Strength Through Support: Rehabilitating War-Wounded in Ukraine
This evening, I’m taking my dog for a slightly longer walk than usual. It’s been an emotionally challenging day at work. Stalker—that’s my dog’s name—always senses when feel overwhelmed and need a release. He runs alongside me and rubs up against my legs. I often confide in him about the strength of spirit and character I witness in my patients.
As a physical therapist at Doctors Without Borders/Médecins Sans Frontières (MSF), I work with a team that runs a comprehensive rehabilitation initiative at a hospital in Kyiv. This project integrates both physical and mental components, aiming to uplift people grappling with severe injuries from the war.
I joined MSF on the recommendation of a friend who was already working in the organisation. She informed me about available positions and the opportunities to acquire the latest experience in physiotherapy.
MSF had brought to Ukraine experienced specialists who had worked during international armed conflicts and wars in various countries and had treated patients with the types of injuries we were now seeing. Although the war in Ukraine has been ongoing since 2014, the demand for treatment for war-wounded individuals had not been comparable to the current situation. These doctors provided me with valuable instruction and guidance in carrying out rehabilitation exercises for patients with injuries and amputations.
Initially, it was challenging to come to terms with what I was seeing – patients with injuries reminiscent of those during the Second World War. These patients arrive in the hospitals by the dozens. I vividly remember one night at the beginning of the full-scale escalation of the Russian-Ukraine war when an entire train carrying people with serious lacerations, bullet wounds, and amputations arrived in Kyiv from the frontline. Some of them ended up in the hospital where we are running the rehabilitation project.
Sometimes, patients that arrive at the hospital are depressed – they do not wish to see anyone and are not in the mood for rehabilitation; they just lay in their hospital bed. Often it requires a great deal of endurance to convince them that there is always hope. I explain the importance of early rehabilitation and we commence physiotherapy so they can learn how to adapt to a normal life with a new body.
Over the past six months, I’ve worked with more than fifty patients, each with a unique story and their own journey to recovery. Today, I met with Andrii, a 27-year-old man preparing for prosthetics after sustaining injuries during fighting on the frontlines this April. Unfortunately, he lost his right arm, leg, and nearly all of his vision.
Andrii and I are navigating a challenging journey together. Prior to fighting in the war, he worked as an IT specialist. After he was injured, he was hesitant to leave his bed and had difficulty imagining a future for himself. With the support of a psychologist and active involvement from his mother, we began our rehabilitation efforts.
I encouraged Andrii to stand on his remaining leg and take small steps with the rolling walker, incorporating breathing exercises as he goes. Gradually, we progress to the physical therapy room. We start exercises with him in a wheelchair – our focus includes stretching muscles in the abdomen, trunk, and limbs, along with specialised exercises to prevent joint mobility restrictions that could hinder being able to use prosthetics.
The preparation of the stump for a prothesis can be accompanied by acute pain. Despite the still-fresh stitches after surgery or amputation, if we don’t work with the joints in time, they will narrow, pull up even higher than before the amputation and it will be impossible to put on a prosthesis – the stump will not hold. I witness how Andrii and other patients overcome this pain, and I find it admirable.
During moments when he feels emotionally burnt out, I suggest simple tasks like “doing a swallow” – balancing on one leg and imagining flying. I include humour and words of support to lift Andrii’s spirits.
To distract ourselves, we often delve into discussions about football and the achievements of the Ukrainian national team. I used to play professional football and I share stories of injuries I endured during my career and how I overcame them. I tell Andrii and other patients that personal belief in victory – over pain, difficulties and challenging conditions – is crucial.
At times, emotions overwhelm me, and when I come home, I may cry alone with my dog. I reassure him, saying, “Don’t worry, Stalker, I’m fine. I just really want my patients not to lose faith in themselves and to find happiness in their new life. In our world, so little is needed for them: learning to walk again, driving a car, playing football, holding a child in their arms, or running with a dog in the park…”
After our session, Andrii went to the prosthesis centre. He sent me a video of himself being measured up for a new leg and arm, saying “Well, now I can’t be stopped!” We both felt happy at that moment.
I often feel what I call ‘satisfying weariness’ after a day of work. It’s that need for an emotional recharge, but my heart is happy for the success of the patients. I energise quickly, especially when my dog Stalker is around. As we stroll down another alley, I breathe in the fresh air, then head towards home, ready for a restful night. Tomorrow, I will be ready to kick off a new day with my patients.
__________________________________
Inna Didych is a physical therapist at Médecins Sans Frontières (MSF). Before the full-scale invasion, she worked as a physical therapist in the Kyiv Regional Hospital’s rehabilitation department, caring for patients who experienced Covid-19, brain injuries, strokes and heart attacks. She holds the title of Master of Sports of Ukraine in football, is a professional trainer, and a FIFA referee.
