treatments for various diseases.
For example, do you know how cholera was treated in the 18th century? Bloodletting! Cholera! With bloodletting! I remember wondering how the medical profession even survived after such “treatments.”
But in those distant times, there were also doctors who worked under the harshest conditions, facing epidemics of cholera, smallpox, syphilis, and tuberculosis. Without protective measures and fully aware that they could become infected and die, they continued treating patients and developed the first strategies for epidemic control.
Many of these doctors were not just medical practitioners; they became educators and advocates for improving social and economic conditions, working conditions, and access to healthcare. After all, many epidemics are directly linked to poverty and social inequality – an issue that, even today, remains unresolved.
How did your journey unfold after university?
I completed my internship while preparing to become an infectious disease specialist. Those two years in the university hospital were some of the happiest of my life. I was surrounded by young, ambitious doctors and incredibly experienced, caring mentors. It was during this time that I first encountered AIDS.
However, this happened at a different clinic, the Institute of Infectious Diseases, which had the first department for people living with HIV in Ukraine. I requested my university supervisors to send me there for a month to familiarize myself with the clinical manifestations of AIDS.
At that time, HIV was considered a completely fatal disease, before the invention of antiretroviral therapy (ART). The atmosphere surrounding HIV was grim and filled with anxiety. But surprisingly, when I walked into the hospital, I saw nothing dark or hopeless.
What was my first impression? People with HIV looked just like people without HIV. They lived their lives, went to work, built relationships, and experienced joy and sorrow just like everyone else. They had spouses, children, and even grandchildren. They carried a deadly virus, yet they made plans like working on dissertations, searching for better jobs, or preparing for their weddings.
I felt an immense sense of relief and realized that working there was not only interesting but not scary at all. Of course, I also saw people dying of AIDS – people who, even as they lay bedridden, still clung to the hope that a miraculous cure would be discovered the next day. Unfortunately, the so-called “cocktails” (as ART was initially called) were developed a little later. And in Ukraine, it would take many more years before treatment became widely accessible. In that time, we lost an unimaginable number of people – people who could still be alive today.
But back to my training. After completing my internship, there were no available positions for infectious disease specialists in Kyiv, so I spent the next three years working as a family doctor.
Could you describe the HIV treatment evolution of that time?
I have witnessed every stage of HIV treatment evolution. In the beginning, all we had was monitoring, treatment, and the prevention of opportunistic infections. Then, the first antiretroviral drugs became available, but they were nothing like the modern ones. Comparing HIV treatment back then to today is like comparing a 19th-century journey from Amsterdam to Los Angeles with a modern flight.
Today, ART consists of just one small pill with little to no discomfort. But in the early 2000s, ART meant taking 12 or more pills daily, at strictly scheduled times, four to six times a day. And the first-generation medications caused severe side effects, some of which were even fatal.
Still, ART was a lifeline. Patients were incredibly happy if they were among the lucky few who received treatment. For doctors, however, it was a heartbreaking time. Imagine having 100 patients in advanced stages of HIV, knowing that without ART, they would soon die—yet having enough medication for only 20 of them. Who do you choose? It was an extremely difficult decision.
How did you start working at AHF?
While working at the Institute of Infectious Diseases, my mentor, Svetlana Antonyak, introduced clinical mentoring. Physicians from Europe and the U.S. came to share their expertise, and in turn, we travelled to regional AIDS centers to help local doctors learn how to treat HIV.
During that time, I met some incredible people who later joined AHF. When AHF needed a medical coordinator, they invited me to join the team.
You started as a medical coordinator and later became the Country Program Director. How was that transition for you?
Oh, it was a challenge. When I took on the director role, I faced two major tasks: budgeting and managing personnel.
Doctors are not trained to work with finances, so I had to learn from scratch. I would open spreadsheets and feel like I was reading another language. But I kept learning, and over time, everything started to make sense.
And what about managing personnel? That’s also a big challenge.
Oh, absolutely. Hiring the right people is an art. It’s not just about finding a good specialist—it’s about finding someone who aligns with the team’s philosophy and mission. If a person disrupts the collective dynamic, even if they are a top professional, they will eventually have to go. Letting people go is one of the hardest decisions, but sometimes it’s necessary.
Dr. Yaroslava speaks at a press conference during AHF’s commemoration of reaching 2 million lives in care worldwide.
What’s the most important lesson you’ve learned from working at AHF?
I admire AHF’s approach. No matter how large and powerful AHF becomes, it never forgets that its purpose is to serve its clients, not to sustain itself as an institution.
And AHF’s commitment to its staff is not just a promise. We truly felt it when the war started, and we faced long periods of blackouts. AHF made sure we had everything we needed, taking care of us during the most difficult times.
I also appreciate that AHF allows me to grow. The most valuable skills I have learned here are financial and personnel management, which are the main tasks of a successful director.
If you could introduce one major innovation at AHF Ukraine, what would it be?
We need to return to our roots. Ukraine lacks hospice care for HIV patients. People living with HIV are aging and developing cancer and chronic illnesses, yet specialized palliative care is almost nonexistent. There are private hospices and nursing homes, but they are extremely expensive, and most of our patients can’t afford them.
Stigma is still widespread, and the likelihood of an HIV-positive person being denied hospice care is very high. This is an area that desperately needs development.
You work so much, constantly on the move. How do you manage stress?
Honestly? I don’t. This job follows you everywhere. Even on vacation, I’m thinking about when I need to check in, sign banking documents, or resolve urgent issues. A director can’t just turn off their phone. But that’s not a downside; it’s simply my life.
You have extensive experience in medicine, management, and public initiatives. What do you dream about?
I’ve wanted to write a book for a long time—a collection of patient stories. Their lives are full of drama, resilience, hope, and incredible strength. I want to preserve these stories and pass them on to future generations. Maybe one day, I’ll meet a talented copywriter who can help me bring this idea to life.
That’s amazing! What would you say to people who are afraid of change?
It’s okay to be afraid. Fear is normal. But try to find something you love in your new circumstances. I’m so glad that at one point, I said “yes” to AHF and to new opportunities. The key is to stay open to the world and never be afraid to try.
