Exclusive
20
хв

«Не завжди якісний протез має бути найдорожчим», — Антоніна Кумка, засновниця Protez Hub

98% пацієнтів, які втратили кінцівки, протезуються в Україні. Більшість з них — за державною програмою. Sestry поговорили з відомою волонтеркою про особливості протезування в Україні, навчання фахівців і те, як обрати заклад та протезиста

Nataliia Zhukovska

Антоніна Кумка

No items found.

Support Sestry

Even a small contribution to real journalism helps strengthen democracy. Join us, and together we will tell the world the inspiring stories of people fighting for freedom!

Donate

Антоніна Кумка — засновниця і президентка Protez Hub. Проєкт спрямований на покращення послуг протезування та реабілітації в Україні, а також й на обмін досвідом між протезистами з усього світу. Впродовж трьох років поспіль команда фахівців з протезування та реабілітації з США, Канади, Великобританії та Австралії приїжджала в Україну як волонтери, щоб поділитися досвідом з українськими колегами. 40 фахівців пройшли практичні курси навчання, понад пів тисячі відвідали одноденні семінари. Сьогодні Анастасія Кумка — радниця Міністра соціальної політики (на громадських засадах), вона продовжує розвивати галузь протезування в Україні, живучи на дві держави — Канаду та Україну. Sestry поговорили з відомою волонтеркою про особливості протезування в Україні, навчання фахівців та про те, як обрати заклад та протезиста.

Наталія Жуковська: Антоніно, як на сьогодні виглядає ситуація із протезуванням військових в Україні?

Антоніна Кумка: За даними міністерства соціальної політики і Фонду соціального захисту осіб з інвалідністю, торік протезами було забезпечено майже 20 тисяч людей. Із них 15,5 тисяч це були нижні кінцівки й понад 500 — верхні. Йдеться не лише про військових, а й про людей, яким виготовляли протези планово. З метою безпеки ми не можемо називати чітку кількість військових із ампутаціями, однак якщо ви чуєте цифри, що приміром 100 тисяч людей втратили кінцівки внаслідок війни — це перебільшено щонайменше уп’ятеро. Немає такої цифри, це забагато.

Чи є складнощі з отриманням протезів? Якими є черги?

Черг насправді немає. Є проблема скерування пацієнтів на протезування, яка не вирішується. Ми неодноразово підіймали це питання. Наприклад, за нашими спостереженнями, найбільше людей чомусь скеровують до Львова. І немає різниці з якого регіону пацієнт. Це можна було зрозуміти на початку військових дій. А на сьогодні майже в усіх областях налагоджена реабілітація і допомога.

Тож якщо ви чуєте, що якийсь центр з протезування каже, що у них немає місць, то це штучно створені черги. Загалом час очікування від моменту подачі документів до протезування нині займає до 2-х місяців. Щодо верхніх кінцівок, тут може бути трішки довше. Тому що протезистів по руках менше.

Яким має бути алгоритм отримання протезів? Чи може військовий, перебуваючи, наприклад, у шпиталі, сам обирати, де він протезуватиметься?

Так мало би бути в ідеалі. Коли у Мінсоцполітики вносились зміни до певних постанов, то там йшлося про те, що заклади охорони здоров'я зобов'язані надавати пацієнтам вибір обирати підприємства з протезування. Але проблема у тому, що іноді пацієнти перебувають у дуже крихкому емоційному стані. Відтак чіпляються за речі, які на той момент їм здаватимуться більш вигіднішими. Іноді до них приходить лікар, дає не найкращі поради, яким вони сліпо довіряють.

Важливо враховувати, що протезування краще робити ближче до місця постійного проживання. Бо протези ламаються, потребують обслуговування

І якщо людина, приміром, із Дніпра чи Харкова, то їздити у Львів буде не дуже зручно.  

А чи представники протезних підприємств борються за своїх пацієнтів? Чи ходять по шпиталях із пропозиціями?

Так, ця проблема також існує, тому що не всі мають однаковий доступ до пацієнтів. Іноді лікарні будують протезне підприємство як частину медичного закладу. І, звісно, що вони переконуватимуть людину там же протезуватись. Або пацієнт сам думає: «Раз я вже тут, то піду сюди на протезування». Але це не завжди добре, тому що у тому центрі можуть не надавати необхідних якісних послуг.

Як обрати заклад і протезиста? На що звертати увагу?

У першу чергу потрібно звертати увагу на досвід. Не можна обирати установу за критерієм того, що у них найбільше реклами або ви про них часто чуєте.

З нашого досвіду, найкращі й найдосвідченіші протезисти працюють у невеликих, маловідомих закладах. У них і так достатньо пацієнтів, вони не потребують реклами

Навіть якщо підприємство розміщене у підвалі, але у ньому працює досвідчений фахівець, то це краще, ніж реабілітаційний центр на три поверхи, де працюють протезисти з дев’ятимісячним досвідом. На жаль, протезування — це бізнес. Бувають випадки, коли пацієнтам кажуть: «Ідіть, збирайте 5-10 мільйонів гривень». І не тому, що це буде найкращий протез для пацієнта, а тому, що він буде найдорожчим, який протезист може продати і, відповідно, більше заробити. Тому, на це теж треба зважати. Важливо завжди спілкуватися з декількома фахівцями, шукати додаткову думку. Якщо вже семеро, наприклад, фахівців опитали, вони всі сказали, що ні, у вас зависока ампутація і ви не зможете ходити на протезах, то напевно, це досить великий аргумент для того, щоби зрозуміти, що це — правда. Багато хлопців не можуть з цим змиритись і, на жаль, знаходяться люди, які цим можуть скористатися і обманути.

