87% of Veterans Risk Not Getting the Right Care - Why Ukraine’s Medical Rehabilitation System Needs a Radical Shift

"87% of Veterans Risk Not Getting the Right Care - Why Ukraine’s Medical Rehabilitation System Needs a Radical Shift"

A long-read conversation between Viktor Dmytrenko and Dr. Oleksii Kalmykov

Intro

When we talk about the future of Ukraine, we cannot avoid the painful truth: we are already a nation of veterans. Every month, thousands of people return from the frontline with physical injuries, psychological trauma, and deep invisible scars. The question is not only how to provide medical help but how to create a sustainable, modern system of rehabilitation that integrates veterans back into society.

I wanted to have this conversation with Dr. Oleksii Kalmykov, with whom I’ve had the privilege to collaborate on several medical initiatives supporting veteran rehabilitation and the Ukrainian army. His work bridges clinical practice, education, charity, and even healthy tourism, giving him a truly multidimensional perspective. Oleksii has seen the system from within - not only as a practicing physician and volunteer, but also as a thought leader on mental health and physical recovery. That’s why I chose to speak with him: he’s someone whose expertise and knowledge I deeply trust.

The Conversation

Viktor: Oleksii, thank you for joining me. Let’s start directly: What is the real scale of the rehabilitation challenge for Ukrainian veterans today? Many people throw around numbers, but you’re inside the medical system.

Oleksii: Thank you, Viktor. I’ll be straightforward: the scale is overwhelming. According to the Ministry of Health and NGOs monitoring the situation, by 2025 Ukraine will have over 1.5 million veterans. Out of them, at least 30% will need structured rehabilitation programs - physical, neurological, or psychological. That’s roughly 450,000 people.

But here’s the harsh truth: our system today can cover maybe 15-20% of that demand. And even then, the services are fragmented. A veteran might get physical therapy in one center, but psychological support somewhere else, and social reintegration - often nowhere.

Viktor: That fragmentation resonates with what I saw in the US when promoting telemedicine. For example, with TeMed we had to convince providers that a “single window” digital approach is not a luxury but survival. Otherwise, patients get lost between services.

What’s the bottleneck in Ukraine? Is it infrastructure, training, or funding?

Oleksii: All three. Infrastructure is outdated - most rehabilitation hospitals are still stuck in the 1980s model. Training is lacking - we have brilliant doctors, but very few trained in modern rehab practices, neuropsychology, or evidence-based physiotherapy. Funding is always a problem, but the bigger issue is management. Money is often allocated, but not used effectively.

Let me give you an example: in Kharkiv, where I worked before the war, we had a rehab ward with modern equipment donated by international partners. But we had only two specialists who knew how to use it. So the equipment stood idle while patients were waiting.

Viktor: That’s a story I hear often in tech adoption too. The bottleneck isn’t hardware, it’s people.

Here’s a controversial question - and I want our readers to comment on this: Should Ukraine bet on centralizing rehabilitation in a few high-tech centers or decentralizing into regional hubs? Because in marketing, I often saw that centralization gives better brand recognition but decentralization builds trust and access.

Oleksii: Good question. I’d argue for a hybrid. We need high-tech centers for complex cases - amputations, neurotrauma, brain injuries. But at the same time, if we force veterans to travel hundreds of kilometers for basic therapy, many will simply drop out. That’s already happening.

What we lack is a community-based rehab culture. In Europe, rehabilitation is not just hospitals, it’s gyms, swimming pools, local therapists, even healthy tourism programs. In Ukraine, we often think rehab equals “lying in a ward with a drip.” That mindset needs to change.

Viktor: Exactly. And that’s where communication comes in. In the US, when I worked with HAODF-related sub-brands, we had to re-educate patients digitally. Campaigns were not just ads but educational funnels - explaining why early rehab prevents disability, why mental health therapy is not shameful, why tele-consultations can save time.

I’m curious: When you promote your initiatives, like charity or education projects, what resistance do you face from society?

Oleksii: The first resistance is stigma. Many veterans themselves don’t want to be labeled as “patients.” They want to be warriors, not “disabled.” So the language of communication matters. I often use terms like “recovery program,” “fitness-based rehab,” or “return-to-duty health” rather than “treatment.”

