LocationsUNDP initiative supports Ukrainians to overcome challenges associated with loss of sight
In Ukraine, visual disabilities rise sharply in wake of war
December 3, 2023
Photo: National Assembly of People with Disabilities
As the world observes the International Day of People with Disabilities on 3 December, our focus shifts to an often-overlooked consequence of the ongoing war in Ukraine. Since the escalation of the Russian invasion in 2022, Ukraine has witnessed a significant increase in the number of people with visual impairments.
The National Institute of Health reports a concerning rise in cases of vision loss and deterioration in the country. In 2021, the number of individuals diagnosed with such impairments stood at 17,478. However, this figure rose to 19,551 in 2022, a noticeable increase. Alarmingly, the first seven months of 2023 alone have seen over 19,000 new diagnoses, already surpassing the total count for the entire previous year.
This surge is inextricably linked to the ongoing war. Many individuals have lost their sight due to injuries from mine explosions and rocket fire, a tragic yet underreported aspect of the conflict. These statistics not only highlight the direct physical toll of war but also underscore the long-term health crises emerging in its wake.
In light of these developments, there is an urgent need to expand and improve rehabilitation services in Ukraine. Enhanced medical care, psychological support, and accessibility measures are critical to address the growing needs of those with visual impairments. As we stand in solidarity on this International Day of People with Disabilities, we must recognize and respond to the challenges faced by those affected in conflict zones, particularly in Ukraine.
The rise in visual impairments serves as a stark reminder of the far-reaching impacts of war, extending beyond immediate physical harm to long-term health consequences. It is a call to action for the global community to work towards conflict resolution and provide comprehensive support to those whose lives are irrevocably altered by such crises.
Situational Analysis of Rehabilitation Services
UNDP conducted a situational analysis to understand better the opportunities and challenges for rehabilitating people with visual impairments in Ukraine.
The examination of the system revealed several gaps. Most significantly, there is a lack of clear regulations specifying the rehabilitation services, the specialists involved, the required qualifications, and the funding sources for such services. This lack of clarity results in disorganised and insufficient provision of services, both within and outside healthcare facilities. Such ambiguity not only creates operational confusion but also severely impedes practical rehabilitation efforts for those with visual impairments.
Consequently, there is a lack of a systematic approach to rehabilitation that guarantees the provision of necessary services. The current framework fails to ensure the provision of essential services, often leaving individuals without the support they need. The issue of workforce preparedness compounds this inadequacy. Training programmes for psychologists, occupational therapists, and physical therapists lack critical components for addressing the specific needs of patients with visual impairments. Consequently, the capacity of these professionals to deliver effective rehabilitation services is significantly limited.
Moreover, the analysis highlighted a scarcity of specialized rehabilitation institutions. This limitation restricts the availability of necessary services and further strains the already overburdened system.
Lastly, the absence of community-level rehabilitation services presents a significant hurdle. This gap mainly affects individuals in remote or underserved areas, who often find themselves without access to the vital support and resources required for rehabilitation.
A Model of Rehabilitation for People with Visual Impairments
Photo: Complex Rehabilitation Centre "Podillia"
Following the insights gained from the situational analysis, a new rehabilitation model for individuals with visual impairments has been proposed, developed collaboratively with the support of UNDP, and backed by the governments of the Republic of Korea and Germany. This model is designed to address the critical needs identified, aiming to enhance the overall quality and accessibility of rehabilitation services.
At the core of this model lies the objective to comprehensively identify the range of services needed to rehabilitate visually impaired individuals. It includes a detailed list of these services, which vary depending on the rehabilitation stage and the specific requirements of each individual. Typically, these services encompass areas such as vision rehabilitation, development of physical skills like balance, psychological support, orientation and mobility training, life skills development, digital literacy, and Braille learning.
Another critical aspect of the model is the specification of the qualifications required by specialists to ensure they can effectively provide these diverse services. By establishing these standards, the model seeks to improve the overall expertise and quality of care provided to individuals with visual impairments.
Additionally, the model focuses on determining the necessary equipment for rehabilitation. This includes outlining a list of mandatory and additional equipment essential for offering comprehensive rehabilitation services. Ensuring the availability of this equipment, especially those listed as required, in rehabilitation institutions is crucial. This step guarantees that the rehabilitation process is implemented correctly and maximizes effectiveness.
Piloting the Model in Practice
UNDP is piloting its rehabilitation model in two Ukrainian institutions, each focusing on different recovery stages for patients with visual impairments. The rehabilitation centre at the First Territorial Medical Association of Lviv caters to patients with various injuries and disorders requiring hospital-based treatment and rehabilitation. Meanwhile, the Centre for Complex Rehabilitation of People with Disabilities "Podillia" in Vinnytsia is dedicated to individuals in advanced stages of recovery, emphasizing the mastery of life skills.
