C Explanatory memorandum
by Mr Jan Filip Libicki, rapporteurNote
1 Introduction
– moment of decision
1. In preparing this report, the
rapporteur relied on information provided by Ukrainian State authorities,
civil society organisations and organisations representing veterans,
as well as on information obtained during meetings of the Committee
on Social Affairs, Health and Sustainable Development
Note and interviews personally conducted
with Ukrainian veterans and representatives of civil society organisations.
Discussions with the secretariats of the Council of Europe Development
Bank and the Human Rights and Justice Co-operation Department of
the Council of Europe provided further details.
2. Europe today stands at a critical moment. The reconstruction
of Ukraine is becoming the subject of increasingly concrete political
and financial planning. Until now, the debate has focused primarily
on infrastructure. Yet Ukraine’s most important resource and potential
are its people – many of whom have suffered health consequences
as a result of the war.
3. The rehabilitation of veterans should not be perceived or
addressed as a single stage following hospitalisation, but rather
as a bridge between surviving war and returning to active social,
professional and family life.
4. The effective reintegration of veterans is not merely a matter
of social policy. It is of fundamental importance for State stability,
social security and the democratic future of Ukraine.
5. A State that fails to provide effective support to those who
have borne the greatest sacrifices of war exposes itself to long-term
social tensions, the deepening of mental health crises and a weakening
of citizens’ trust in public institutions.
6. In this sense, policy towards veterans constitutes an element
of democratic security for the whole of Europe. Council of Europe
member States and partners cannot fail in their duty to support
the soldiers who have fought hard to uphold freedom in Europe.
2 The scale of the problem – systemic
and long-term challenge
7. The number of persons with
disabilities in Ukraine has exceeded three million.
Note Among them is a very large
group of war veterans requiring specialised rehabilitation and long-term
support. It is important to underline that the most common injuries
are blast and fragmentation, often caused by drones, causing complex injuries
with overlapping symptoms, often requiring amputations and complex
rehabilitation.
8. With regard to prosthetic care, in 2024 Ukrainian services
provided prostheses and assistive devices to approximately 11 400
individuals, including 2 500 military personnel, while the total
number of prostheses of various types distributed reached nearly
20 000. In the first six months of 2025, 9 400 upper and lower limb prostheses
had already been provided.
9. According to data provided by the Polish HumanDOC Foundation,
which supports wounded Ukrainian soldiers, and based on analyses
by the World Bank and the Government of Ukraine, the number of persons with
disabilities resulting from the war exceeded 200 000 in 2024 and
continues to rise. Between 15% and 20% of this group may consist
of persons with sensory impairments, including hearing loss, vision
loss or dual sensory disabilities. Data from the Ministry of Defence
of Ukraine further indicate that in 2025, more than 33 000 soldiers
received rehabilitation in military medical facilities.
Note
10. Information provided by the Ministry of Veterans Affairs of
Ukraine complements the data concerning the scale of rehabilitation,
prosthetic care and professional reintegration. According to figures
for 2024-2025, more than 435 000 people received free rehabilitation
services in 2025 under the Medical Guarantees Programme, compared
with approximately 366 000 patients in 2024. In the first half of
2025 alone, 229 159 Ukrainians received rehabilitation services
through the National Health Service of Ukraine (NHSU), including
more than 89 000 in inpatient settings. Veterans and military personnel
make up a significant portion of service recipients. According to
this ministry,
Note in 2025, 1 334 people
utilised State vocational rehabilitation services, including 762 individuals
with war veteran status. According to information submitted by the
regional and Kyiv city state administrations, as of 1st April 2026,
409 people had used the aforementioned services, 214 of whom held
war veteran status.
11. The material provided by the ministry further confirms that
patients may receive treatment in any facility contracted by the
NHSU, regardless of their place of residence or registration.
