A man wearing green scrubs stands behind a girl as she exercises with a weight machine

Local medical staff offer rehabilitation, psychosocial care

Humanity & Inclusion provides rehabilitation and psychosocial support training sessions to medical professionals at one of its partner centers in Ukraine, the Vinnytsia Medical Rehabilitation Center for children.

Since February 2022, the Vinnytsia Medical Rehabilitation Center for children has taken in hundreds of children and adults who fled their homes in the midst of violent bombings. Staff provides psychological and physical rehabilitation care, as well as shelter for internally displaced people to stay.

Sometimes patients arrive in critical conditions including shell shock, physical injuries, and trauma-related psychological syndromes. Most of the patients are expressing a need for psychological support, many having lost loved ones or their homes.

Much of the staff have been personally affected by the consequences of the war, and at the same time must find the strength to provide support and professional help to the families at the center as their workload increases. Centers like this one across the country are seeing cases of burnout and a need for staff support in order to continue their services.

Rehabilitation and mental health care

HI’s experts have trained center staff on rehabilitation and psychosocial services. The organization also provides assistive devices to people with mobility needs. The trainings help professionals practice specific tasks and provide high-quality services, especially when working with people with disabilities.

“We provide assistive devices to the center and supplementary training on which devices to choose, how to maintain them, and to use them safely,” says Lilia Tkachuk, HI’s health project supervisor. “The staff also requested that we exchange skills on how to engage caregivers of children with disabilities in group activities. Finally, we focus on staff self-care and building their resilience in these difficult times, to make an indirect positive impact on the quality of the rehabilitation services they provide to patients.”

So far, HI has provided rehabilitation training and psychosocial first aid training to more than 170 health staff and frontline workers across Ukraine.


'We felt their bewilderment'

Yevhenia Hryhorivna, head of the Rehabilitation Treatment Department of Vinnytsia Medical Rehabilitation Center for children, shares her experience:

“Internally displaced persons started to arrive at the center here in March. There were a lot of children. When the first group arrived, these people had lost their homes, their relatives, their loved ones and they lost the most basic elements of their lives. It’s immensely traumatic. We felt their bewilderment. We gave them shelter, we treated them, and we provided them with psychological support. Our psychologists worked with every patient. Since then, our facility has cared for more than a thousand people, and I genuinely believe we have helped all of them.

“The training provided by HI has been useful both for supporting our patients and for the personnel. There is an influx of patients with complex psychological needs. Our staff is in constant communication with people who have been traumatized and have psychological disorders. These people came to us from the frontline where they've experienced all kinds of trouble and suffering. It can be very hard work. Day after day, their experiences accumulate and our employees feel burned out. That's why these trainings are so important. They help to revitalize the employees. Even an hour and a half can be meaningful. We learn how to treat the patients and how to protect ourselves from burnout so that we can continue supporting these people.

“We also use the trainings to collaborate with HI and improve our rehabilitation processes. First, we share our own experiences, then HI specialists explain how we can improve our work. So, the positive changes come from the combination of our own experience and HI’s experience. Nowadays physical rehabilitation is always accompanied by psychological rehabilitation. It's an equally important aspect. If we can restore the psychological condition of a patient, their physical treatment will likely be positively impacted as well. That's the connection.

“Finally, we attended lectures and received recommendations on using specific technologies and received some guidance materials. We will use all of this in our work in the future and continue following these directions. We are so glad to have HI here, and find the training extremely relevant during these hard times.”


'Protect your own heart'

Kateryno Kotyrlo, psychologist and head of the outpatient care and consultations department at Vinnytsia Medical Rehabilitation Center for children, adds her perspective:

“Since the war began, psychological assistance has become a priority. Over 90% of our patients now require psychological support services, particularly those receiving rehabilitation care.

“We have two psychologists at the center, and we both hold individual and group sessions. We see post-traumatic disorder, depression and different phobias as a result of the war. Experiencing stress also affects people’s attention spans and their memory. For example, some events related to shootings or explosions may be erased from memory. A patient who has experienced these situations may not remember it if you ask them about it. All that's remembered are the feelings.

“Since we are a children’s center, we provide direct family consultations. This involves explaining to parents the importance of a family environment for child growth, development and their emotional state during uncertain times.

“The common problem for many Ukrainians today is a lack of certainty about what tomorrow brings. There is uncertainty regarding what to do and how to carry on after losing your home, your family, or if you’re left alone. People have worked so hard to build their lives and just had to leave it all behind without knowing if they will ever see it again.

“As a psychologist, it can be really difficult to hear this from our patients, because you want to help as much as possible. There are a lot of situations when a wife and children evacuated, while the husband remains on the other side. People feel worried for their relatives.