Roman Shtohryn, the director of "Podillia," acknowledges the significance of UNDP's support: "The UNDP’s rehabilitation model fills a critical gap in our country's healthcare system, especially for those affected by war-related injuries leading to vision loss,” he said. “It provides a comprehensive 'road map' for regaining independence, covering everything from spatial navigation using a white cane to social interactions and daily activities."
The piloting of this model, supported by UNDP and the Government of Japan, involves attracting and enhancing the qualifications of necessary personnel, purchasing equipment to facilitate rehabilitation services, and includes the following components:
- Recruiting occupational therapists to develop social and practical skills for visually impaired patients.
- Engaging a diverse team of specialists, such as psychologists experienced in working with visually impaired individuals, digital skills trainers, orientation and mobility trainers, and Braille experts. Notably, the Lviv centre also incorporates an optometrist, marking an innovative approach in Ukraine.
- Procuring essential equipment like white canes, sound signalling devices, tactile aids, hearing aids, motor skill simulators, and Braille writing tools.
Offering a comprehensive service range for adults with over 70 percent vision loss, encompassing psychological counselling, skill training, digital literacy, and Braille education.
The current scarcity of widespread, comprehensive rehabilitation services for people with visual impairments in healthcare and social protection institutions presents a significant challenge in Ukraine. The UNDP's initiative aims to bridge this gap, establishing a sustainable foundation for these services.
This pilot programme enhances the immediate capacity of rehabilitation facilities and sets the stage for long-term sustainability. The outcomes will inform the development of standardized medical guidelines for rehabilitating visually impaired individuals, ensuring access to these critical services and upholding the right to rehabilitative care in Ukraine.
Specialized Training for Orientation and Mobility Specialists
Photo: National Assembly of People with Disabilities
Addressing the need for skilled professionals to assist people with visual impairments, UNDP, in partnership with the National Assembly of People with Disabilities, organized a specialized training programme. This initiative aims to equip teachers, educators, social workers, occupational therapists, physical therapists, and rehabilitators with the necessary theoretical and practical skills for effective spatial navigation and mobility instruction..
The programme brought together 18 specialists from various Ukrainian cities like Kyiv, Lviv, Kharkiv, Vinnytsia, and Odesa. These participants were engaged in hands-on training focused on teaching visually impaired individuals how to better navigate and move through different spaces. A key component of this training involved blindfolded exercises, enabling the specialists to empathetically understand the experiences of blind students. To extend the reach of this training, video lessons were recorded and made available for specialists who couldn't attend in person, thereby expanding the programme's impact.
Liudmyla Shramko, a training group member, said the training was enriching and goal-setting for her. “It comprehensively covered how to teach navigation in micro and macro spaces for those with visual impairments,” she said. “This initiative underlines the importance of continuing to develop a robust system for training instructors across Ukraine, a need that has become increasingly urgent."
Integrating Orientation, Mobility, and Digital Skills Training
In a concerted effort to enhance the independence and quality of life for individuals with profound visual impairments, two specialized educational initiatives have been established at the Complex Rehabilitation Centre "Podillia."
The School of Orientation and Mobility teaches people with visual impairments to orient themselves and move independently in various environments. Navigating space effectively is fundamental for fostering independence, accessing education and employment opportunities, and managing daily routines and personal life autonomously. By focusing on these critical skills, this programme is vital in empowering individuals with visual impairments to lead more independent and confident lives.
Alongside mobility training, there is a pressing need for digital literacy among people with visual impairments. Recognizing this, the "School of Digital Skills" was developed with the support of UNDP and the governments of the Republic of Korea and Germany. This programme aims to bridge the digital divide for visually impaired individuals, enabling them to perform everyday tasks like paying bills or shopping online more independently.
The month-long training course at the rehabilitation centre in Vinnytsia has already seen eleven students acquire essential digital skills. The curriculum includes ten-finger blind typing, file management, text editing, and basic internet navigation. It also teaches the installation and utilization of specialized software and applications that assist blind individuals in their daily activities.
By combining orientation and mobility training with digital skills education, the Centre "Podillia" addresses two of the most significant barriers faced by people with visual impairments. These programmes provide practical skills while opening doors to broader social participation, enhancing the overall autonomy and independence of the participants.
Photo: Complex Rehabilitation Centre "Podillia"
Analysis of government resources web accessibility
Barriers faced by people with visual impairments exist not only in physical space but also in virtual. After all, with the help of auxiliary tools, they use the Internet and digital technologies the same way as other users. However, it often becomes impossible to use a site or mobile application if the developers have not considered the needs of different user groups and web accessibility requirements.
