Every country in the world requires a well functioning system to rehabilitate patients with serious conditions, such as spinal cord injury (SCI) and more. War and the use of explosive weapons often result in overwhelming numbers of complex and life-altering traumas, such as SCI and traumatic brain injury (TBI). The war in Ukraine is increasing the number of patients in need of intensive care and rehabilitation.
People with such injuries require intensive care and rehabilitation that continues long after the acute phase of their treatment. They often benefit from occupational therapy. The World Federation of Occupational Therapists defines it as “a client-centred health profession concerned with promoting health and wellbeing through occupation”.
The goal of occupational therapists is to enable their clients to participate in everyday activities. The therapists do so by working with them and their communities to enhance their ability to engage in the occupations that they want to, need to or are expected to do, and by modifying the occupation or the environment to better support engagement.
Finding a special approach
In Ukraine, occupational therapy (referred to as ergo-therapy) is relatively new, with only about 50 specialists across the country. One of them is Yuliya Tereshkovich, who has been working at a rehabilitation centre in western Ukraine for the past year and a half. The novelty of occupational therapy is exactly what intrigued her.
“I’m interested in things that are new,” Yuliya says, explaining her career choice, “and I get inspired by helping people become independent. That’s the greatest satisfaction I can ever get from my work.”
As part of the rehabilitation response strategy following the outbreak of war in Ukraine, the Ministry of Health has set out to transform a rehabilitation centre in Rivne into a national centre for SCI and TBI care. The United Kingdom’s Foreign, Commonwealth & Development Office (FCDO) has supplied vital equipment.
In addition, through financial support from the FCDO, WHO has been working to build staff capacity at the centre through training, clinical leadership, and provision of additional equipment and assistive technologies.
The rehabilitation centre will become the first priority referral facility for SCI care in Ukraine. Having expanded bed capacity from 50 to 100, it has received double the number of referred patients this year.
“Some of them have very strong personalities and can show a lot of resistance,” Yuliya says, a stark contrast from those she used to treat before. “We have to find a special approach. I use all of my charisma and sense of humour in such cases. It’s important to be adaptable and understand people well.”
Yuliya and her colleagues are getting better at this special approach and are refining their technical skills with the help of international consultants, who have been supporting the staff as part of WHO’s capacity-building effort.
“It’s just wonderful, I barely have words to describe it. I feel like the entire world is now present in Rivne,” Yuliya says about the experience. Her team has not had a chance to visit similar facilities abroad, so they are eager to learn from foreign guests like Johanna Wangdell, an occupational therapist from Sweden.
“I’m so happy to have a mentor like Johanna, who shares her expertise with us completely free of charge and has all the answers to all our questions,” she says.
Despite years of experience in occupational therapy, Yuliya admits that only at this rehabilitation centre does she feel she can actually make a difference. Helping Ukrainians become independent is at the heart of her work and, lately, she wants to go the extra mile for them. “Most patients here are young, they’re around my age. I really want to keep finding ways to help them.”
Looking to the future, she hopes to see more opportunities for people with disabilities in Ukraine to participate in work, sports and social activities. “In the meantime, we as occupational therapists will keep doing everything in our power to help these people achieve independence in self-care. And we will build on that for their future needs,” she concludes.