Spinal cord injuries, brain damage, burns, limb amputations and complex limb trauma are some of the new rehabilitation challenges caused by the war in Ukraine, Dr Volodymyr Golyk, a World Health Organization (WHO) officer dealing with disability and rehabilitation in Ukraine, told a WHO Europe media briefing on Tuesday.

Prior to the war, Ukrainians already had significant rehabilitation needs because of the country’s high burden of non-communicable diseases (NCDs).

However, WHO’s Dr Satish Mishra said that “thousands of people in Ukraine have sustained complex war-related injuries that need rehabilitation services and assistive technology”, including wheelchairs and walkers.

“Injuries resulting from war can cause devastating and long-lasting physical and psychological impact, requiring early and specialised rehabilitation interventions from multidisciplinary rehabilitation team and long-term follow-up to reduce complications and to optimise independence and quality of life,” added Mishra, WHO Europe’s Technical Officer for Disability and Rehabilitation.

Despite severe injuries sustained during the war in #Ukraine, Anastasiia and Oleksii are making progress in recovering and regaining their independence and mobility.

Joint work of @MOH_Ukraine @WHO_Europe on #Rehabilitation #Assistive Technology ⬇️ pic.twitter.com/1yi5TR0Kad

— WHO/Europe (@WHO_Europe) March 7, 2023

Pre-existing conditions

Ukrainians often had pre-existing health conditions alongside “multiple complex injuries that require rehabilitation”, added Mishra. 

But the rehabilitation needs of the Ukrainian population are increasing in the face of complex barriers to accessing health care during the war, including “targeted attacks on healthcare facilities, fewer health care workers due to displacement, reduced public transportation, interrupted supply chains and power shortages”.

“Providing coordinated ongoing care and rehabilitation for those affected by war is one of the greatest challenges faced in many health emergencies. There can be significant and life-changing consequences for those whose rehabilitation needs are unmet or delayed, leaving a legacy of deprivation and exclusion from society for years to come,” he stressed.

However, Iuliia Sokolovska, deputy head of the Office of the President of Ukraine, said that her country had started to create “a modern effective rehabilitation system built on evidence-based medicine” before the war.

“Notwithstanding the invasion of the Russian Federation, the development of the new rehabilitation system was not stopped. We accelerated our efforts and took into account the new challenges that we have faced now.”

Sokolovska added that improved organisation meant that injured citizens and military personnel “start to receive rehabilitation assistance in the hospital immediately after surgery or medical intervention” with the involvement of multidisciplinary teams.

Ukraine was also developing its capacity to manufacture prosthetic limbs and other assistive technology.

Amputations

“Due to the war, the complexity of cases and amputations is enormous,” she added. “This stimulates the acquisition of unique skills by both doctors and other specialists, while WHO and other international partners supply assistive technologies and rehabilitation equipment to Ukraine.”

But, stressed Sokolovska, “Ukrainians also suffer from psychological stress and trauma on a daily basis. This is why psychological health should be as accessible as medical help.”

Dr Jarno Habicht, Head of WHO Country Office in Ukraine, described the health system as “resilient, even after more than 800 attacks on health facilities”.

“As a WHO, we have supported more than 4000 people in more than 25 facilities with rehabilitative services. This is related to the services, and the equipment and supplies needed to provide those services.”

Image Credits: WHO Europe.