Радниця міністерки соціальної політики Олена Кульчицька цього року розповідала що протезування в Україні  є безоплатним і оплачується коштом державного бюджету і ніби то немає потреби збирати гроші для тих, хто потребує протезування. Навіть йдеться про біонічні протези. Наскільки це відповідає дійсності?

На протезування однієї кінцівки держава виділяє до 50 тисяч доларів. Сума залежить від рівня мобільності та потреб пацієнта. Держава не фінансує експериментальні протези. Тобто, якщо людина хоче отримати за державною програмою протез, то він має бути зареєстрований держлікслужбою, як сертифікований медичний виріб. Наприклад, якщо людині хтось із благодійників пропонує 3d протез, то такі не відносяться до медичних виробів, є експериментальними і не оплачуватимуться державою.

Функціональний протез коштує від 10 до 40 тисяч доларів. Тому грошей, які виділяє держава, вистачає

Багато хто думає, що, наприклад, біонічний протез — це найкраще, що може бути. Однак це панацея, яку створюють самі пацієнти. Іноді такі протези їм пропонують протезисти, бо їм це вигідно, вони можуть більше заробити. Але, як ми бачимо, навіть по наших американських колегах і пацієнтах, то багато хто користується саме тяговими протезами, механічними, і лише у деяких випадках використовують біонічні. Тому що вони мають складніший механізм, ніж тягові. Частіше ламаються, вони тендітніші, їх не можна мочити, бруднити, потрібно захищати від пилу. Їх використовують переважно для офісної роботи. Якщо ж військовий хоче повернутися назад в армію і продовжити службу, то біонічний протез буде абсолютно недоречним.

Гроші держава дає, протези є, але чому час від часу у соцмережах можна зустріти пости про збори на протези?

Мені теж це цікаво. Ми вже втомилися людям говорити: «Перестаньте збирати гроші на протези. Для чого ви це робите?». По-перше, це роблять благодійні фонди, тому що вони з цього живуть. Збирають гроші на протези і частина коштів залишається у них. Другий момент — коли людям кажуть: «От вам такий протез не підійде, який можна отримати у рамках державної програми. Вам потрібна ось така кисть, яка коштує 50 тисяч євро. Однак згори ще треба заплатити за роботу фахівця, витратні матеріали і так далі». Тобто грошей не вистачає. Людина оголошує збір. Були випадки, коли ми пропонували дофінансувати протези, то нам казали: «Не лізьте не у свою справу». На жаль, є багато недоброчесних моментів. Ті ж, хто їздили протезуватися закордон сьогодні говорять, що іноземці іноді відстають від того, що вміють робити наші спеціалісти. Вони не мали такого досвіду з подібними травмами. 98% пацієнтів все-таки протезуються  в Україні.

В Україні наразі є майже сотня протезно-ортопедичних підприємств — як приватної, так і державної форм власності, які виробляють протези. Protez Hub співпрацює з усіма установами?

Ми переважно співпрацюємо не з підприємствами, а з фахівцями. Збираємо інформацію про те, які у них є потреби щодо професійного розвитку. На основі цього формуємо навчальні програми. От, наприклад, ми  організовували велику подію, присвячену пацієнтам з обома ампутованими верхніми кінцівками. Це люди, які потребують особливого підходу, а їхня реабілітація займає довше часу. Ми скооперувалися з однією організацією в США. Їхня діяльність присвячена саме роботі з такими людьми. Двоє ерготерапевтів, протезист і четверо американців, які живуть з такими травмами вже понад 10 років, приїжджали в Україну для обміну досвідом.

В Україні досі неможливо здобути вищу освіту в галузі протезування. Яка ситуація з кадрами, зокрема, з протезистами? 

Це мій біль. Насправді, сьогодні рух у цьому напрямку йде і я з цим живу 24 на 7. Це наступний крок, який вже повинен був змінитися. Ми, як організація, яка, зокрема, займається й навчанням спеціалістів з протезування, хотіли це зробити ще у 2016-му. Але тоді, на жаль, у нас не вийшло. У чому полягає зміна? Перше, що ми зробили зараз, — за кілька місяців розробили й затвердили професійний стандарт «протезист-ортезист». Це кваліфікація, яка відповідає міжнародному стандарту Міжнародної спілки протезистів і ВООЗ, і вони є фахівцями першої категорії в усьому світі. Це люди, які безпосередньо мають право працювати з пацієнтами. Інші категорії позбавлені цього.

Під час навчання протезистів

Тобто, якщо ти технік, протезист-ортезист, то ти можеш працювати з машинами, але не з людиною. Ти маєш мати клінічну освіту для того, щоб працювати з пацієнтом. У нас є певна кількість фахівців, які можуть відповідати цій професії, бо вже протезують понад 10 років та пройшли досить багато різноманітних курсів. І наразі проходять курс спеціалізації, який ми створили у рамках цього прискореного процесу кваліфікації фахівців разом з Харківським національним медичним університетом. І ось по завершенню ми матимемо перших 13 фахівців, які вже будуть вважатися протезистами-ортезистами, відповідно до європейських вимог.

Чи достатньо цієї кількості протезистів-ортезистів?

