Assistive technology offers renewed hope to nearly 1,500 civilians affected by the war in Ukraine
People affected by the war in Ukraine are now getting the assistive technology they need, a crucial part of emergency response.
Aleksandra (Sasha) Riabushenko, 13, has cerebral palsy, and received a wheelchair under the AT10 programme in Ukraine. Photo credit: WHO Ukraine
“Getting into my yard using a wheelchair feels completely different compared to being locked in my house and only looking out the window. I have rabbits, I have chickens. I can go to the barn to look at them. It psychologically affects the recovery process. And then I will be able to move my hand more. And the leg will start bending at the knee, and I think my functional capabilities will increase.”
These are the words of a civilian caught up in the Ukraine war, who has now benefited from receiving a wheelchair as a result of ATscale’s financial support and collaboration with Ukraine’s Ministry of Health and the WHO Regional Office.
Assistive technology – such as wheelchairs, prosthetic limbs, eyeglasses or hearing aids – is extremely powerful in supporting people to recover from trauma and injuries, both psycho-socially and physically. During armed conflict and other emergencies it can also be lifesaving, helping people to escape from dangerous situations and enabling them to access critical humanitarian services such as food, water, shelter, health care, and protection. Yet, a survey conducted in 2021 found that 12% of Ukraine's population were in need of, and did not have, assistive products.
ATscale supported the Ukrainian Ministry of Health, through the WHO European Regional Office, to provide WHO’s ‘AT10’, a kit of the 10 assistive products that people displaced due to emergency need the most. The kit includes wheelchairs, crutches, walking frames, walking sticks, self care incontinence products and more. So far 2,458 assistive products have been provided through ten health facilities in five oblasts in eastern Ukraine, meeting the needs of 1,485 people affected by the war.
“The partnership with ATscale is an instrumental component of our emergency humanitarian support to those affected by the ongoing war. We’re thrilled that it has materialised at the early stage of the war in May 2022 and that we’ve already been able to reach 1,500 people ,” said Dr. Jarno Habicht, WHO Representative in Ukraine.
ATscale’s support has also encouraged other donors, including the Ukraine Humanitarian Fund, to provide five additional kits, reaching even more people in need. “In a war zone, assistive technology might seem like the last thing to think about, but we cannot underestimate its importance. People of all ages are fleeing violence, and many are suffering injuries. Some people have lost or broken their assistive technology during the crisis, some never had it in the first place, and sadly many now need support for new impairments. ATscale is immensely proud to be able to respond to this need in Ukraine, working in close collaboration with the Ministry of Health and WHO Europe,” said Pascal Bijleveld, CEO of ATscale.
The need for assistive technology in humanitarian contexts
During armed conflict, and indeed any disaster, specific groups of civilians are at particular risk. This includes women, older persons, children, and persons with disabilities. The global mortality rate of persons with disabilities in disasters is four times higher than of persons without disabilities. For someone forced to flee home in a humanitarian crisis, having access to assistive technology can be a matter of life and death.
Globally, up to 30% of the population needs one or more assistive products. The need for assistive technology increases further during conflict due to loss and damage of products, new injuries, and displacement to different environments.
Yet, assistive technology, unlike food, water, shelter, sanitation, healthcare, and protection, is often not seen as an important part of humanitarian response. Where the provision of assistive technology in humanitarian settings does exist, it tends to be specialized, small scale and limited to procurement and distribution with little attention to service delivery. Assistive technology requires a system of support and services, including tailored fitting, follow-up and regular maintenance, to ensure its safe and effective use.
A rehabilitation professional provides training to an internally displaced person in Ukraine. Photo: WHO Ukraine
ATscale’s collaboration on system-wide assistive technology services
With support from ATscale, WHO Europe is working to integrate procurement and distribution with service delivery systems in ‘Assistive Technology Clusters’ within the health system. The clusters are set up to provide services that meet realtime assistive technology needs of people in Ukraine. WHO Europe has worked closely with the Ukrainian Ministry of Health to establish up to ten ‘AT clusters’ equipped with WHO’s ‘AT10’.
The project initially focused on internally displaced persons, but it quickly became clear that other groups of people affected by the war had lost or damaged their products or had new injuries or conditions. Ultimately, the project met the assistive technology needs of a wide range of people, including internally displaced persons, returnees, people with disabilities, and older people.
WHO provided specialised training for health workers in prescription, referral, fitting and maintenance of assistive products, and monitored and tracked the provision of assistive technology by incorporating service delivery modules in an existing e-health platform. For Ukrainians who are unable to attend the clusters, WHO set up additional services to ensure they could get the assistive technology they need.
“We’re particularly pleased with the impact of this partnership on the overall integration of assistive technology in the Ukrainian health care system,” Habicht said. “It is critical to maintain essential health services in war-affected areas in the short term, but it is equally important to keep investing in longer-term post-war health system recovery and improvement.”
Key lessons learned included the need for assistive technology preparedness plans to address disruptions in procurement, delivery or distribution, as provision can be complex in humanitarian settings. Information about assistive technology availability, referral pathways, and service delivery points should be communicated through a variety of channels, to ensure all people in need are made aware of the availability and ways to access it.
The project showed that integrating assistive technology into emergency responses within existing healthcare services can build health system capacity and help ensure continuity of care even after the emergency.
“ATscale’s support to Ukraine is designed to be catalytic, to show proof of concept and get the approach off the ground. Already other donors have come forward to fund more clusters and AT10 kits, and we actively encourage even more to add their support. It is urgent. There are around 854,000 internally displaced persons in Ukraine and, along with many other people, their assistive technology needs are mostly not being met,” said Pascal Bijleveld.