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Ukraine’s War-Wounded: Gravely Injured but Unbroken

Connecting those injured in the war with state-of-the-art rehabilitation services is at the heart of a Lviv hospital's mission.


Ukraine Relief

Patients tour the new rehabilitaiton room at Unbroken on April 11, 2023, the day their new seven-story rehabilitation center opened. (Photo by Roman Baluk for Unbroken)

As Russia’s war on Ukraine rages on in the country’s east, it creates a steady flow of wounded soldiers and civilians needing complex surgeries, long-term rehabilitation, and prosthetic limbs. Many of these patients arrive by evacuation trains and ambulances at the Unbroken National Rehabilitation Center in Lviv, the center of the country’s comprehensive efforts to heal those gravely wounded by war.

Like much of the Ukrainian people’s response to the attack on their country, the rehabilitation effort is marked by scrappiness, speed and adaptability.

In a three-month sprint, Unbroken turned a vacant seven-story building adjacent to the Lviv First Medical Union hospital, where it had already been operating, into a modern rehabilitation center. The building, which opened April 11, is equipped with a robotic walking system, exoskeletons, robotic gloves to move arms, a swimming pool for water rehabilitation, a simulated store where patients can practice shopping with their prosthetic arms, and an ergotherapy apartment with a kitchen where patients can learn to care for themselves once again.

The organization’s rehabilitation program includes amputation recovery, speech therapy, and psychosocial support. Occupational therapists help patients relearn how to hold a toothbrush or pen.

Unbroken manufactures and fits prostheses to help people return to normal life. In a comprehensive approach to the patient’s needs, a patient’s multidisciplinary team includes a surgeon, a traumatologist, a prosthetist, a rehabilitation specialist, and a psychologist or psychotherapist.

According to the United Nations High Commissioner for Human Rights (UNHCR), More than 14,600 Ukrainian civilians have been injured since the start of the war. Over 5,000 Ukrainians have lost limbs since the start of Russia’s invasion, according to Unbroken.

On April 11 and 12, more than 300 leading scientists, researchers, practitioners, policymakers, and patients met at the new Unbroken facility to share knowledge and experience on rehabilitation services, during the first International Rehabilitation Forum.

Unbroken patient Olena Svitlova (left) shares her story. (Alexey Shivrin/Direct Relief)

The gathering opened with a panel of Unbroken patients who shared their stories. Among them was Olena Svitlova, a teacher who was walking down the street when a cruise missile flew into a nearby nine-story building. Debris flew in all directions, hitting her directly in the face, destroying her right eye and carving a large hole in her nose.

She ended up coming to Unbroken, where maxillofacial surgeons perform the most complex reconstructive surgeries, literally putting patients’ faces back together, closing wounds and holes in bones. In a matter of weeks, Olena was able to return her job teaching chemistry, though she shared that she doesn’t turn on her camera because she knows her students will be afraid of her. According to Project Director Iryna Gudyma, Unbroken’s “Unbroken Beauty” project is raising funds for the equipment needed for more advanced facial reconstruction surgeries, which Olena will need so she can connect face-to-face with her students.

After that, healthcare and rehabilitation leaders from Ukraine, the United States, Australia, France and Israel joined panels on rehabilitation policy, mental health, rehabilitation for war-traumatized children, the use of multidisciplinary teams in rehabilitation and more.

Attendees heard from the representatives of Ukraine’s Ministry of Health, who discussed their plans for making multi-disciplinary rehabilitative care teams available across the country. Specialists from the United Kingdom, United States and Israel provided strategic guidance and offered to continue to help support Unbroken’s staff with specialized training.

Prior to the war, rehabilitation had been a neglected topic in Ukraine, said Vasl Strilka, Director of the Department of High-Tech Medical Care and Innovations at Ukraine’s Ministry of Health. The country has since developed rehabilitation capacity, with 8,000 beds now available for patients undergoing rehabilitation. The country has defined rehabilitation as starting the day after the injury and made multi-disciplinary teams the standard of care, Strilka told the attendees.

New equipment in a rehabilitation room at Unbroken’s new seven-story rehabilitation center on April 11, 2023. (Photo courtesy of Roman Baluk for Unbroken)

A strong rehabilitation program is crucial not just for affected individuals but all of Ukraine, said Major General Tim Hodgetts, Surgeon General for the U.K.’s Headquarters Defense Medical Services. If soldiers know that they will be cared for, he told the gathering, it provides a huge morale boost for the war.

On April 11, Direct Relief announced plans to infuse an additional $10 million to support rehabilitation efforts for people with war injuries in Ukraine. The funding announcement was made by Direct Relief President and CEO Thomas Tighe at the Unbroken National Rehabilitation Center in Lviv during the first International Rehabilitation Forum.

Since the war’s start, supporting rehabilitation and recovery from war injuries, both physical and psychological, has been a core focus of Direct Relief. The April 11 announcement brings to $15 million the amount Direct Relief has allocated to specifically support rehabilitation and injury recovery efforts in Ukraine.

Direct Relief has helped Unbroken procure rehabilitation equipment, develop treatment protocols, and train rehabilitation personnel.

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