Social Post-Rehabilitation

Since the onset of the full-scale war, rehabilitation departments have been established within the existing hospitals of the JSC "Ukrzaliznytsia" in Kyiv and Kharkiv. These departments focus on rehabilitating military personnel, veterans, and railway veterans with complex injuries. Medical rehabilitation in these facilities is conducted using a multidisciplinary approach, involving the collaborative efforts of occupational therapists, psychologists, neurologists, speech therapists, and physical rehabilitation physicians.
Over the two years of operation, we have observed a shift in the nature of injuries since the beginning of 2022. Mine-explosion injuries have become the leading cause of disability. About 35% of patients with mine-explosion injuries acquire disabilities, and approximately 20% of them are forced to use a wheelchair subsequently.
Specialists in the rehabilitation department have noticed that, despite all necessary medical interventions, appropriate medication, psychological management, and positive treatment dynamics, there remains a significant need for patient socialization and assistance in transitioning to civilian life.
Currently, there are no programs or specialized institutions in the country to help veterans with disabilities transition back to normal life after the medical rehabilitation process. Individuals face challenges such as learning to cope with obstacles in the community and at home: how to use a wheelchair in inaccessible environments, adapt their living space according to their injury's specifics, and how to interact with family members.
The solution could be creating a specialized space (training center) where patients can learn to use a wheelchair according to road conditions and obstacles encountered in non-adapted environments. This will allow patients to adapt more quickly to civilian life. Involving family members in the training process is crucial for psychological comfort and achieving quick results.

Mobile Psychological Rehabilitation Teams

War, with all its manifestations, is a prolonged and intense stressor that now affects nearly the entire population of Ukraine. In particular, the enemy frequently damages railway infrastructure through missile and artillery attacks on stations, depots, and trains. Alongside military personnel, employees of JSC "Ukrzaliznytsia" continually experience physical and psychological trauma, especially while performing their duties to ensure the railway's capacity to supply the army with necessary resources. The leading cause of severe psychological trauma and post-traumatic stress disorder (PTSD) is mine-explosion injuries due to the combination of multiple factors of impact.
We have observed that even after quality physical rehabilitation, patients still require psychological support for themselves and their families. Psychological assistance and stabilization for those affected by mine-explosion injuries are essential for returning to normal life, proper socialization, and the ability to resume their duties, particularly in strategic sectors. Based on international experience and the practices of rehabilitation centers in our country (such as the UNBROKEN National Rehabilitation Center), psychological support for trauma must be comprehensive. This involves the collaborative efforts of cognitive-behavioral therapists, medical psychologists, neurologists, and psychiatrists. A holistic approach and the interaction of specialists are key to patient recovery, stabilization of psychological and physical conditions, and adaptation to normal life.
JSC "Ukrzaliznytsia" can provide professional psychological assistance to military veterans and employees affected by mine-explosion injuries at its own health facilities. This will be achieved through the work of mobile psychological teams with the capability to travel to different regions.