An insightful conversation with Hryhorii Dunas, Director of the Halychyna Rehabilitation Center.
Every day we see photos and videos from the front lines—feedback from our Defenders. But few people know what a patient’s life is like after an injury. Who is by their side, what hopes do they have, and what do they need? Let’s visit an institution which regain the hope. This is a non-profit state institution, Center for Comprehensive Rehabilitation “Halychyna”.
Have you Heard About The Halychyna Rehanilitation Center?
If not, it is time to meet its head and director, Hryhorii Dunas. With two higher education degrees and many years of experience in rehabilitation medicine, he helps soldiers recover and maintain their spirit. Not breaking down emotionally is perhaps the hardest task for those who have lost upper or lower limbs, suffered traumatic brain injuries, spinal cord injuries, or even lost their homes and families.
Long before the full-scale invasion, the Center primarily worked with civilian patients. Since 2014, it has been actively working with those injured in the conflict zone. As of February 24, 2022, there were 180 patients in the Center. On the first day, the Center began receiving refugees from the East and Kyiv region. Two locations provided shelter for 2,300 people. Within a month, the Center returned to its primary activity but did not receive the expected 60 or 70 patients. Their number gradually increased to 300.
The day after the decision was made to admit patients, the first 10 wounded were brought in. Subsequently, vehicles transported 15 to 20 patients at a time. There was a shortage of staff; some personnel had volunteered for the front lines. Volunteers and local residents were involved in the work. Ukrainian doctors who had been living in France and other countries for a long time came to help, working without being officially employed by the institution.
300 Patients at a Time
This is the number of people undergoing rehabilitation simultaneously at the Halychyna Center—the highest among similar centers in Ukraine. The Center became an “unplanned record-holder” as the number of patients continuously increased during the war.
To date, the Center has served 1,720 people, conducting 5,160 rehabilitation cycles and providing prosthetics for 1,270 patients. Daily, the Center receives calls of gratitude. Many of these patients will return, as rehabilitation after such serious injuries must be repeated at least once a year. Patients come to restore their health, to repair and adjust prostheses that wear out.
Thus, the number of people needing rehabilitation constantly grows, and there are not enough places. Director Hryhorii Dunas cannot turn anyone away in such a situation.
“The proportion of military patients has increased from 3-5% to 100% during the war,” says the director. The most common injury is the loss of upper and lower limbs, accounting for 90% of diagnoses. Other injuries include abdominal injuries, traumatic brain injuries, spinal cord injuries, and the consequences of strokes and heart attacks combined with limb loss (10-15%).
Patients come here after surgeries, and side effects often occur during rehabilitation—such as osteophytes and neuromas. Sometimes reamputation is necessary.
The war has changed much of the Center’s work. Both the Center’s specialists and prosthetics experts had to learn how to work under wartime conditions. Initially designed to meet civilian needs, the medical field was not sufficiently developed for wartime demands. The opening of two prosthetic laboratories at the Center, where measurements and prosthetics are performed, partially solved the problem. This saves valuable time, as patients do not have to travel elsewhere. This allows 30-35 people to undergo prosthetics simultaneously.
“This is good but not enough,” asserts the director of Halychyna. Other patients are assisted by external prosthetic companies. Significant help comes from public organizations and volunteers. Some patients receive invitations for prosthetics abroad and continue their rehabilitation at Halychyna upon their return.
The Center accepts not only those who have lost limbs but also those with combined vision and hearing losses, stroke survivors, and those with traumatic brain and spinal cord injuries. Wounded individuals often suffer strokes and heart attacks as well. Thus, the work is comprehensive, including rehabilitation measures, professional orientation, and educational activities. Such people need to know what to do and how to support themselves after leaving the Center. Therefore, an individual home rehabilitation program is developed.
Support Today, Tomorrow, and Beyond
When preparing veterans to leave the Center after rehabilitation, Hryhorii Dunas ensures they are not saying goodbye forever. He strives to provide them the opportunity to return at least once a year.