Нам не потрібно тисячі протезистів. На всю країну їх поки вистачить до ста

Техніків потрібно втричі більше. Це люди, які будуть безпосередньо за верстатами працювати, виконувати завдання протезиста-ортезиста. Ми зараз працюємо над тим, щоб створити освітній стандарт магістра протезування-ортезування. І це вже буде офіційна програма, яка відповідає тому, що є в Європі та США. Основною вимогою для того, щоб людина могла бути протезистом-ортезистом в Україні буде проходження ось цієї магістратури. Навчання триватиме 2 роки. 

Антоніно, ви розвиваєте галузь протезування в Україні від початку російсько-української війни, з 2014-го. Є керівником проєкту та президентом організації Protez Hub. З чого все розпочиналося? 

Почалося все з однієї людини. Це був військовий, який втратив обидві кінцівки вище коліна, по стегно, і на той момент для нього єдиним виходом було їхати протезуватися за кордон. Таких технологій, які він хотів, на той момент Україна ще не мала. Не було й фінансування. Коли я почула його історію, стало зрозуміло, що таких хлопців буде багато, бо війна тільки розпочиналась. І потрібно вже починати щось робити, аби підтримка таким людям була системною і щоб ми могли це робити в Україні. Бо протезування закордоном коштуватиме удвічі дорожче. Йшлося на той час про 70-100 тисяч доларів на людину. І мені прийшла думка, що ми маємо це змінити. В першу чергу я почала шукати тих, хто міг би навчати наших фахівців, вдосконалювати їхні навички і підвищувати знання в Україні. Так я познайомилася з американцем Джоном Батздорфом, який є президентом благодійної організації Prosthetika та одним із екзаменаторів сертифікаційної ради США, які підтверджують кваліфікації протезистів і ортезистів.

З Джоном Батздорфом, президентом благодійної організації Prosthetika

Він погодився допомогти і з того часу ми працюємо разом для того, щоб це все далі розвивати.

Який протез на сьогодні є найфункціональнішим?

Це все дуже індивідуально. Залежить від діяльності людини. Тому найперше, що фахівець запитує: «Що ви хочете робити цим протезом?». Комусь підходить електричне коліно, а хтось хоче простіший протез, тому що його можна мастити, бігати і стрибати з танків і не потрібно заряджати. Бо, наприклад, якщо хлопець повертається на передову на протезі з гідравлічним коліном, то йому не треба перейматися тим, що десь немає блоку живлення, щоб його підзарядити. А електричне коліно треба заряджати. Відповідно, його  не можна мочити. Воно важче, тому що в нього складніший механізм. Це все треба враховувати.  

НЖ: Чи очікували ви, що Росія наважиться на повномасштабне вторгнення? Де вас застала велика війна?

Звісно, що не очікувала. Я була у  Канаді. Перші пів року ми спали по дві години на добу. Все було, немов у тумані. Це був нескінченний потік роботи. Ми шукали все, що можна було дістати, і відправляли до України.

Вже у травні 2022-го я поїхала до України. У мене було дві валізи, забиті тепловізорами і  дронами

Як давно ви проживаєте у Канаді, чим займаєтеся, окрім волонтерства?

Моя перша вища освіта — викладач, магістр германської філології і літератури. Я навчалася у Чернівецькому національному університеті і одного разу  поїхала подивитися на англомовну країну, до Канали. У мене ніколи не було думок кудись виїжджати. Але так сталося, що саме там я познайомилася зі своїм майбутнім чоловіком. Спочатку приїжджала до нього і згодом залишилася. Здобула другу вищу освіту економіста. Час від часу викладаю математику. Однак це буває рідко, бо багато часу забирає все, що пов’язане з Україною. Інколи буває так, що два тижні живу у Канаді, а потім місяць в Україні. Деколи пів року у Канаді, потім знову декілька місяців в Україні. Все залежить від того, що і де відбувається та чи потрібна моя присутність. Багато чого я роблю дистанційно. У Канаді на мене чекає чоловік та двоє дітей. Старшому сину 16 років. Молодшому — 7. Вони вже звикли до моєї відсутності. Деколи важкувато, але що поробиш.

Розумію, що роблю потрібні для країни речі. І поки є така можливість я допомагатиму

Якою б ви хотіли бачити Україну після війни?

Такою, якою вона, на жаль, не буде ще за нашого життя. Звісно, що ми все для того робимо, але у мене все більше сумнівів, що це відбудеться скоро.

На жаль, деякі люди досі не розуміють, чому треба жити по совісті і не думати лише про те, як набити грошима власні кишені

Кожен на своєму місці повинен розуміти, для чого мають існувати якісні і добре сформовані державні інституції. І це усвідомлення має бути від Києва і до будь-якої сільської ради. Хочу, щоби було більше відповідальності у людей за свої власні дії. І це має бути однаково для всіх, незалежно від того, хто чий кум, брат чи сват. Лише за таких умов, на мою думку, ми зможемо побудувати міцний фундамент. Поки його не збудуємо — все буде сипатися одразу. Це буде бутафорія. Ми маємо це зробити. І головне, що нам це під силу. 