12. With regard to mental health, the material provided by the
ministry indicates that between September 2023 and May 2024 the
MARTA system (MARTA Centre Ukraine) recorded a 30% decrease in suspected
post-traumatic stress disorder (PTSD) cases among persons undergoing
rehabilitation. At the same time, the number of officially diagnosed
PTSD cases increased almost fourfold compared with 2021.
Note
13. It should nevertheless be noted that part of the data concerns
all Ukrainian citizens using the rehabilitation system, and not
exclusively war veterans. However, these figures clearly illustrate
the scale of the burden placed upon the State system.
3 Veterans’
experiences – individual perspectives as a systemic diagnosis
14. It is worth recording the testimonies
of wounded soldiers, as they demonstrate the real functioning of
the support system as well as the human impact
15. Serhii Khrapko, wounded near Debaltseve in 2015, first lost
an arm and later a leg. After sustaining his injuries, he had to
learn by himself how to function with prostheses, as at that time
there was no mentoring system or co-ordinated support. He pointed
out that, even today, many wounded veterans remain dependent on
volunteers and civil society organisations for assistance. The presence
of family members was particularly important for him, although hospital
conditions often prevent relatives from accompanying the wounded.
Note
16. Mykhailo Bakaliuk was severely wounded in 2023 in the Zaporizhzhia
region. Following an above-knee amputation, the most difficult experience
proved to be chronic pain and limited access to pain medication.
Only later did the need for psychological support and adaptation
to a new life situation emerge. Bakaliuk emphasises the enormous
importance of mentors, support of the family and access to rehabilitation
close to one’s place of residence.
Note
17. Volodymyr Hera was seriously wounded in 2014 in the area of
Luhansk airport. A spinal cord injury deprived him of the ability
to walk. Mr Hera underlined that one of the greatest barriers faced
by veterans remained the inaccessibility of public spaces, transport
and the labour market. In his assessment, the problem lies not only
in disability itself, but also in the failure of the State and society
to adapt to the needs of persons living with severe injuries.
Note
18. These testimonies demonstrate that rehabilitation does not
end in hospital. The most difficult stage often begins after returning
home.
4 The
rehabilitation system – the importance of institutions and the role
of the family
19. The material submitted by the
Ministry of Veterans Affairs of Ukraine indicates that rehabilitation
begins already during the acute phase – within the first hours or
days following injury – in intensive care units and subsequently
includes post-acute and long-term rehabilitation stages.
20. The experience of the State rehabilitation centre “Halychyna”,
located in the Lviv region and directed by Danylo Kryvko, demonstrates
the infrastructural limitations and shortage of specialised personnel.
Note
21. By contrast, the model developed by Alla Sviatenko points
to the necessity of a comprehensive approach encompassing treatment,
rehabilitation, psychological support, and work with families.
Note
22. HumanDOC Foundation underlines that the greatest systemic
gap emerges between the completion of clinical rehabilitation and
long-term social reintegration.
NoteNote
23. The family very often becomes a “second rehabilitation team”.
It is the family that helps transfer the skills acquired during
clinical rehabilitation into everyday life.
24. At the same time, the family cannot replace the State. Without
professional support, a model based solely on family care leads
to caregiver overload, family crises and the secondary social isolation
of veterans.
Note
25. Particular attention should also be devoted to the children
of veterans’ families. Severe war injuries, amputations, PTSD and
long-term health problems affecting relatives have an impact on
the emotional and social stability of entire families.
Note
26. The State should therefore develop psychological, educational
and social support programmes directed towards the children of wounded
soldiers and families experiencing long-term crises related to the consequences
of war.
5 Women
and war – an overlooked dimension of support
27. The war in Ukraine increasingly
affects women as well – both as soldiers, medics, volunteers and members
of the armed forces, and as partners, mothers and caregivers of
wounded veterans.
28. Women acting as caregivers very often assume responsibility
for organising rehabilitation, maintaining contact with institutions,
providing psychological support and ensuring everyday care for injured
family members.
