Unbroken helps people affected by war return to everyday life in Ukraine

Text: Jarkko Anbrusin
Picturest Andriy Tymoshchuk

Ukrainian Andrey is relearning everyday tasks from the very beginning at the Unbroken Center. At the time of the interview, he had already been at the center for eight months.

I was injured on the front line when I stepped on a mine while searching for one of our troops’ drones, Andrey says.

Andrey suffered, among other injuries, a traumatic brain injury in the explosion. His rehabilitation is now focused on helping him learn to walk again and rebuild strength in his muscles.

He is staying in a ward donated by the Swedish furniture giant IKEA. The ward is designed for practicing independent living skills, such as cooking, personal hygiene, using a computer, and other basic everyday activities.

– We have many patients who are unable to sit up on their own or eat independently, says Khrystyna Dvoretska, Communications Director of Unbroken.

Located in Lviv in western Ukraine, the Unbroken Center is not just a hospital, but a comprehensive rehabilitation center. There, people practice returning to everyday life after the horrors of war — one step at a time.

The Unbroken model is spreading across Ukraine

The center’s facilities have been thoroughly renovated during the war. Just a few years ago, they resembled a typical Soviet-era hospital, but now the treatment environment is modern and meets international standards.

The walls of the rehabilitation center’s therapy spaces are filled with paintings and drawings. Many traumatized patients begin to paint before they are even able to speak.

– Art therapy is one of the most powerful ways to communicate with people who are unable to express themselves verbally,” says Khrystyna Dvoretska.

Communication is also supported through technology. For example, eye-tracking devices help patients express themselves and practice memory and concentration when speech is not yet possible.

The work being done in this room does not remain within a single center. The goal is to ensure that treatment for war-related injuries and trauma does not depend on one city or one hospital alone, but that best practices spread throughout the country.

In particular, treatment models for trauma therapy, rehabilitation, and recovery from captivity experiences are being widely shared across Ukraine’s healthcare network.

Released prisoners of war and deep trauma

The Unbroken Center also treats people who have been released from captivity as prisoners of war. Mariana Mamonova, a psychotherapist and coordinator for matters related to released prisoners of war, describes the treatment pathway as complex and extremely demanding. She also has personal experience: she herself was imprisoned in Mariupol at the beginning of the war.

After their release, patients are first referred for neurosurgical evaluation, then to a trauma unit, and finally to psychiatric care. The majority are diagnosed with post-traumatic stress disorder, PTSD.

It is not about a single treatment, but an entire process. Trauma-specialized therapies are needed, such as art therapy and touch therapy, Mariana says.

Doctors are not allowed to ask directly about experiences in captivity. Only trained trauma specialists do that, because poorly timed questions can worsen the trauma. The experiences often include physical, psychological, and sexual torture.

According to Mariana, the behavior of severely traumatized people often falls into three extremes: mania, aggression, or deep apathy.

– It is impossible to forget captivity. People learn to live with their experiences, but they stay with them for the rest of their lives, she says.

The prolonged war is increasing bottlenecks in care

At the moment, the biggest acute bottleneck at Unbroken is space. Wounded people are evacuated weekly from the front line and from cities under attack, and not everyone can be admitted for treatment immediately.

– Unfortunately, we do not have enough places for everyone,” Khrystyna Dvoretska says.

The lack of space is being addressed by expanding the current rehabilitation center. The existing building will undergo a complete renovation, and new facilities will be constructed alongside it, increasing the center’s total floor area from approximately 5,100 square meters to more than 9,100 square meters. The new complex will be built in the immediate vicinity of the current center.

There is also a constant shortage of equipment, including ventilators, monitoring devices, and patient monitors. At the beginning of the war, international willingness to help was widespread, but as the war has dragged on, fundraising has become increasingly difficult.

– Many of the aid programs launched at that time have already ended. The need has not decreased — quite the opposite, Khrystyna Dvoretska says.

Although space and funding are acute challenges, the greatest long-term difficulties are related to expertise. The treatment of war injuries is an area without an established research tradition or standardized treatment models. Many methods have had to be developed in practice during the war itself.

Doctors and nurses at Unbroken have trained in different parts of the world and brought their expertise back to Ukraine. International specialists visit the center to provide training and perform demanding procedures together with Ukrainian colleagues, but responsibility for patient care remains with local professionals.

The prolonged war is also placing a heavy burden on healthcare staff. For this reason, employees are offered psychotherapy, group rehabilitation, and shared leisure activities.

– This work changes a person’s understanding of the body, pain, and what is considered normal. That is why the well-being of nurses and doctors is also critical.

Unbroken is about life after war

At Unbroken, rehabilitation is aimed at helping people reconnect with life. According to Yaroslav Zelizko, Deputy Director of the center and a specialist in physical and rehabilitation medicine, war-related injuries challenge a person’s understanding of their own body and everyday life.

Even when a person intellectually understands what has happened, the body and mind do not always follow. That is why rehabilitation is seen above all as a return to everyday functions — helping people rediscover their place and rhythm in society.

People who have lost their sight or limbs take part in sports, study, and serve as mentors to others. The center organizes sporting events, art exhibitions, and other shared activities.

– One of our patients, a quadruple amputee, is now driving a car and mentoring others, Khrystyna Dvoretska says.

At Unbroken, the focus is not on what has been lost, but on what can still be rebuilt.

Unbroken is about life after war. It is about returning to dignity, everyday life, and society, Khrystyna Dvoretska says.

Unbroken works together with international partners, and companies and experts with solutions to urgent needs can also get in touch through the center’s network.

Unbroken in brief:

• Location: Lviv, western Ukraine
• Founded: after Russia’s full-scale invasion
• Patients treated: more than 25,000
• Services: acute care, rehabilitation, mental health services, and social rehabilitation
• Expansion: the rehabilitation center will grow this year from 5,100 square meters to 9,100 square meters
• Staff: primarily Ukrainian professionals, with international support in training and equipment

Unbroken Ukraine