No items found.
Р Е К Л А М А
Join the newsletter
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

A TV host, journalist and author of over three thousand materials on various subjects, including some remarkable journalist investigations that led to changes in local governments. She also writes about tourism, science and health. She got into journalism by accident over 20 years ago. She led her personal projects on the UTR TV channel, worked as a reporter for the news service and at the ICTV channel for over 12 years. While working she visited over 50 countries. Has exceptional skills in storytelling and data analysis. Worked as a lecturer at the NAU’s International Journalism faculty. She is enrolled in the «International Journalism» postgraduate study program: she is working on a dissertation covering the work of Polish mass media during the Russian-Ukrainian war.

Support Sestry

Nothing survives without words.
Together, we carry voices that must be heard.

Donate

Since 2014, the return of prisoners of war has been handled by the Joint Centre for the Search and Release of Prisoners of War under the SSU. However, with the onset of full-scale war, the number of captives increased significantly, leading to the establishment of the Coordination Headquarters for the Treatment of Prisoners of War in March 2022. The Head of its Central Representation, Yuliya Pavliuk, emphasises: the main priority is to locate and bring back all captives, but equally important is supporting the families of those missing in action and those waiting for their loved ones to return from captivity.

Nataliya Zhukovska: How are the lists of prisoners of war for exchange formed?

Yuliya Pavliuk: At the onset of the full-scale invasion, Ukraine established the National Information Bureau (NIB). According to the Geneva Convention on international law, this serves as a registry that records all defenders who are missing in action, regardless of their status. Even if military personnel have no relatives, information still has to be included in the NIB by the units where they served. This registry, in essence, becomes the exchange list as it is continuously communicated to the Russian side. In reality, according to international conventions and laws, prisoner exchanges should not occur during active combat. Ukraine currently has unique experience in this field.

There is no clear and regulated system for conducting exchanges. Every exchange and every negotiation is a special operation. Different negotiations for every individual

Of course, we do not disclose the uniqueness, methods, or schemes of conducting negotiations. This is classified information. However, in general, there is prioritisation. Those who have been in captivity since 2014 are a priority. We understand these individuals have spent more than nine years in captivity. However, when Russia proposes to return someone with a shorter duration of captivity, Ukraine accepts them.

Ukrainians freed from Russian captivity

Sometimes, after exchanges, misunderstandings and questions arise from families: «Why was that person exchanged and not ours?» Unfortunately, we cannot always dictate conditions to the enemy.

In addition, priority is given to severely ill and wounded men and women. According to international law, such categories of military personnel should be returned to their home country outside of exchanges. However, we know that our enemy does not adhere to these agreements. Overall, Ukraine's official position remains unchanged: we are ready to exchange everyone for everyone.

And who is exchanged with «more difficulty»?

There are categories of officers from certain Armed Forces units, the National Guard of Ukraine, and border guards whom Russia is reluctant to return. Furthermore, sometimes the Russians attach particular significance to prisoners of war with media coverage - those prominent in the media. As a result, media stories do not always positively influence exchange processes. We emphasise this when communicating with families. If relatives want to help somehow, they must consult specialists. War must be managed by the military. When improvisation begins, it is not good and can only cause harm.

If we look at the exchange statistics, for instance, if 100 people are returned, this number proportionally includes military personnel from different units. And if the Armed Forces are the largest, then their members will constitute the majority in captivity

The Armed Forces include the Marine Corps, ground units, assault brigades, reconnaissance battalions, tank crews and artillery personnel. The Armed Forces also have transport services, for example, which are less publicised and discussed, but many of their members are also in captivity. When families question why there are so few of «theirs», it is essential to understand that we consider the approximate total number of those who might be in captivity - tens of thousands of people. In each exchange, there will be more members of the Armed Forces of Ukraine, slightly fewer from the National Guard, border guards, and so on.

Yuliya Pavliuk: «Media stories do not always positively influence exchange processes»

Fortunately, there has been significant progress in negotiations, as evidenced by recent exchanges. We have been able to return many defenders who had received life sentences or terms of imprisonment of 8-9 years.

Why are there delays in the exchange of prisoners? What causes prolonged pauses?

Regrettably, this does not depend solely on Ukraine. There are no fixed timelines, such as exchanges every Tuesday or every second Wednesday. It is an unregulated process. There have been instances where timelines and the number of people were agreed upon, only for the exchange to be cancelled either by Russia or due to the overall security situation. For example, if the exchange point comes under fire, the exchange cannot take place that day or soon after.

The exchange itself is a special operation. It may be scheduled for 8:00 in the morning but could be delayed until noon or 8:00 in the evening

Sometimes, Russia announces through its media that the exchange has already taken place when, in fact, it has not. The conditions under which the exchange occurs largely depend on the Russian side.

Where are Ukrainian prisoners held? Where are the worst conditions? What do freed military personnel say about captivity?

There is no «good» captivity. Detainees in prisons and detention centres have limited access to fresh air. They are confined to one room containing a toilet, a table where they eat and sleep, and a single window high up on the wall that does not open. Sometimes walks are allowed, but regimes are not always adhered to. From our side, the only demand we can and do make to the aggressor country is compliance with international conditions and conventions. If they held our defenders under conditions at least consistent with those outlined in the Geneva Convention, the health and well-being of the returned men and women would be significantly better.

Yuliya Pavliuk with Mariyana Chechelyuk, who spent 25 months in enemy captivity.

Unfortunately, we cannot always influence this situation. Of course, upon their return, military personnel speak extensively about the torture they endured. We continually appeal to our international partners, particularly the UN mission and the International Red Cross. They are responsible for the condition of our military personnel.