“The workload for us has increased by several times, so there has been a lot of burnout. Working with people coming from the front line requires serious emotional efforts. I'm a citizen of my country as well, so it's hard to separate myself as a professional and as a person who is fully compassionate with my patients’ experiences. Your first instinct is that you want to help. But instead of sitting and crying together with the patient, you also have to protect your own heart. I have seen patients specifically request for someone to be there just to cry together with them.

“I've attended some of the trainings from HI. It reinforces a lot of the knowledge that we already had, and gives us the possibility to acquire a theoretical basis as well as practical skills. When we played out some roles during training, it helped us resolve some of our issues by discussing them with other professionals. I was able to cooperate with some more experienced specialists or colleagues who gave me some useful advice.”


Better serving people with disabilities

Liudmyla Vladymyrovna, head nurse in the rehabilitation therapy department of the Vinnytsia Rehabilitation Center, shares her experience:

“Since the war began, there are a lot of patients who need treatment. They are psychologically traumatized and overwhelmed. They need the assistance of a psychologist. We need to help the patients to adjust to their current life conditions in this changing situation. We are learning ourselves and teaching the patients how to carry on.

“With HI, we've attended some very useful lectures on psychological burnout and also on rehabilitation. Knowing the specifics of people with disabilities, we were able to learn a lot of new things. These lectures and trainings allowed us to update our knowledge regarding people with disabilities.

“For example, we had one lecture on the selection of wheelchairs, the right way to approach patients, wheelchair adjustment, and the correct way to lift, seat, and move people using a wheelchair. We also talked about providing rehabilitation services, sitting or lying a patient down, and choosing the right crutches for them based on their size and functional capacity.

“Our colleagues from the psychology department also helped us to defuse our emotions. We did a lot of simulated situations for us to discuss and resolve some of the issues we face. It was a very interesting and fruitful training.”


A reminder in best practices

Oleksii, a physical therapy assistant at Vinnytsia Medical Rehabilitation Center for children, adds his perspective.

“I have been working at the center for six months now. I used to have my own private practice, but when the conflict escalated, most of my clients left Ukraine. I was no longer able to sustain myself and needed to begin working somewhere else. I work with people of all ages, doing exercises to improve their backs, arms, legs, and general muscles. My youngest patient is 3 months old, and my oldest is 86, so I see all kinds of conditions: people with illnesses, people with disabilities, and we also see people who have been displaced by the war. Just recently, I worked with a woman who had to leave her husband and farm behind in Kherson.

“The training with HI has been very useful. I already knew some of the information from my previous experiences, but I had not practiced it in a while, so it was a good reminder. For example, we practiced the correct way to lift people out of wheelchairs and put them back. You have to ensure that you keep their back straight while you move them.

“I have chosen to work in rehabilitation so that I can help people, and I think it does help people.”


Supporting local medical staff

Lilia Tkachuk, HI’s health project supervisor, explains the importance of the organization’s work alongside local medical facilities:

“The project goal is to support rehabilitation facilities. After evaluating the area, we found that there are many rehabilitation clinics in the Vinnytsia region, working to improve people's health, their functionality and overall quality of life.

“Our team strives to support the work of these facilities not only in terms of professional growth, but also with psychological and social support. This means taking care of the people who are taking care of others, which is exhausting work. Medical facility personnel are under a great deal of pressure during the war. They have to be all-inclusive and provide both support and motivation. We determine our objectives based on the needs expressed by the facility personnel. We're not there to evaluate them or intrude, but simply to provide the support they need. When we arrive, they say, ‘Look, our friends are here!’ which is very pleasant to hear. They express their gratitude and they appreciate that we don’t only care about their work, but also about the personnel themselves.

“Apart from that, we also provide them with the technical means to offer rehabilitation services, including crutches, wheelchairs, and rehabilitation equipment. We conduct trainings to improve the rehabilitation response. We discuss the basics of using assistive devices because the basics are still very important. For example, many people don’t realize that you should not give someone only one crutch to use, as it could distort their gait pattern. After one training, we had a specialist saying, ‘I couldn't imagine that the selection of crutches could be such a meticulous task.’

“We teach the staff to take care of their psychological and physical health. These things must always be combined; you can't take care of one thing and neglect the other. One method we teach during the training is self-relaxation techniques for crisis situations.

“We also initiated awareness-raising sessions regarding disability. This session explains that disability is not a medical concept, but a social one. It's not related to a diagnosis, but rather to society's perception of this issue. Our mission is to shape positive attitudes toward the fact that despite any injuries, or incomplete physical and psychological functionality, a person can still have a good life if you remove the barriers and motivate that person to live independently. We also provide training on the safe evacuation of people with special needs."