For many, the work continues beyond the Center’s walls, as adapting to society after losing two, three, or even four limbs is challenging. The inability to return to a familiar profession and physical limitations can severely impact an individual’s sense of self.
Some patients at the Center have lost not only their health but also all their loved ones, leaving them without anyone to rely on in daily life. Some are driven by a desire for revenge for their ruined lives, though few have the means to act on it. Therefore, the primary goal is to help them find purpose, acquire a profession, and not feel isolated and abandoned, says Hryhorii Dunas.
This issue is not new; it has affected every patient even before the war. That is why the Halychyna Center employs a comprehensive rehabilitation model, patented back in 2008. Since the war began in 2014, the program has undergone several stages of modernization, but its aim remains the same: to help individuals reintegrate into society and socialize as much as possible after injury.
Additionally, injured individuals are provided with housing if necessary, assistance in organizing their documents, the opportunity to undergo a medical commission, and apply for disability status. The Center’s staff establish connections between patients and local authorities to secure housing and further support.
Center at 30%, Work at 100%
By 2023, more than 10 rehabilitation centers were operating in Ukraine, but even this is not enough to meet the current needs of the patients. According to preliminary estimates, between 300,000 and 400,000 people require medical rehabilitation. The Halychyna Center is the largest of these institutions and could take on even more workload if it were operating at full capacity, as it is currently built to only 30% of its potential.
The Cabinet of Ministers approved the proposal to allocate 376 million UAH for Center’s further construction. This funding will enable the addition of new facilities where soldiers will undergo physical, medical, psychological, and social rehabilitation.
However, the physical space alone is not sufficient. The new rooms require high-tech equipment for physical recovery, including exercise machines and diagnostic tools. These are crucial for enabling patients to achieve rehabilitation successes that are otherwise unreachable. For example, those with spinal cord injuries urgently need Lokomats—robotic systems that move the body and stimulate the restoration of movement and walking skills. Whether a patient can undergo therapy on such a machine can determine their ability to walk independently, be self-sufficient, and even work.
There is also a critical need for specialists, as the number of patients continues to grow while the number of doctors decreases. Although Western partners invite our specialists for training and Ukrainian universities offer education according to international standards, the situation remains critical due to the war.
Despite these challenges, the Center’s staff strive to help everyone in need, often working one and a half shifts, dividing their time among patients, and individually managing the workload for each person.
The Most Challenging Patients -- Who are They?
No, these are not the individuals who are currently between life and death. Here, at the rehabilitation center, immediate life-saving interventions are rarely required. The patients arrive after hospital treatments and surgeries, and their lives are not in imminent danger.
However, another danger looms here: despair and an overwhelming sense of grief, unique to each individual but equally painful. Doctors, physical therapists, occupational therapists, assistants, speech therapists, psychiatrists, and psychologists must find various ways to heal these individuals, a task not everyone can handle.
The Center has patients who have lost three or even four limbs. Often, they also suffer from spinal or traumatic brain injuries. Some have no one to care for them, as the war takes away not only health but also loved ones.
Sometimes, a loved one meets the soldier after an amputation, is frightened by the challenges, and leaves their life forever. In such cases, the abandoned soldier shares all their pain and despair with the staff, pouring out their frustration, as there are no closer people for them at that moment.
Upon starting their work, some young specialists cannot withstand the emotional burden and quit.
A Happy Story
Patients create their own happy stories, as these are not about extraordinary luck but about self-belief and persistence. Such was the case with a soldier who lost both legs. His amputation was high, leaving him with no legs at all, making prosthetics out of the question.
Yet, the power of spirit can overcome all obstacles. He directed his willpower towards training his arms, setting a goal: to become a rock climber and ascend a 30-meter height. And he achieved it. He conquered a steep cliff, not an easy task even for a healthy person.
Now, the hero of this story lives an active life, with his beloved wife by his side. The colleagues have immortalized his story in a book.
Collaboration Between Halcyna Rehabilition Center and Social Projects Center of Future
The paths of the Foundation and the Rehabilitation Center crossed when a surge in patients highlighted a severe shortage of equipment, much of which was outdated. Progress was slow. The Halychyna Rehabilitation Center reached out to the public for help, and representatives from the Foundation came forward to offer assistance.