Many of the freed men suffer from severe illnesses, consequences of serious injuries, and significant weight loss due to torture and inadequate nutrition

Upon returning from captivity, they undergo interviews with specialised services. The war crimes committed by the enemy are meticulously documented. What we can do now is document all the facts and transfer them to the appropriate international bodies.

How would you evaluate the activities of the International Committee of the Red Cross (ICRC)? What are the challenges in working with them?

Regrettably, representatives of this organisation in Russia are almost never allowed access to places where Ukrainian prisoners are held. Their work in temporarily occupied territories and in Russia is currently very limited and insufficient. Most of our defenders, returned from captivity, claim they have never seen Red Cross representatives even once. This particularly includes the delivery of letters and parcels. Even if parcels are sent via the Red Cross, they do not always reach the prisoners. We understand that the administration of the detention facilities may keep the parcels. However, the Red Cross should ensure that the parcels reach their intended recipients.

Yuliya Pavliuk: «Most of our defenders, returned from captivity, claim they have never seen Red Cross representatives even once»

That is why we appeal to all international organisations and urge them to ensure the implementation of the mandate granted to the ICRC specifically in the aggressor’s country. They are the guarantors of the safety of our defenders there. We, in turn, provide every possible assistance to the Red Cross Mission in Ukraine. We have even created so-called mixed medical commissions, where representatives of various organisations, including the Red Cross, can visit prisoners and assess their condition. Through this initiative, we hoped Russia would follow our example and provide the same access to our prisoners. Unfortunately, to date, we see no results.

Can this explain why the Russians treat some battalions in captivity worse than others?

I see the men and women who return. I am present at every exchange. I cannot say that the condition of the military personnel depends on the unit they are in. I always state that much depends on the condition of the defenders at the time of their capture, their endurance, and their internal strength.

For those weaker in character and spirit, of course, it is harder. During one exchange, representatives of Ukraine’s KORD unit and the National Police were among those returned. One serviceman appeared to be in good physical shape. I asked him: «How did you manage? What were your conditions?» He replied: «I used all my efforts to keep myself in good shape. Whenever possible, I exercised - push-ups or pull-ups.»

Why are the conditions of Russian prisoners of war so drastically different from those of Ukrainian ones? How do they form the lists for exchange on their side?

The conditions differ because Ukraine is a legal state, which sets us apart from our enemy. We adhere to international conditions, conventions, and legislation. This is why all civilised countries of the world support us.

Freed from captivity, medic Halyna Fedyshyn of the 36th Separate Marine Brigade of the Ukrainian Navy (left)

There are prescribed conditions under which prisoners of war should be held. In Ukraine, there are camps — special places for keeping prisoners. We are not like Russians.

Regarding the formation of exchange lists by the Russians, we cannot comment on this. Sometimes even the lists published by Russia do not always correspond to reality

If we analyse the latest Russian disinformation campaigns, the lists include individuals who have already been freed from captivity. At the same time, there are no severely wounded individuals, those who have been in captivity since the early days of the war, members of the Mariupol garrison, Chornobyl NPP personnel who are still held, or defenders from Zmiinyi Island. This is all done to spread disinformation and provoke our society. In my opinion, they form these lists randomly. Additionally, the Russians sometimes include civilians in the lists who, under the Geneva Conventions, should have been released without any exchange.

What should be the first steps if a loved one goes missing or is taken captive?

The first step when a serviceman goes missing is for the family to receive a notification from territorial recruitment centres if it concerns Armed Forces units. For units of the National Guard, border guards, or police officers, families receive information from their respective units. Next, families should contact law enforcement and file a report stating that their loved one is missing. Naturally, they should also contact the Coordination Headquarters. This is where people can receive clarifications on various issues. The Coordination Headquarters website has a personal account feature, which family members or representatives of the defender must use. It contains the most comprehensive information.

Relatives of prisoners of war and the missing during a meeting with representatives of the Coordination Headquarters on the Treatment of Prisoners of War

We always emphasise that this is a very powerful system where all available information about the defender must be provided, and families must ensure that this account is always active. And, of course, stay in touch.

What should absolutely not be done? Are there known cases where families of captives are approached with fraudulent offers, such as asking for money to return someone from captivity?

We constantly tell people to verify all information carefully with representatives of law enforcement or security units. War is a matter for the military. Unfortunately, fraudsters exploit human grief. Families post information on social networks, and fraudsters use it.

Yuliya Pavliuk during a meeting with the relatives of prisoners of war

My personal advice as a representative of the Coordination Headquarters and a human rights lawyer is never to do this. Information posted online can also be found by representatives of the aggressor country. Fraudsters use it for personal gain through deceitful means, and the enemy uses it to obtain, among other things, intelligence data. Therefore, we advise: «Consult with special services». We know precisely how to follow this path correctly to avoid harming the family, the defender, or the state’s security.

How can the relatives or loved ones of captives assist in their release?

The exchange and return of prisoners are operational special operations that relatives are not involved in. Today, many families unite in community organisations. A coordination council has been established under the Coordination Headquarters, which includes representatives of these community organisations. We understand that the number of missing servicemen is too large for the Coordination Headquarters to handle alone. However, these community organisations will be involved in these processes. Such work is effective.

They also participate in international negotiations and conferences. Furthermore, relatives often find information about captives - possible photographs or videos - in enemy public forums. Verified information is then added to the personal account by the Coordination Headquarters. Such assistance from families is invaluable.

