Rehabilitation of Ukrainians affected by the war: problems of prosthetics

Because of Russia's full-scale invasion of Ukraine, many people, military as well as civilians, including children, are suffering. The first are injured on the frontline defending the country and families, whereas the others are injured near the active battle line and even in cities, which, although located in relatively safe areas, are subject to constant rocket attacks. One way or another, they all are in need of medical rehabilitation. While treating minor injuries and getting psychological help is a comprehensive and relatively easy process, limb prosthetics are still sometimes a real challenge for everybody who faces it.

Many experts mention that problems in rehabilitation field in Ukraine have become obvious since 2014. Post-Soviet resort system, which was still present in the country and had nothing to do with real rehabilitation and wasn’t of any real help to anybody, was noticeable. Simultaneously, the first steps were taken to modernize the system and establish cooperation with foreign partners who shared their experience and helped set up rehabilitation centres in Ukraine. The situation with limb prosthetics is much more complex. 

According to approximate evaluation of Ukraine prosthetic support project, due to the war, the number of amputations in Ukraine has risen at least three times. In June 2022, Health Minister, Viktor Lyashko, stated that more than 500 Ukrainians needed prosthetics and further rehabilitation. Since then, this figure has only increased as the shellings of Ukrainian cities have formidably intensified in the autumn of 2022, causing a huge number of civilian casualties.

In front of a person who needs prosthetics there are two options: either organize this in Ukraine or go abroad. Prosthetics in Ukraine is free of charge – it is funded by the government, but it involves a number of bureaucratic procedures. You need to collect a package of documents, find a qualified prosthetist and get on a waiting list for prosthetics. Another problem is that not every prosthesis can be manufactured and fitted in Ukraine, and budget money is not always enough for everyone. 

The situation is also affected by the lack of professional rehabilitation centres and the workload of Ukrainian doctors, there aren’t enough modern and fast technologies for the manufacture of individual parts of prostheses. Although the Ukrainian prosthetics industry has significantly developed over the last 9 years, this is not enough in time of the war. The number of injured has become a major challenge for Ukrainian medicine, so the practice of civilians and soldiers travelling abroad for treatment and prosthetics helps relieve the pressure on local specialists. 

Patients with major injuries, who suffered high amputation and are in need of more difficult procedures, which Ukraine almost doesn’t have any experience of making and fitting, are mainly sent to Europe or the USA. Some types of high-tech prostheses, such as myoelectric-controlled feet, are not produced in Ukraine at all.

Another option, i.e. going abroad, is also not an easy task. A person needs to get documents for leaving the country - visas or passports, pay for the trip for themselves and their companions; start prosthetics and undergo further rehabilitation, which often takes several weeks or even months. But making and fitting of a prosthesis is not all. This process is very complex, and not all of its components are visible at the initial stage.

Approximately for a year a person gets used to the prosthesis, over time it wears out, so it needs to be maintained: adjusted to fit or replace some parts of it. This can only be done at the place where the prosthesis was fitted, so it means additional costs during all further lifetime. Sometimes the total cost reaches hundreds of thousands of dollars. The price of the prosthesis itself depends on many factors: the type and its configuration, the patient's lifestyle and wishes.

This is an incredibly difficult way, which is almost impossible to undertake without third-party support. That is why foundations and organizations that finance treatment abroad come in handy. This includes the WH Foundation, which helps Ukrainian soldiers and civilians receive high-quality prosthetics and rehabilitation under the supervision of experienced American doctors. Thanks to voluntary contributions from individuals around the world, Ukrainians injured in the war are already receiving treatment at Miami medical centres: Mount Sinai and Jackson Memorial Hospital.

Prosthetics lets its patients who have lost their limbs live a full life: move, participate in sports and be fully independent in everyday life. Despite their physical and psychological injuries, they can return to their normal lives.