29. International experience demonstrates that the long-term overburdening
of caregivers leads to deteriorating mental health, economic difficulties
and secondary family crises.
Note
30. The rapporteur underlines the necessity of incorporating the
perspective of women both into veterans’ policy and into programmes
for the reconstruction of Ukraine.
6 Sensory
disabilities – the missing dimension of veterans’ policy
31. Sensory disabilities remain
a particularly overlooked area.
32. The loss of hearing or vision affects not only health, but
also communication, family relations, the ability to work and the
sense of security.
33. HumanDOC indicates that approximately 12-15% of veterans assessed
by medical commissions may suffer from hearing damage, while every
third patient experiences symptoms of tinnitus.
Note
34. However, the material provided by the Ministry of Veterans
Affairs of Ukraine does not contain comprehensive data regarding
the number of veterans living with vision loss, hearing loss or
dual sensory disabilities.
Note
35. It is therefore necessary to establish a State system for
monitoring the specific needs of persons with sensory disabilities
and to develop services that are also accessible outside the largest
urban areas.
7 Social
and professional reintegration
36. According to data from the
Ministry of Veterans Affairs of Ukraine, between 75% and 82% of
wounded defenders return to military service following treatment
and rehabilitation.
37. In the civilian sector, however, the situation is more difficult:
approximately 58% of veterans of working age are employed, while
only around 30% return to their previous occupations.
Note
38. More than half of veterans encounter barriers when seeking
employment. The most frequently mentioned problems include: bureaucratic
barriers, employers’ concerns regarding mental health, lack of adapted
workplaces, inaccessible infrastructure. To access vocational adaptation
services, individuals should apply to the relevant local authority
responsible for veterans’ affairs in the area. Applications may
be submitted, either in person in paper form or electronically,
using the application form, and sent to the designated email address.
The application should be submitted to the authority corresponding
to the applicant’s declared or registered place of residence (or
stay), or to their actual place of residence (or stay).
Note
39. HumanDOC confirms that professional
reintegration should be considered part of rehabilitation rather than
as a separate stage.
40. The long-term psychological consequences of war remain a particularly
serious challenge. PTSD very often coexists with depression, anxiety
disorders, addictions, chronic pain and difficulties in family relationships.
41. The experience of NATO member States also demonstrates an
increased risk of homelessness, family breakdown, social isolation
and suicide attempts among some veterans who remain without adequate psychological
and social support.
42. Mental health support should, therefore, encompass not only
crisis intervention immediately after injury, but also a long-term
system of monitoring, therapy, community-based support and assistance
for families.
8 A
cross-sectional example: the HumanDOC Foundation model
43. The HumanDOC Foundation project
entitled “Building Systemic Support for Veterans with Motor and Sensory
Disabilities and Their Families” may serve as an example of a model
solution addressing the gap between clinical rehabilitation and
the everyday functioning of veterans.
Note
44. The project, being implemented during the period 2025-2027,
covers Kyiv, Odesa, Kharkiv and Ivano-Frankivsk and has a budget
of EUR 900 000. It aims to provide support to 500 veterans and members
of their families.
45. The model combines medical rehabilitation; psychosocial support;
peer-to-peer mentoring; family support; sensory rehabilitation;
community-based activities; specialist training; development of
local support networks.
46. Particularly important is the fact that the project is to
be institutionally implemented in co-operation with the Institute
of Traumatology of the National Academy of Medical Sciences of Ukraine,
thereby creating the possibility for further scaling at the national
level.
47. Ukraine’s experience also demonstrates the fundamental role
of civil society organisations and volunteer initiatives in building
a support system for wounded soldiers.
48. Non-governmental organisations very often fill the gap between
the medical system and the everyday functioning of veterans. Their
experience should therefore be incorporated into the development
of long-term State policy.