Do public actions in support of prisoners of war help accelerate exchanges, or do they hinder them?

In my opinion, awareness campaigns are appropriate during a time of war. Our nation must demonstrate its unity.

A rally in support of prisoners of war

Moreover, these campaigns are a constant reminder to the world that we are enduring a bloody war, and thousands of prisoners are still held in the aggressor’s country and must be brought home.

Awareness campaigns are for the community. Negotiations and exchanges are handled by the military

However, when campaigns involve accusations and discrediting of state institutions, this undeniably plays into the hands of the Russians.

The UN Human Rights Monitoring Mission in Ukraine reported in October on torture and mistreatment of Ukrainian prisoners of war. At the same time, they noted that they had documented mistreatment of Russian armed forces prisoners of war. How objective is this report?

Ukraine is fully open to international observers, primarily to representatives of the UN and the Red Cross. We provide them with complete assistance. At the same time, the Russian side does not allow these representatives to even interview prisoners of war. This creates a very unequal situation, where we are fully transparent, and representatives can interview Russian prisoners of war and visit places of detention, but our men and women are completely inaccessible. This is a one-sided situation. The claims about the alleged mistreatment of Russian armed forces prisoners are just testimonies and statements. Let me tell you as a former investigator: to prove crimes, you need evidence. And that is not just words. There must be evidence, such as an inspection of the location and the condition of the defender. When we see our men returned with visible injuries, these are documented. This provides a much stronger evidentiary base than just words or statements someone might provide.

Ukrainian soldiers freed from Russian captivity and the Head of the Central Representation of the Coordination Headquarters, Yuliya Pavliuk

Does international humanitarian law work during the war in Ukraine? What are the chances of holding Russian war criminals accountable for violations of the Geneva Conventions?

We need to win the war. All those guilty must and will be punished. If we are speaking about the documentation of war crimes, everyone sees the condition in which Ukrainian prisoners of war return home. The evidence and facts that Ukraine possesses are indisputable. Accountability will happen. It is just a matter of time.

Photos provided by the press service of the Central Representation of the Coordination Headquarters on the Treatment of Prisoners of War

20
хв

Yuliya Pavliuk: «Every exchange and every negotiation is a special operation»

Nataliia Zhukovska

In 2024, Russia significantly expanded the network of «re-education camps» and increased the militarisation and indoctrination of abducted Ukrainian children. Each of these children, upon returning home, requires rehabilitation - receiving a complex of various forms of assistance. How many Ukrainian children were actually abducted by Russia, what they are taught in the «re-education camps», and what are the prospects for the return of deported Ukrainians - discussed in an interview with Olena Rozvadovska, the founder and head of «Voices of Children» Charitable Foundation.

Nataliia Zhukovska: On October 2nd, seven children aged between 3 and 14 were returned to Ukrainian-controlled territory. All of them were from the Kherson and Crimea regions. This was reported by the head of the Save Ukraine organisation, Mykola Kuleba. And at the end of September, according to the ombudsman Dmytro Lubinets, nine children were also returned home. How many Ukrainian children in total have been abducted by Russia?

Olena Rozvadovska: According to open sources, Russia has deported over 700 thousand people. The official figure from the Ukrainian authorities is around 20 thousand children. This is the number we rely on. However, it is impossible to state the exact number. Since the war continues, there might be one number of children today and another tomorrow. We also do not have access to the occupied territories or Russian territory.

A woman greets her son, who has returned from the occupied territory. Photo: SERGEI CHUZAVKOV/AFP/East News

What happens to Ukrainian children in Russia?

Recently, together with the public association «Ukrainian Network for Children's Rights», the NGO «Regional Human Rights Centre» prepared a report based on specific cases. Our part focused on children's psychological support and rehabilitation after their return. Speaking generally about what happens, according to the children, the scenarios vary.

In some cases, there is group deportation, and they are placed in various child-like camps in Crimea or on the territory of Russia and Belarus. It is known that in the occupied territories of Ukraine, processes are underway to deprive parents of their parental rights according to Russian legislation

Children can be taken under the pretext of so-called threats to life or health without further clarification. Afterwards, they can be placed in foster families. All of this is undoubtedly illegal and constitutes a war crime, which the Ukrainian side is documenting.

How does the process of «liberating» Ukrainian children take place?

Our foundation «Voices of Children» is not involved in the return of children. In fact, each case is individual. There is no return mechanism, just as there is no mechanism for prisoners of war. Generally, the official sides cannot agree on the return of a certain number of children home. This is not that type of case. Russia does not recognise the fact that these are abducted or deported children. According to the Russians, they are rescuing them from shelling. For them, this is a «humanitarian mission». We, however, understand that this is abduction, forced deportation and russification of the nation on RF territory.

Olena Rozvadovska: «Russia does not recognise the fact that these are abducted or deported children». Photo: Telegram channel of Ombudsman Dmytro Lubinets

As of today, it is the relatives of the child who is in Russia that go to retrieve them. Volunteers who work in coordination with the Ministry of Integration, the President's Office, the Ombudsman, and others assist them in their logistics. That is, the relatives themselves search for those children.

What is the greatest difficulty?