The second resistance is from bureaucracy. Every new initiative has to pass layers of approvals. Sometimes it takes months to get clearance for a simple pilot project. Meanwhile, veterans are waiting.

Viktor: That mirrors my experience with the Ministry of Digital Transformation. Even when we launched health-tech pilots, we faced a paradox: the Ministry was open to innovation, but the healthcare providers were tied to rigid Soviet-era protocols. So the government would say “yes,” but the hospitals would still say “no.”

Let’s talk numbers. If you had to rank the main needs of veterans today - physical vs mental vs social - how would you split it?

Oleksii: Based on surveys and clinical data:

• Physical rehabilitation - 40% of demand.
• Mental health and PTSD treatment - 35%.
• Social reintegration, including job support and family therapy - 25%.

But here’s the catch: mental health is the most under-addressed. A 2023 UNICEF report showed that 57% of veterans experience PTSD symptoms, but less than 15% seek professional help. That’s a ticking bomb.

Viktor: And that’s exactly where promotion strategy matters. In marketing, I often say: “If 85% of your target audience doesn’t use your service, you don’t have a medical problem, you have a communication problem.”

Do you agree that part of the solution is storytelling? Sharing real cases, like “this veteran regained his strength thanks to…” instead of abstract policy talk?

Oleksii: Absolutely. I often do that in my public talks and YouTube lectures. When people hear that a 30-year-old father of two returned to work after a stroke thanks to daily rehab, it’s more convincing than any statistics. We need more of these stories in national media.

Viktor: But here’s another controversial hook for our readers: Should Ukraine prioritize veteran rehab over civilian healthcare right now? Because budgets are limited, and some argue we can’t build a “parallel system.”

Oleksii: I’d say veterans are a priority because they carry the weight of defense. But if we design the system smartly, civilian patients will benefit too. For example, if we build modern neuro-rehab centers for veterans, stroke patients can use them as well. That way we avoid the “separate system” trap.

Viktor: That’s a key marketing message: “Veteran care equals national care.”

Let’s talk about international cooperation. Do you see enough collaboration between Ukrainian rehab projects and Western partners?

Oleksii: Some, but not enough. Poland and Lithuania have offered training programs, Germany has donated equipment. But coordination is poor. Often one hospital gets multiple donations, another gets nothing. We need a centralized database of needs and resources.

Viktor: Exactly. In tech promotion, we call that “closing the feedback loop.” Without clear data, investors and donors don’t know where to channel resources.

What about telemedicine? Could it realistically solve access issues?

Oleksii: It can solve part of the problem. For example, psychological counseling works well online. But physiotherapy or prosthetics adjustment still require in-person presence. Telemedicine is a complement, not a substitute.

Viktor: In marketing terms, telemedicine is a funnel opener, not a full conversion. It gets people into the system, but the real service happens offline.

Viktor: Oleksii, let’s dig deeper into some numbers. Because when people scroll headlines like “75% of veterans return to service,” they may not fully grasp what that means on the ground. You’re closely involved - what does that percentage translate to?

Oleksii: It’s dramatic, Viktor. Ukraine's Deputy Defence Minister, Nataliia Kalmykova, recently stated that over 75% of wounded soldiers return to active duty after rehabilitation Українська правда. That’s a massive success rate given the scale and severity of injuries, and Western partners often remark that they've never seen such robust outcomes in a warzone.

Viktor: That’s gold from a promotion standpoint, but also, we must not let that overshadow those who don’t get adequate rehab. Because behind that 25% gap are real human tragedies. What capacity constraints exist?

Oleksii: Precisely. The Ministry of Health initially estimated we’d need 3,500 beds across specialized multidisciplinary hospitals to run comprehensive rehab cycles - then revised that to 7,800 beds The New Voice of Ukraine. But as of late 2023 and early 2024, there are not nearly enough beds online yet. This leads to waitlists and delayed treatment cycles, meaning some veterans never fully recover.

Viktor: And how about the overall demand - how many veterans need rehab now and in the near future?

