Kyiv, December 3, 2015. Ukraine desperately needs to reform rehabilitation medicine. Such profession as “physical therapist” and “occupational therapist” need to be included into the classification of occupations. Despite the fact that ministries of Healthcare, Social Policy, Education and Science have preliminary agreed to it, the process is being back-pedaled, said physical therapists, volunteers, members of the Ukrainian association of disabled ATO veterans during discussion at Ukraine Crisis Media Center. “In times when the war in Ukraine is on for two years and we have thousands of wounded, blocking the reform of rehabilitation medicine can be considered a state betrayal,” said Vitaliy Rodin, physical therapist of the Ukrainian Physical Therapy Association. According to him, the problem is in the fact that rehabilitation specialists do not exist de jure, thus people cannot work as such specialists according to law. Respectively, they do not want to go and work at state-run medical institutions, because there they are offered positions that absolutely do not match their skills. “In the past 20 years I have already been registered as an exercise rehabilitation instructor and a nurse in the personnel chart,” quoted own example Rodin. He explained that physical therapists are medics as well but they do not aim at doctors’ posts. They are different from doctors as they cannot use pharmaceutical and invasive methods of treatment, but these people are responsible for everything that concerns movement of a patient.
Lidia Butska, volunteer and physical therapist, explained that rehabilitation means restoring internal mechanisms of a person after the acute phase of the disease has been treated. It has to start already from the first hours of the patient’s disease. It means a team of rehabilitation specialists needs to work in parallel with the doctors to lead the patients through until they completely adjust themselves to social life. Occupational therapists also work with the every patient from the first days. However, in contrast to the physical therapists that restore person’s movement, occupational therapists “put the meaning into this movement,” elaborated Rodin. They help a person adjust to the environment and restore his/her habits – to dress up, brush the teeth and cook. Although, the discussion participants noted that such occupations do not exist in Ukraine and no systematic rehabilitation has been set up for patients.
According to Lidia Butska, no progress has been achieved in this issue, in particular because civil servants emphasize that the actual laws need to be re-written. “I see that the only way to resolve this issue in our country is to step aside from the system that has decayed indeed and create our own instruments and mechanisms. As our two-year experience has demonstrated they are in the hands of the community – associations, professionals and volunteers,” the physical therapist noted. The laws on rehabilitation must stipulate issues like “where to direct the money for rehabilitation, which centers are to be certified, which universities are to be allowed to train the specialists” need to be decided upon by professional associations and by those who need those services, Butska is convinced.
Serhiy Triskach, member of the Ukrainian association of disabled ATO veterans, thinks that the state has taken up the monopoly for rehabilitation of ATO veterans. However, it is does not cope with this task properly as the programs for rehabilitation of wounded are not operational in reality but exist only “on paper”. Civil society organizations on the contrary are capable of organizing this process and engaging best professionals they are not let participate in establishing rehabilitation centers. It is important to set up cooperation between the state and the civil society in this field, says Triskach. “We are noticed and heard only when some PR activities need to be done,” said member of the Ukrainian association of disabled ATO veterans. He also emphasized that the state must fulfill its duty towards ATO veterans who have fulfilled their duty towards the country and lost their health. The state needs to provide them with decent conditions for adaptation and with the opportunities for personal self-realisation. It includes things without which a person with disability cannot even walk out of his/her house – wheelchair ramps, accessible public transport and elevators etc.
Uliana Suprun, Director of Humanitarian Initiatives of the Ukrainian World Congress, director of Ukrainian Catholic University School of Rehabilitation Medicine, said that the difference between Ukraine and the West as to the barriers is huge. There are also a lot of such people in the U.S. but the government has created all the decent conditions for them and they daily are seen on the streets. “In Ukraine I was quite shocked as I did not see these people. While I was three months on Maidan I saw probably three-four disabled people, not because they did not want to come to Maidan but because they physically cannot do that,” noted Suprun.