The greatest difficulty is that any person who goes to Russia for the child is in a high-risk zone. There is a chance that they may not return with the child because they could be detained. Moreover, the process always involves humiliating and difficult filtration procedures and an extensive number of various checks. The return process may take several weeks or even months. In one case documented in our report, a grandmother was ready to travel to Russia to get her granddaughter. The return of the child lasted 14 months. The woman faced 18-hour interrogations at the Russian border and threats. Russia hindered the process in every way possible. To delay the child’s exit from Russia, the grandmother was made part of a criminal case. The family was only reunited after a second attempt, and only after the girl’s mother reported the obstacles faced in returning the child at a UN Security Council meeting.

The logistics are also challenging. Typically, the journey to the occupied territories or Russia involves passing through several European countries

The difficulty lies in locating, verifying, and finding these children. It is all very monotonous and complex work. According to official statistics published on the «Children of War» website, 388 children have been returned to date. As you can see, the figure is not even in the thousands. The complexity lies in the fact that there is no organised return of, for example, an entire group of children from an institutional-type facility that was taken. However, the greatest difficulty is the time we lose every day. Children who were taken at 2,5 years of age are now 5,5 years old. They may not remember what happened to them. Moreover, for the child, this is already a trauma. The longer they remain in isolation and subjected to active brainwashing, the harder it becomes to bring them back. And we understand that this is exactly what Russia is doing.

In August 2024, 14 children were successfully returned to their homeland. Photo: Telegram channel of Ombudsman Dmytro Lubinets

And of course, when children end up in Russian families and are adopted, these cases are even more difficult. Imagine yourself as a little three-year-old girl. You are brought into a family, and you adapt. At that age, it does not matter where the child lives because they do not understand the situation they have ended up in. They simply live.

In your recent report, you mentioned over 5500 clubs of military-patriotic education and hundreds of «re-education camps» operating in Russia and Belarus. How exactly are Ukrainian children re-educated there? How does indoctrination occur?

This research was conducted by the Regional Human Rights Centre. Their specialists describe the patriotism lessons that the children go through. In the curriculum approved by the Russian Ministry of Education, Ukraine is not depicted as an independent and united state. According to our colleagues’ research, propaganda narratives are embedded not only in textbooks but are also imposed during extracurricular but mandatory classes such as «Conversations About Important Matters» and «Lessons of Courage». The «cadet and Cossack classes» operate within schools, aimed at preparing students for military service.

One manifestation of political indoctrination is the activities of so-called patriotic and military-patriotic movements

In Russia, so-called «re-education camps» also operate. Russia spares no expense on their operation. They are very professional in their information warfare. This machine is in full motion at every level. Every teacher, adult, and school administrator knows where to get the «correct» information that needs to be conveyed to the children. And even if someone turns on the television, they will find confirmation of everything they have already been told. In these camps, there is a system of so-called patriotic education. They introduce children to their «heroes», teach them, and sing the Russian anthem. In doing so, they erase national self-identity. The Russians' goal is to make Ukrainian children see themselves as part of the Russian people.

What methods does Russia use on Ukrainian children to make them literally forget that they are Ukrainians?

It is primarily about psychological and moral pressure. Our psychologist, who worked with a boy who was returned to Ukraine, also spoke about how he endured physical abuse and torture. I know that human rights defenders are recording even more severe and horrific cases. The hardest situation in Russia is for those children who openly demonstrate their pro-Ukrainian stance. They are constantly subjected to moral pressure and intimidation. The Russians calculated that the children would break. They were constantly told: «No one cares about you, no one will come for you. You have been forgotten. If you return, you will be recognised as collaborators or as those who worked with Russia and will be sent to prison». The children, not knowing whether it was true or not, thought: «Maybe I really will be imprisoned for being in Russia?». Any scary thought can take root in a stressed mind.

Olena Rozvadovska: «The hardest situation in Russia is for those children who openly demonstrate their pro-Ukrainian stance». Photo: Telegram channel of Ombudsman Dmytro Lubinets

Freedom House, together with ZMINA. The Centre for Human Rights and the Regional Centre for Human Rights presented new evidence to the International Court regarding the direct involvement of the Lukashenko regime in the displacement, political indoctrination, and militarisation of education for over 2200 children from occupied Ukrainian territories. How can this evidence contribute to the return of Ukrainian children?

Firstly, it is about documenting violations. Cases in The Hague can take decades to review. Despite this, someone must continue documenting these violations. It is also about increasing international pressure. If no one speaks about this, documents it, or submits it, it may seem like the problem is resolved, and there are no issues. This needs to remain in the public domain and be discussed at various levels.

Of course, we would all like for this to be resolved in one day, and for Russia to be excluded even from the UN. However, we understand that it cannot be done so quickly

I believe that it is absolutely the right path for both state authorities and public organisations to continue working on documenting, collecting violations, and passing them on to the relevant institutions. As a result of documented violations, arrest warrants have been issued for Putin and Lvova-Belova. I am confident that Russian sanctions will only intensify. It is important not to grow tired of this work. Every Ukrainian, at their own level, must shout about the genocide that Russia is committing in today's world, right in the heart of Europe.

What is Ukraine doing to ensure that Russia is held accountable under international law for the abduction and illegal adoption of Ukrainian children?

Ukraine is doing everything within its power. International coalitions for the return of children are being created. International groups of prosecutors and investigators are working to document information on violations. Ukraine is regularly represented on various international platforms.

Olena Rozvadovska during a speech at a meeting of ombudsmen from 16 countries, human rights defenders and diplomats in Vienna. Photo: private archive

A wide range of measures are being taken to hold Russia accountable for its crimes - and not only those concerning children. It is unfortunate that these processes are not as swift as we would like them to be.