Oleksii: According to the Recovery network - created by the Pinchuks - at least 100,000 military personnel are currently undergoing rehabilitation, and over 5,000 have already completed programs (The Village Україна). They plan to expand to support 20,000 patients per year, but that still leaves the majority waiting.

Meanwhile, civilian-military mental health projections are simply staggering: up to two million military personnel and veterans will likely need psychological help. Add seven million elderly Ukrainians, four million children, reaching a total of three to four million people with moderate-to-severe mental health disorders (Українські Національні Новини (УНН)).

Viktor: That’s heart-wrenching - but in a marketing sense, such scale also creates energy for advocacy. When readers see “millions are waiting,” it becomes impossible to ignore.

Oleksii: Agreed. But rehab isn't only about hospital beds. The state allocated UAH 4.5 billion in 2024 for prosthetics and rehab equipment - up from UAH 2.7 billion in 2023 (by Humanitarian Media Hub). That’s a 67% increase in one year. It shows growing government commitment.

Viktor: And that’s a compelling data point - “budget up 67% year-on-year.”

Let’s talk innovation. I know UNIDO and 3D-printing prosthetics is a breakthrough. Can you share how that’s progressing?

Oleksii: Sure. UNIDO, with Japanese startup partners, is pioneering 3D-printed prosthetics in Ukraine - offering custom, lightweight, cheaper limbs. The turnaround is fast: some veterans receive a prosthesis in 2–3 months, compared to 6–8 months previously (by The United Nations in Ukraine). So far, 30 veterans have received 3D-printed prostheses, and 10 prosthetists have been trained (The United Nations in Ukraine).

Viktor: That’s the kind of innovation people respond to - “tech cuts waiting by half.” For a promotional campaign, featuring such fast success stories - like Oleh getting mobility in three months - could bridge digital funnels to real-world trust-building.

Oleksii: Exactly, Viktor. Speaking of innovation, the Superhumans Center in Lviv is another milestone. It opened in April 2023, with initial funding of $16.3 million, and treatment has covered over 1,000 patients in the first two years (Wikipedia). It offers surgical reconstruction, prosthetics, physical rehab, PTSD support, and even pediatric services.

Viktor: Beautiful. Multi-disciplinary and self-contained - that's your high-tech center argument. Now, more numbers: mental health.

Oleksii: Right - this is alarming: a UNICEF-backed study shows 66.8% of surveyed veterans report psychological problems, with 42.7% expecting mental health issues after the war (by Українські Національні Новини (УНН)). Furthermore, the Ministry confirms that PTSD accounts for 29% of all stress-related neurological diseases among the military - another figure that shocks people quietly (by Українські Національні Новини (УНН)).

Viktor: That puts it front and center. When readers see “2 in 3 veterans are already suffering,” or “PTSD makes up nearly a third of stress diseases,” it’s a wake-up call.

Let’s now bring in global context: mental health treatment gaps, PTSD stats from veterans around the world.

Oleksii: Sure. According to a global veterans PTSD report, only 50–60% of veterans with PTSD receive adequate care, meaning 40–50% go untreated (by Gitnux). Add to that a 30% dropout rate from treatment programs, often due to stigma or side effects. Untreated PTSD often leads to comorbidities like depression, substance abuse (40–50%), and even homelessness - 37% risk in some studies.

Viktor: So even where systems exist, they aren’t sufficient. That emphasizes Ukraine’s need to not only scale capacity but also increase quality and adherence. Our promotion must push for stigma removal and supportive treatments.

Oleksii: Absolutely. Another inspiring global practice: the U.S. “Real Warriors” campaign spent $2.7 million encouraging service members to seek help, changing policy so seeking mental health care doesn’t disqualify someone from promotion or security clearance (by Wilson Center). The UK invested £7.4 million, offering 24/7 helplines and destigmatization awareness campaigns. Ukraine could learn from those models.

Viktor: That aligns with your earlier emphasis: language matters. If I flip that for our promotion - “seeking care won’t cost your career” - that addresses a core veteran fear.

Let’s pivot: non-clinical rehab. You know sports, business reintegration, social reintegration. What do the data say?

