To return childhood to wounded children:

Baking pizza, swimming in the pool and skiing. These are not entertainment, but important components of the rehabilitation process for children who suffered from mine injuries. They learn to do everything again and know for sure that movement is life. What is important for children's rehabilitation? How does play help in the recovery process and what does skiing have to do with it? These and many other questions were answered by experts in children's rehabilitation. 

Alina (name changed for ethical reasons) and her parents came under fire near Pokrovsk in the summer of 2024. In serious condition with burns and an open shin wound, she was first taken to the Pokrovsk City Hospital. Later, after her condition was stabilized, she was taken to the Regional Medical Center for Family Health in Dnipropetrovs'k region. The girl spent 39 days in the intensive care unit.

Elsa (name changed for ethical reasons) sustained a spinal cord injury when she was wounded in Bakhmut.

Andriy (name changed for ethical reasons) received shrapnel wounds in Kharkiv. His liver, ribs, and muscles were injured.

These are just some of the stories of children affected by the war. According to the UNSince the beginning of the full-scale invasion of Russia, as of February 2025, 1865 Ukrainian children have been injured.

Overcoming the challenges of hard experiences together

In Ukraine, there is an approved list of rehabilitation institutions and facilities health care institutions that provide rehabilitation for children with disabilities. As of March 2025, 126 institutions were registered. Among them is the Regional Medical Center for Family Health of the Dnipro Regional Council. Head of the Department of Physical and Rehabilitation Medicine Irina Arkhipova says that the hospital started treating children with mine injuries back in 2014. But these were isolated cases and not so severe injuries. Until the full-scale invasion began. Since February 2022, the institution has admitted 201 children with injuries, wounds and complications sustained as a result of hostilities.

"Behind every statistic is someone's life. This is an experience I would never want to have." - Iryna says.

Alina, whom we mentioned at the beginning of the text, was a patient of the center where Iryna works. The girl was in a very serious condition. She had to endure terrible pain. She was also very depressed. Her mother was with her in the intensive care unit all the time.

"Tendons and bone fragments were visualized at the bottom of the wound. Doctors performed several surgeries and skin grafts to close the defects." - Iryna Arkhipova recalls.

Gradually, the girl learned to move around in a wheelchair, and then work began to restore her gait. Thanks to the efforts of the multidisciplinary team, Alina gradually recovered.

"The girl has become more contactable. At first she walked with crutches, then barefoot on her own, and later in shoes with a special insole."Iryna Arkhipova said.

The doctor noted that thanks to the charitable foundation «Zaporuka» and Soleterre with the financial support of the Italian Agency for Development Cooperation, the conditions at the medical facility have been significantly improved. A renovated inpatient rehabilitation unit was opened, providing care during acute, post-acute and long-term treatment. At each of these stages, people need proper comfortable conditions that will help them recover. About 30 patients receive inpatient rehabilitation care per month. Four rehabilitation rooms were also renovated. The total cost of the renovation works in the Physical and Rehabilitation Medicine Department is as follows UAH 4.5 million.

"Rehabilitation of children with mine-blast injuries is a complex multifactorial process that requires a multidisciplinary approach, starting with the child's admission to the intensive care unit, cooperation with surgeons, traumatologists, and orthopedists. Our hospital has such an opportunity. Timely diagnostics and a multidisciplinary team help the child to recover physically and psychologically," says Iryna. 

Rehabilitation and pizza

The material support of the hospital is important for quality rehabilitation. Acting Head of the Rehabilitation Department of St. Nicholas Hospital, Lviv Territorial Medical Association Serhiy Khuda says that the facility is equipped with the necessary exercise equipment, a swimming pool, and several rehabilitation rooms.

"Our corridors are also our workrooms. On average, we have 45 to 55 patients a day, and every centimeter is important to us," said Sergiy.

The doctor emphasized that the game component is important in the rehabilitation of children.

"All simulators contain a game module. Patient motivation is the most important thing for us. Children are playing games, but they are actually doing certain strength exercises and, accordingly, you can get results," says Huda. 

An occupational therapy kitchen is also effective in working with children. This is a place where patients can practice cooking and eating skills. According to Serhiy Huda, they most often cook pizza there.

"We immediately start walking with the children and training all the skills we can. This is possible thanks to very close cooperation with all colleagues. We hold multidisciplinary meetings where we can discuss all patients, communicate, and review clinical cases. For our convenience, we have made a schedule and can distribute patients according to the availability of specialists," explains Serhii Khuda. 

Elsa, whom we mentioned at the beginning of the text, is in the hospital where Serhiy Huda works. She is learning how to use a wheelchair, dress herself, get off the floor, etc.

Serhiy Khuda emphasizes that education is important for patients and doctors. That's why teachers come to the children, and the team of doctors undergoes training in different countries: USA, UK, Italy, France, Germany, and Lithuania. The training of Ukrainian specialists in Italy took place within the framework of the project "Strengthening the Capacity of Ukrainian Medical Institutions" implemented by the Zaporuka Foundation together with Soleterre and funded by the Italian Agency for Development Cooperation.

"High-quality rehabilitation depends on a great team that has to develop and think about the patient first," the doctor noted.

Skiing and snowboarding

Children undergoing rehabilitation can benefit from team and individual sports. Vasyl Leskiv - is an instructor at the Holosiiv-Park ski base, vice president of the Association of Professional Ski Instructors of Ukraine. He has been cooperating with the Okhmatdyt National Children's Hospital in the area of physical rehabilitation for two years. In winter, children undergoing rehabilitation had the opportunity to practice skiing and snowboarding. Vasyl emphasizes that all the children attend the classes together: those who are just training and those who are undergoing rehabilitation.

"An eight-year-old girl with a leg amputation was very afraid to go skiing because there were so many people around. That day we were setting a Ukrainian record. She skied 50 meters and felt the spirit of competition. There were a lot of emotions. Having overcome her fear for the first time, she is now achieving new results, riding a bike, and we are going to try rollerblading. This is a very good example for other children to understand that they don't have to stay at home," says Vasyl. 

Vasyl's wards go in for outdoor activities. In winter they go skiing and snowboarding, in spring they go rollerblading, biking, scootering, and in summer they go water skiing and wakeboarding.

«"During physical activity, psychological adaptation also takes place," Vasyl is sure. "Social skills are developed through teamwork, and there is a decrease in isolation and an increase in social integration.".

Vasyl notes that the main indicator of effectiveness is the child's emotional state.

He advises:

• Set realistic goals;
• celebrate achievements;
• go from simple to complex;
• apply an individual approach and take into account the capabilities of a particular child;
• take into account medical indications and contraindications.

Thus, the rehabilitation process can be complicated and lengthy. However, physical therapists and multidisciplinary teams do their best to help children master the skills they can after being injured. They try to use all possible methods and means to make the rehabilitation process not only effective but also interesting. And philanthropists support them in this process of miracle making by providing the necessary tools and opportunities for professional growth.

The specialists shared their experience of working with these and other patients, the latest techniques and personal achievements during II All-Ukrainian Conference "Rehabilitation in Pediatrics" as part of the Rehabilitation of War Trauma initiative, which took place in March at OKHMATDYT. It was organized by: BF Patients of Ukraine, Soleterre, Charitable Foundation Zaporuka, the Italian Agency for Development Cooperation, a project of Ukrainian-Norwegian cooperation with the support of Sunnaas sykehus HF, NGO "All-Ukrainian Association of Physical Therapists", as well as the Advisor to the Presidential Commissioner for Barrier-Free Access Tatiana Lomakina і Ministry of Health of Ukraine.

The text was prepared by: Olena Kushchenko