Web accessibility is essential for government resources because they have no alternative, unlike the private sector. To assess the situation with basic web accessibility in the public sphere in Ukraine, UNDP, with the support of Sweden, has been analysing 100 websites of executive authorities at the central and local levels for three years in a row. Monitoring allows you to understand the situation with the basic accessibility of these web resources, identify the most common errors, and help developers to eliminate them.
The latest analysis showed a positive trend – the level of web accessibility of Ukrainian authorities' websites is gradually increasing. Seventy-three sites (compared to 61 in 2021) of the 100 analysed at the beginning of 2023 had average to above-average basic accessibility.
Training on web accessibility for public servants
To ensure inclusivity in digital government services, it is essential that public officials responsible for managing web resources in government bodies are equipped with the necessary knowledge and skills to create accessible web content. Addressing this need, UNDP has launched a systematic training programme for civil servants, with the support of Sweden, focusing on the fundamentals of web accessibility.
Initially, this training series targeted web developers and communication specialists from central government authorities. In 2023, with additional backing from Japan, the programme expanded to include regional-level training. These expanded efforts involved two-day sessions on web accessibility, reaching over 500 civil servants and local self-government representatives from 14 oblasts. The training sessions were conducted in Vinnytsia, Lviv, and Poltava, marking a significant step in enhancing the accessibility and inclusivity of government digital services.
Recordings of specialized training were published online so that as many people as possible could gain the necessary knowledge and know how to increase the accessibility of their site or text.
For the same purpose, together with the team of the Ministry of Digital Transformation of Ukraine, they developed an online course for the Diia.Osvita portal – “Web accessibility.” In 10 series, all essential information on the topic was briefly presented: how blind people use the Internet, how to create understandable texts, what colours and contrast to choose, and how to check the accessibility of a website or mobile application.
The course formed the basis of the “Quick Guide to Web Accessibility,” which contains all the instructions on increasing the accessibility of your web resource, publication or even text in the social network.
Fundamental change in legislation governing web accessibility
Photo: Andrii Krepkykh / UNDP in Ukraine
In June 2022, a new state standard for digital accessibility, developed by the Ministry of Digital Transformation with the support of UNDP, entered into legal force in Ukraine. This standard was recommended by the authors of another UNDP study – regarding mobile accessibility in other countries. In July 2023, the Government of Ukraine adopted Resolution No. 757, which made compliance with its requirements mandatory for executive authorities. The new Ukrainian DSTU duplicates the European standard (EN 301 549), thereby harmonizing Ukrainian legislation with international standards on web accessibility.
The standard is based on the international guidelines for the accessibility of web content WCAG (Web Content Accessibility Guidelines) 2.1, which UNDP officially translated into Ukrainian to support this initiative. This will significantly bring global web accessibility standards closer to Ukrainian developers and facilitate their implementation.
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In conclusion, the initiatives undertaken in Ukraine represent a significant step towards creating a more inclusive society. Through the concerted efforts of UNDP and its partners, including the support from Sweden and Japan, a dual approach has been adopted to empower people with visual impairments and educate those responsible for designing and providing services, especially state services.
Through comprehensive efforts – educating both the visually impaired people themselves and those who create services for them, including state services – we strive for as many people as possible in Ukraine to be able and know how to build a space around them in which there will be no barriers so that it is comfortable for all people to live in it. This holistic approach improves the lives of those with visual impairments and contributes to building a society where inclusivity is a norm, and barriers are a thing of the past, ensuring a comfortable and accessible environment for all, leaving no one behind.
Background
The initiatives focused on rehabilitating and training individuals with visual impairments are part of two key UNDP projects. The first, "Supporting the Rehabilitation of People with Disabilities Caused by the War," is backed by the governments of the Republic of Korea and Germany. This project specifically addresses the needs of those whose disabilities stem from war-related incidents. The second initiative, "Promoting Human Security in Ukraine through Responding to the Multidimensional Crisis Caused by War,” is funded by the Government of Japan. It takes a broader approach to support those affected by the various crises stemming from the war, emphasizing the multidimensional aspect of human security.
Additionally, the web accessibility initiatives fall under the “Digital, Inclusive, Accessible: Support to Digitalisation of Public Services in Ukraine” (DIA Support Project). This project, focusing on enhancing the digital inclusivity of public services, is spearheaded by UNDP with financial support from the Government of Sweden. This alignment signifies a comprehensive effort to integrate digital accessibility into public services, ensuring that they cater to the needs of all citizens, including those with visual impairments.
