"Medical Rehabilitation in the Armed Forces of Ukraine" by Prof Col Vsevolod Stebliuk, Assistant to the Minister of Defense of Ukraine on medical matters, Ministry of Defence of Ukraine

1. System of Medical rehabilitation for
WAR VICTIMS
in the MoD of Ukraine
By Professor
Dr.Vsevolod Stebliuk, MD, PhD
Medical Colonel

2. UNDECLARED WAR
• More than 1500 died soldiers
• More than 6000 wounded soldiers
• More than 100 amputee

3. Combat injuries and their
consequences
wound
Morphological changes Mental disorders
Functional disability
Physical Psycho-social

4. System of military medical care
RED and YELLOW ZONE:
Combat medicine
GREEN ZONE:
First line hospitals
REGIONAL MEDICAL CLINICAL CENTERS
(with rehabilitation units)
HEALTH RESORTS

5. Treatment and Rehabilitation
• Termination of the
damaging factor
• Restoration of
disturbed
morphological
structures
• Prevention of
complications
• Restoration of
disturbed functions
• Adaptation to new
conditions of life
(when it is
impossible to fully
restore function)
• Maximum personal
and social
adaptation

6. Ideal rehabilitation system
• Medical rehabilitation
(reconstructive surgery,
restorative treatment)
• Physical rehabilitation
• Acute psychiatry care
• Recovering psychiatry
• Psychological care
• Social re-adaptation

7. The structure of wounds (%)
head; 33,5
arms and legs;
52,4
chest; 6,4
neck; 1,6 pelvic; 0,7
spine; 0,4
head
arms and legs
chest
neck
pelvic
spine

8. Rehabilitation system in the MoD of
Ukraine
First surgical care Secondary surgical care Reconstructive surgery
Post-surgery treatment/
rehabilitation
Sanatorium (health resort)
treatment and rehabilitation
MoD hospitals Veterans hospitals
MoD sanatorium Private or state
sanatorium
rehab
rehab

9. Rehabilitation beds in MoD
• «Трускавець» - Karpaty region 500 beds – gastro-
intestinal pathology (abdomen trauma)
• “Хмільник” Central region 400 beds – traumatological
rehab center
• Вінниця Central (rehab-department) – 100 beds –
early rehabilitation
• Ірпінь Kyiv region – 70 beds - early rehabilitation
• Пуща-Водиця Kyiv region – 250 beds, psycho-somatic
pathology
• Львів West region – 30 beds – spinal rehabilitation
center

10. Veterans hospitals (MoH)
Україна
58 (8572) 2 (225)
5 (420)
3 (259)
1 (50)
1 (60)
1 (240)
5 (580)
1 (300)
1 (810) 4 (480)
1 (240)
1(230)
1 (120)
4(425)
3 (370)
1 (210)
1 (100)
м.Київ 6 (1656)
1 (200)
4 (200)
1 (250)
6 (415)
1 (232)
1 (250)
1 (200)

11. Three Steps Program of complex
rehabilitation for soldiers and their
families
• The First step: early rehabilitation in the
hospital
After-surgical rehabilitation, first contact with psychologist, physical therapy

12. Three Steps Program of complex
rehabilitation for soldiers and their
families
• The Second step: rehabilitation center
Physical and psychological rehabilitation, SPA, first contacts
with social workers. Family therapy.

13. Three Steps Program of complex
rehabilitation for soldiers and their
families
• The third step: back to life!
New skills, adjusting to life and social reintegration

14. Regional MoD Rehabilitation
complexes

15. IRPIN
scientific-practical rehabilitation center
Occupation therapy
Physical rehabilitationIREX-rehab system Audio-visual stimulation
Traditional physiotherapy

16. Opening ceremony of Irpin Rehab
Center

17. Perspective of Rehab system
• The introduction of standard protocols
rehabilitation, on the basis of the international
classification of functional disorders and
disabilities
• 100% for the rehabilitation of the three-stage
systems of all the wounded
• Establishment the Department of Medical and
psychological rehabilitation in the Ukrainian
Military Medical Academy

18. We need:
• Educational programs for rehabilitation:
physical therapy, psychological counseling,
post-traumatic stress disorder management
• Teaching of teachers
• Equipment for rehabilitation

19. Help the wounded - return them to
life!