What are the challenges facing Ukraine in the field of rehabilitation

Russia’s aggression against Ukraine is causing devastating consequences in the economic, social and humanitarian spheres. The demographic crisis, which has been going on for many years, has deepened significantly.

According to various estimates, from six to nine million Ukrainians, who were forced to leave their homes, live abroad today. The birth rate is not increasing. There are many dead and wounded.

Ukrainian children are forcibly taken abroad. Therefore, the issue of restoring human capital is very acute.

During the war, the rehabilitation of military personnel requires special attention. This is an important contribution both to the Security and Defense Forces today and to the restoration of the country’s human capital in the future.

How is military rehabilitation perceived?

The importance of rehabilitation can sometimes be underestimated by society or misinterpreted. For many years, when it came to rehabilitation, society associated this concept with rest and sanatorium-resort procedures: massage or mineral waters.

In today’s world, rehabilitation is a separate strategy of the World Health Organization (WHO), along with treatment, prevention, palliative care and promotion of a healthy lifestyle.

Active evidence-based rehabilitation is the basis of the modern vision of the process of recovery of the wounded in most countries of the world. And in Ukraine, too, this sphere is already changing significantly. The war greatly accelerated the development of the rehabilitation industry, and our doctors are gaining enormous experience.

Rehabilitation is a complex process that should take place in multidisciplinary teams. This is determined at the legislative level. Such teams are headed by a doctor of physical rehabilitation medicine, and they include physical therapists, occupational therapists, speech and language therapists, and many other specialists who, depending on the patient’s injury, join the team. But the main thing in this process is the patient, because effective rehabilitation can only happen if he or she works hard.

How is rehabilitation in Ukraine today?

Rehabilitation in all state medical institutions, in particular in the network of RECOVERY rehabilitation centers, is free of charge. The minimum cycle of rehabilitation is designed for a period of two weeks. The number of such cycles may vary depending on individual characteristics and the degree of traumatic damage.

Some cases may require much more time and effort. That is, one or two cycles are enough for someone, after which patients return to the front. For many, the issue of rehabilitation will be relevant throughout their lives.

Of course, physical recovery is an important part, but psychological and social rehabilitation are no less important. Most often, it is the psychological component that is recognized as the starting point, since the patient must go through an internal conflict and acceptance of a new reality.

The perception of rehabilitation by the military themselves can be completely different. It is important to take into account the individual characteristics of everyone, since the psychological state of the patient is determined by his unique experience and personal approach to rehabilitation.

Medics must also find the right approach to a wounded soldier. And it can be expressed in small things. For example, I know from my own experience that some military personnel do not accept when they are called Heroes, and may even be offended by it, because they believe that they were just doing their job.

Others expect it and are indignant when they don’t hear it. Many military patients, even with complex psychological conditions, demonstrate impressive intrinsic motivation and willingness to actively participate in rehabilitation programs: they perform exercises overtime and remain very energetic.

Family support plays an important role in a positive recovery process. We have seen many cases when relatives “pulled out” defenders after serious injuries. But, of course, there should be a limit to this, because excessive care and efforts to do everything for the wounded sometimes get in the way. We have seen cases when families, in their desire to help, simply did not allow a wounded fighter to learn the necessary skills.

Of course, there are cases when, for various reasons, military personnel experience a loss of internal stability and hope, which affects the level of their involvement in the rehabilitation process. Working with such patients, the entire medical team is at risk of burnout and sometimes needs psychological support.

What are the challenges facing Ukraine in the field of rehabilitation?

The field of rehabilitation in Ukraine is developing rapidly, and the results are already visible. However, it is still too early to say that the issue of accessibility has been resolved. The number of people who need rehabilitation is increasing every day.

The rehabilitation industry in Ukraine is relatively young. She was not prepared for the challenges she faced because of the war. I am convinced that no medical system in Europe would be prepared for such a rapid increase in the flow of patients.

If we take the experience of, for example, Latvia, Lithuania, Estonia, which were also in the Soviet Union and had similar medical facilities, they gradually switched to more modern methods of rehabilitation and did so for 20 years.

We don’t have that time. The situation is also complicated by the fact that we do not have a sufficient number of the necessary medical personnel. And this is the biggest challenge of the industry – the lack of well-trained specialists.

It is obvious that solving the problem of military rehabilitation in Ukraine requires a comprehensive approach and cooperation of all interested parties.

Developing a ten-year strategy can be an effective tool to help address this issue and improve the quality of life for military veterans. And this is not only a task for the state, but also a challenge for public organizations, the private sector and international partners. After all, this is a struggle for our most valuable capital – people.

Svitlana Hrytsenkomember of the organizing committee of the Ukrainian House in Davos, head of the RECOVERY project, member of the board of the “Victor Pinchuk Foundation”

Publications in the “View” section are not editorial articles and reflect exclusively the author’s point of view.