Amputees in Ukraine face many problems during rehabilitation, including a lack of information about available medical care options, a complex and tedious process of filing documents, a lack of specialized programs, institutions, and specialists, a lack of barrier-free environments in public places, and much more.

Experts talked about these and other problems and needs of people with amputations, as well as ways to solve them, during the presentation of the study “Evaluation of the results of providing services to people with amputations”, organized together with the Kharkiv Media Hub team on August 2.

The study aims to study and record the needs of people with amputations.

“When our team began to deal more systematically with the issue of assisting people with amputations, we encountered the fact that there are many studies on the topic that are offered – both by the state and private organizations – to people with amputations and prostheses. This is also a study on employment, the “veteran’s path” and others. Still, we did not find a study that was specifically devoted to the study of the needs of people with amputations themselves,” said the director of the “Kharkiv with You” Charity Foundation, head of the project “Prosthetics as a part of life” Olena Rofe-Beketova.

With in-depth data in hand, we will be able to implement effective projects and programs aimed at meeting the needs, that is, providing not only medical and rehabilitation assistance, but also a comprehensive approach to the integration of these people and their families into society, on the one hand, and the preparation of society to such integration – on the other hand”

The results of the study show that the main needs of people with amputations and their relatives are:

• Receiving both primary psychological support at the initial stage, as well as psychosocial and psychophysical support at the stage of preparation for prosthetics, rehabilitation, mastering the prosthesis, and beyond.
• Obtaining the most complete and systematized information regarding the process of filing documents, regarding the choice of a prosthetic enterprise; assistance in preparing documents, concluding a contract, etc.
• Involvement in an appropriate education of amputees to implement the “equal to equal” principle, where people with similar experiences help others to adapt and re-establish social connections.
• Creation of common spaces for communication, leisure, medical, and sports events for people with and without amputations.
• Creation of a barrier-free environment: in public spaces, at workplaces, in everyday life. This issue is most painful in villages and small settlements, where there are no ramps, conditions for public transport, elevators in medical and other institutions, etc.
• Creation of facilities for providing long-term medical care and rehabilitation, palliative care, because currently there are not enough facilities that would be focused on people with serious health conditions and the improvement of their lives quality
• Creation of patronage services, centers (volunteer, medical, informational), and points at hospitals, where one could get advice, psychological help, and legal support. Experts also suggest that social workers be present in such centers who navigate through the documents, collect requests, and help issue/restore the necessary documents.
• Development of criteria for quality control of rehabilitation services. Due to the increase in the number of private enterprises that provide prosthetics and rehabilitation services, including psychological ones, the issue of quality control of these services arises.
• Strengthening the information campaign on the inclusion of people with amputations in various spheres of life with the involvement of veterans, bloggers, and public figures. Systematic educational work with all strata of society on the basics of communication with amputees to facilitate resocialization.
• Access to educational and professional opportunities. According to the study participants, society is not ready to hire people with amputations. Currently, there are many opportunities for training and employment of such people, however, in practice, there are certain problematic points. People who have survived a traumatic experience are often not ready for regular 9-to-18 employment due to mental problems (e.g., depression, lack of motivation) and health conditions (pains of various degrees and origins).
• Legal and informational support at the stage of choosing a prosthetic enterprise and concluding a contract with it. Assistance in the restoration and processing of documents (for example, MMC for disability, obtaining social benefits, etc.).

During the discussion, the participants repeatedly drew attention to the fact that the whole family should receive a wide range of services, including medical and psychological, from the very initial stage of rehabilitation. This requires additional housing at medical institutions for family members of people with amputations. Currently, family members are forced to rent housing at their own expense near the medical facilities where their loved ones are being treated.

The main threat to the implementation of future plans and the development of rehabilitation services is the lack of specialists, which causes the rapid burnout of specialists already working in the system.

“Such studies must be conducted, because we understand that this is a very pressing issue. There has been a war in Ukraine for 10 years, people are injured and amputated every day, and more and more. “Such studies must be conducted, because we understand that this is a very acute issue. There has been a war in Ukraine for 10 years, people are injured and amputated every day, and more and more. And if before the full-scale war, there were not the most difficult amputations, now there are combined injuries, three or four amputations. All this fell on the system. We understand that we do not have enough rehabilitation specialists to restore these people and socialize them, – Vadym Svyridenko, the authorized officer of the President of Ukraine for the rehabilitation of ATO participants, shared his impressions.

According to experts, other important negative factors that significantly affect rehabilitation are:

• Lack of information about available options for medical care, rehabilitation support, stages of prosthetics, maintenance of prosthetics, etc. For example, not everyone is informed that prostheses installed abroad are not serviced under the Medical Guarantee Program in Ukraine.
• Insufficiency or abstinence of specialized programs, institutions, and trainers whose work is aimed at maintaining the physical form of people with amputations throughout their lives.
• Lack of rehabilitation services for people with partial and total vision loss.

“Now a lot of research is being done on this issue, but the research led by the Charity Foundation “Kharkiv with you” confirmed the general trend that the legislation needs to be regulated, it is necessary to find clear ways of communication so that people know how to exercise their rights. This is an obligation for both executive authorities and medical and rehabilitation institutions. All systems in the country must be reconfigured, must adhere to the principles of respect and dignity for veterans, defenders, people who lost their limbs due to the war and need rehabilitation,” emphasized the director of the Northern Interregional Department of the National Health Service of Ukraine, Victoria Milyutina.

The discussion of the research results was also joined by the director of the Ukrainian Scientific and Clinical Center for Prosthetics and Rehabilitation Antonina Saleeva, veteran, military medic, pediatric traumatologist Serhiy Filippov, member of the Help Army volunteer group, organizer of competitions for adaptive athletes “Games of Heroes” Oleksandr Goncharov, representatives of specialized departments of the Kharkiv Regional Military Administration, public organizations and foundations, specialized doctors, psychologists and volunteers who care for people with amputations and their relatives, journalists.

The study was conducted within the framework of the project “Prosthetics as part of life” with the support of The King Baudouin Foundation (Belgium). The survey itself was conducted by the NGO Research Bureau “Sociologist” from April 30 to June 23, 2024. It was attended by 12 experts working in Kharkiv, Dnipropetrovsk, Lviv regions, and the city of Kyiv.

The full report on the results of the study can be viewed at the link – here.

In addition:

“Kharkiv with you” Charity Foundation has been working with people with amputations since 2015 — primarily in the direction of psychophysical and psychosocial assistance. In particular, in partnership with the “Games of Heroes” project, competitions were organized for wounded veterans in Kharkiv and other cities of Ukraine.