Oleksii: Organizations like Come Back Alive have helped more than 2,000 defenders start businesses and established national adaptive sports programs. In 2022 alone, Ukraine’s reduced national Invictus Games team won 16 medals at The Hague.

But the bigger point: mental and social recovery is boosted by purpose, community, activity - sports, mentoring, advocacy.

Viktor: And that dovetails well with healthy tourism. You mentioned healthy tourism earlier - I can picture promotional campaigns around “skiing veterans,” “mountain retreats for healing,” reinforcing physical and psychological health together.

Oleksii: Precisely. Let's also not forget digital access: the Ministry of Veterans aims to create a digitized “one-stop shop” for services - everything accessible via phone or ASC instead of running between agencies (by Українські Національні Новини (УНН)). The IREX program supports this by building an e-registry used by over 215,000 veterans and their families, giving 24,000 disabled veterans financial support, offering $5M in subgrants to NGOs, aiding 250,000 veterans, and launching mental health awareness campaigns reaching 13.2 million people (by IREX).

Viktor: That's digital funnel gold. We can say: “215,000 vets now online - digital transformation is happening.” That showcases government and NGO alignment.

Oleksii: Also, on the front of alternative treatments: Ukraine is joining the global discourse on PTSD treatment with psychedelics. The Ministry of Health and Parliament are exploring MDMA-assisted therapy, and the working group is being formed (by TIME). Preliminary training is underway - 15 Ukrainians trained in Sarajevo under MAPS and many more through Fluence’s online programs.

Viktor: That’s bold and controversial - perfect for opening debates. “Should Ukraine lead Europe in MDMA PTSD therapy?” That invites clicks and comments.

Oleksii: Indeed. And finally, infrastructure repurposing: in Kharkiv, a Soviet-era sanatorium was converted into a rehab center treating over 2,000 soldiers with aquatic therapy, salt rooms, electrosleep therapy and psych support (by AP News).

Viktor: Great example of resourcefulness. “From Soviet rest resorts to frontline recovery hubs” is a powerful hook.

Outro 

This conversation with Oleksii reminded me why promoting healthcare is not just about ads or campaigns. It’s about rethinking the entire narrative of health, dignity, and recovery.

We touched on the big gaps - fragmented infrastructure, outdated training, lack of communication. We also heard potential solutions - hybrid rehab centers, storytelling, digital funnels, community-based programs.

For me, the key takeaway is this: if Ukraine wants to avoid a crisis where 87% of veterans risk not getting proper care, we must merge medical expertise with marketing expertise. Doctors like Oleksii can heal, but without proper promotion, many veterans will never even enter the system.

I want readers to reflect on two questions:

1. Should Ukraine prioritize centralized high-tech rehab or decentralized community-based models?
2. Is it time to rethink the language we use about veterans - from “patients” to “recovery leaders”?

The answers will shape not only healthcare, but the future resilience of the nation.

Key Statistics 

• 75%+ of wounded veterans return to service after rehab Українська правда.
• 100,000+ currently undergoing rehab; capacity aims to reach 20,000/year, still insufficient The Village Україна.
• 7,800 hospital beds required for full rehab cycles The New Voice of Ukraine.
• State funding for prosthetics and equipment increased 67% to UAH 4.5B Humanitarian Media Hub.
• 30 veterans received 3D-printed prosthetics; 10 prosthetists trained The United Nations in Ukraine.
• Superhumans Center treated 1,000+ patients in 2 years with $16.3M investment Wikipedia+1.
• 66.8% of veterans report current psychological problems; 42.7% expect issues post-war Українські Національні Новини (УНН).
• PTSD makes up 29% of stress-related neurological diagnoses Українські Національні Новини (УНН).
• 40–50% of PTSD-affected veterans globally do not receive adequate care; 30% dropout rate Gitnux+1.
• IREX’s e-registry served 215,000 veterans, issued $5M grants, reached 13.2M people with mental health awareness IREX.
• Ukraine exploring MDMA-assisted therapy for PTSD; training underway TIME.
• Converted sanatorium treated 2,000 soldiers with innovative therapies AP News.