Your foundation, «Voices of Children», has been active since 2015. How have these «voices» changed since Russia's full-scale invasion?

Since 2015, I have been working as a volunteer with children in the east of the country along the entire frontline, and in 2019, we officially registered as a foundation. There have been many changes over nearly 10 years. In 2015, I was alone, but now our team consists of 220 people. The difference is that in 2015, the war was confined to two regions, but today it spans the entire country. Another change is that as of 2019, we had between 50 and 100 children under our care in various frontline locations and just one psychological support programme. It was very localised and targeted work. We travelled to remote villages where buses did not go. After 24 February 2022, when drones and missiles began flying across the whole of Ukraine, the format of our work changed drastically. The frontline today is more intense and much larger in scale.

Children during sessions conducted by staff from the «Voices of Children» foundation. Photo: private archive

Today, our centres are located in the largest cities along the frontline - from Chernihiv to Kharkiv, Zaporizhzhia, Dnipro, Kryvyi Rih, and Mykolaiv. It is not easy to work there due to the constant shelling. However, the children living there need socialisation. Their schooling is online, and they do not go anywhere - so our sessions are a small escape for them. War, whether large or small, always impacts children.

Why do parents return with their children to areas under shelling despite the danger?

It is hard to understand, but that is how it is. Everyone has their own story. You cannot say that all people have lost their minds about returning to dangerous cities and villages. That is not true! Sane, healthy, and thoughtful people are returning. The reasons vary greatly. Many simply could not settle elsewhere. People leave, spend all their money on renting accommodation, fail to find work, and return. This is the reality for many families. Some remain or return to dangerous regions because they have bedridden parents they cannot leave behind. That is why I never judge these people, although I am convinced that it is wrong to remain under shelling, especially with children.

Psychologists from the «Voices of Children» foundation constantly work with children affected by the war. Photo: private archive

How do you work with parents who refuse to evacuate with their children from dangerous zones?

It is a difficult process. If adults do not want to leave the area, they simply sign a refusal to evacuate. Parents bear primary responsibility for their children. Often, they refuse out of fear. Here, the state has not done enough to ensure that everyone has a clear understanding of where these people are going. They need to have at least some certainty in emergency situations. There is another group of parents who simply abuse their position and manipulate their children. Generally, these are the adults who do not take care of their children and are not interested in saving their mental health and lives. The state mechanisms must also work in these cases.

These children need to be removed. This is the job of social services, but it is not easy for them to work on the frontline. Many factors have come together to create the situation as it stands

I remember one story where we moved a family with three children from a frontline village and bought them a house in a rear area. A year later, they returned to their village. In this situation, there was nothing we could do because we do not have the right to remove children from their families.

What is the current psychological state of the children? Does it differ depending on where they live in Ukraine?

Various factors influence the psychological state of children. Certainly, the place of residence plays a role. There is a difference between living in Uzhhorod and living in Zaporizhzhia. These are two completely different realities. Obviously, the more dangerous the area of residence, the more threatening the situation for their mental health. However, much also depends on the family. A child senses the anxiety of adults. Parents are the window to the outside world for children. It is not just the rockets that scare them during war, but also their mother’s reaction to them. The presence of education, peer groups and opportunities for communication also have an impact on a child's mental health. Children in Kharkiv and Zaporizhzhia suffer greatly. Recently, we gathered children’s dreams in Zaporizhzhia, and one girl wrote: «I want this online schooling to finally end».

A session with children conducted by the «Voices of Children» foundation. Photo: private archive

Our psychologists report that today, children are more frequently presenting with anxiety and depressive states, especially teenagers. Some children develop enuresis, hand tremors, and sleep disturbances. Others, due to stress or traumatic experiences, may exhibit eating behaviour disorders.

What do you think the state should do to work with children currently abroad, and how should they be brought back?

We understand that in addition to returning children abducted by Russia, we also need to work with those who are currently displaced abroad. Ukraine must be highly interested in ensuring that all working-age people, and not only children, return. For example, we often receive requests for online psychological assistance from parents abroad, as they are looking for Ukrainian-speaking specialists for their children. It is no secret that living abroad was a dream for some, but for many, it is not a fairytale.

A very large number of people dream of returning home. However, urging them to do so now is certainly wrong, as the war continues

For people to return, the economy must function, jobs need to be created, and education must develop. But first and foremost, the war must end with our victory.

Children at the «Voices of Children» camp in Zakarpattia. Photo: private archive

Even the country with the best economy in the world cannot function normally when drones hit schools. It is abnormal and wrong. Today, hubs need to be created so that people abroad can still feel connected to Ukraine and remain within the Ukrainian information space. Moreover, we must constantly keep the world's attention focused and, of course, talk about the fact that Ukraine alone cannot counter Russian propaganda and stop such a powerful enemy.

Main photo: AA/ABACA/Abaca/East News

20
хв

Olena Rozvadovska: «Whether big or small, war always affects children»

Nataliia Zhukovska

You may be interested in ...

Ексклюзив
20
хв

Farewell to the Protectress

Ексклюзив
20
хв

Knowledge is our first shelter

Ексклюзив
20
хв

When the Russians entered, not a single dog barked

Contact the editors

We are here to listen and collaborate with our community. Contact our editors if you have any questions, suggestions, or interesting ideas for articles.

Write to us
Article in progress