The Foundation provided the Center with modern and crucial equipment for rehabilitating patients with limb injuries. Conducting training sessions for the medical staff is also planned.
Luna
This device aids in restoring walking skills after the loss of lower limbs. The suspension system allows for adjustable load management, which can be increased gradually. As a result, patients who are new to prosthetics experience less fatigue, feel more confident, and learn to walk more quickly. Additionally, there is a Luna device for upper limbs, which is also greatly needed at the Halychyna Center.
Neuromyograph
The Foundation also provided the Center with a long-awaited neuromyograph. This device is used to detect nerve endings in individuals with damaged or lost limbs. Every patient with limb injuries undergoes an examination with this device. In September, one of the neurologists will undergo specialized training to use the neuromyograph effectively.
The model provided by the Foundation is an advanced version, and the psychological aspect is significant: modern equipment sparks interest and trust among patients. Before this advanced device, doctors relied on what Hryhorii Dunas referred to as “folk methods”: ultrasound examinations followed by mechanical testing. The neuromyograph allows for much faster and more accurate assessments, speeding up rehabilitation and increasing efficiency.
Without the support of the Foundation and other public organizations, the Center’s achievements would not have been possible, the staff asserts. State assistance accounts for only a small part of what the Center receives and needs. Organizing meetings with public organizations, initiated by the government, also provides substantial support.
Plans and Dreams
The dreams of the director of the Halychyna Rehabilitation Center, like all his time, are dedicated to the Center…
Currently, the two locations of the Center in the Lviv region can accommodate 300 patients. Completing the construction of a new complex, which the Center desperately needs, will allow for the simultaneous treatment of more than 500 individuals.
While developing the project, Hryhorii Dunas used the experience of Western specialists he observed during a trip to Austria. Among the plans are a spacious gym and balneological procedures that accelerate tissue regeneration and help adapt to prosthetics without complications such as osteophytes and neuromas.
The natural environment of the region supports this effort: it is rich in minerals, hydrogen sulfide waters, and healing muds. The delay lies in completing the building and equipping it with the necessary equipment.
Completing this project will elevate rehabilitation to a new level. Hryhorii Dunas, along with his team, has developed a phased rehabilitation program where each patient will undergo step-by-step treatment. Once the first phase is mastered by 60%, patients can move on to the second phase, which presents new tasks requiring greater activity.
Gradually, basic exercises will be supplemented with pool activities, kinesitherapy, and game activities on rehabilitation and sports grounds. Play is a powerful motivator, according to the director of the Halychyna Center. What seems impossible on a machine can be quickly overcome during a game, driven by the spirit of competition. Hippotherapy is already actively practiced at the Center.
Achieving these plans requires significant investment, but less than what would be needed to open a new rehabilitation center. Investing in a project that is already underway is more cost-effective.
Take for example:
- Construction began in 2004 at the existing site at Khutorivka 38 in Lviv, and within a year and a half, the team built a 6,200 m² facility;
- In 2009, construction began on the first phase of a rehabilitation complex located in Velykyi Lyubin, Lviv region, at Sportyvna St. 4. The complex became operational in 2018, with 30% of the construction completed, including all engineering networks, a boiler room, and a transformer station, covering an area of 7800 m²;
- By next fall, the plan is to complete and launch a 11,000 m² complex.
Thus, restoring and completing an already started project can take 1.5 to 2 years, whereas a new one would take 10 years.
“Rehabilitation is needed here and now,” asserts Director Dunas. The functions lost by an injured person today may not be recoverable in the future. The inability to take care of oneself necessitates additional workers to assist the injured, which would require a large staff, costing the state much more than the restoration and modernization of existing rehabilitation centers.
In Ukraine, there are currently many unfinished Social Projects Center Of Future projects worth continuing, which would save not only money but also time. This would help develop the future of our country.
Valeria Granovska
Project manager
Author
Source & Image Credit: Social Projects Center of Future