9 Comparison
of support systems in NATO and European States and recommendations
for Ukrainian authorities
49. An analysis of veteran support
systems in European and NATO member States clearly demonstrates that
the most effective solutions are comprehensive and long-term in
nature.
Note
50. In Germany, the support system is based on linking benefits
to the loss of working capacity and income.
51. In the United Kingdom, specialised rehabilitation programmes
and priority access to treatment for veterans have been developed.
52. Canada distinguishes itself through extensive family support
and a system of individual veteran case managers.
53. Poland has established a model providing privileged access
to treatment, rehabilitation and educational support for injured
veterans.
54. In Denmark and, to some extent, in the United Kingdom, veterans’
organisations, mentoring and co-operation between the State and
non-governmental organisations play a particularly significant role.
55. By contrast, systems operating in Romania, Bulgaria and Greece
focus primarily on financial benefits and social security protection.
56. These different approaches and experiences point to a need
for Ukraine to develop a model combining all the following elements:
rehabilitation; family support; housing; employment; infrastructure
accessibility; co-ordination of benefits and services and mentoring
and local community support.
57. With this in mind, Ukraine should develop a comprehensive
policy for veterans with disabilities, taking into account the long-term
nature of the issue, including the following recommendations:
- adoption of a unified law on
veterans and veterans with disabilities;
- introduction of a benefits system linked to the loss of
working capacity;
- creation of a specialised military medicine pathway;
- expansion of the national network of rehabilitation and
prosthetic services;
- establishment of a State system of veteran mentors;
- inclusion of families within the support system;
- creation of a national veterans’ employment programme;
- adaptation of public infrastructure and transport;
- establishment of a “one-stop shop” system for veterans;
- adoption of a long-term strategy for financing veterans’
support.
58. In this regard, the rapporteur emphasises the importance of
collecting consolidated and disaggregated data on all categories
of disabilities, including complex or “invisible” disabilities and
psychosocial trauma related to conflict, in order to inform evidence-based
policy.
10 Conclusion
59. The experience of NATO member
States clearly demonstrates that an effective support system for veterans
must encompass not only medical treatment, but also family support,
employment, housing, mental health and social participation.
60. Ukraine has already established the foundations of a modern
rehabilitation and prosthetics system. However, the scale of the
war requires the development of a long-term, integrated State model.
61. International experience demonstrates that the absence of
sufficiently early rehabilitation and reintegration leads to significantly
higher social and economic costs in the future. The costs of long-term unemployment,
social isolation, mental health crises, addictions and family exclusion
are substantially higher than the costs of comprehensive support
introduced at an early stage.
62. Financing rehabilitation should, therefore, be regarded not
as a social expenditure, but as a long-term investment in social
stability, the labour market, State security and Ukraine’s capacity
for post-war reconstruction.
63. The history of Europe demonstrates that wars formally end
much sooner than the suffering of those who bear their consequences.
64. The reconstruction of Ukraine will be judged not only by the
rebuilding of cities, roads and infrastructure, but also by the
manner in which Europe and Ukraine treat those who lost their health,
physical abilities and former lives while defending the freedom
of their State. All arguments lead to one fundamental conclusion: without
clearly defined funding levels, the support system for veterans
will not be able to meet the scale of challenges. Setting a level
of at least 10% of reconstruction funds reflects the long-term and
cumulative nature of needs related to rehabilitation, healthcare,
social support and professional reintegration.
65. For this reason, support for veterans with disabilities should
be recognised as one of the fundamental priorities of the European
reconstruction of Ukraine. The future of Ukrainian veterans and
Europe’s responsibility for ensuring their dignified and full participation
in social life now and following the end of hostilities are of crucial
importance. More generally, adopting a positive approach to disability
in Ukraine can pave the way for progressive societal change and
improved inclusivity across various communities.
66. Finally, the rapporteur would like to express his sincere
gratitude to all individuals and institutions who, despite difficult
circumstances, supported the preparation of this report by sharing
their knowledge, experience, testimony and expert assistance.
