“She used to look away from the mirror — now she smiles”: How Neopalymi burn survivor program helps Ukrainian children heal from scars of war

What's the problem?

Nearly 1,800 children in Ukraine have been injured since the start of Russia's full-scale invasion, according to the Children of War portal, which collects up-to-date information about Ukrainian children killed or affected by war.

Many of the injured children have visible wounds from hostilities — scars from explosions, burns, or shrapnel. Along the path of their physical rehabilitation, children have to go through a challenging emotional recovery. Children with visible injuries may struggle to accept their new appearance, face bullying, or hear hurtful questions that reopen their trauma.

Nadiia Oksiuta and her daughter, Alisa, were both injured when a helicopter crashed in Brovary, Kyiv region, on January 18, 2023. That morning, Nadiia was walking her six-year-old daughter to kindergarten. When the aircraft fell, she threw herself over Alisa to protect her. Both suffered burns to their faces, arms, and legs. They were first treated in Lviv, Ukraine, then transferred to Austria for further care.

Two years later, Neopalymi doctors are helping Nadiia and Alisa heal their burn scars, still visible, reminding them of what they went through. Alisa's mother says scars are part of their story but don't define them. Unfortunately, not everyone sees it that way.

"Sometimes we deal with unwanted attention, stares, questions, or pity. Alisa has burn scars on her arms and legs. Once, during a dance class, she was changing when another child noticed the marks and asked her mother, 'What's that? Why does she look like that?' Instead of explaining, the mother turned the child's head away and said, 'Not pretty, don't look.' That's the worst thing you can do, because it makes a child feel like something is truly wrong with them," Nadiia recalls.

According to Nadiia, children need to understand reality—you, as a parent, can't shield them from it forever. Sooner or later, kids will see different people on the street, in stores, everywhere. If you explain this to them honestly and kindly, children will accept it more easily.

"Adults often don't know how to react — some feel sorry for us, some are surprised, some ask uncomfortable questions. But we don't need pity," says Nadiia. "The most important thing is that we're alive and moving forward. Some Ukrainians face far greater challenges, so people must understand that before making quick judgments."

Ten-year-old Anhelina from Kupiansk also knows what it's like to face insensitive reactions from adults to her appearance. In October 2022, a Russian missile hit her home. Her father was killed, and Anhelina miraculously survived, rescued and brought to the hospital by Ukrainian soldiers. The only family she has are two older brothers and a sister.

The Russian attack left Anhelina with injuries — gunpowder burns, shrapnel wounds, and damage to her leg and eye. After months of treatment in Ukraine and abroad, she returned home with tiny, colorful scars scattered across her face — reminders of the explosion.

"Doctors said they would fade in a few years," says her foster mother, Zoia Lavrykova. "But the scars constantly reminded her of the pain and attracted unwanted attention from both children and adults. Over time, I noticed she started avoiding mirrors, trying not to look at herself."

Anhelina's psychological trauma was severe, and simply waiting for her to "get over it" wasn't an option. It would have only worsened her distress. That's why her foster mother Zoia sought help from the Neopalymi program.

Zoia says that when Anhelina found out they would remove the explosion scars from her face, she became a different person—it was as if she had come back to life. She counted down the days, eagerly waiting for that moment.

What's the solution?

The program Neopalymi (which stands for "unburnable" in Ukrainian) works across Ukraine, providing free rehabilitation and treatment for people with post-war injuries, burns, and scars to both adults and children affected by the war. The treatment takes place in the program's partner clinics.

"We provide help in more than 32 clinics across 16 regions of Ukraine, as well as in Poland and Moldova," says Oleksandr Turkevych, the medical director of the Neopalymi program. "Scars can cause not only psychological discomfort but also physical pain. We want to give people the chance to understand and feel that this isn't forever."

Both adults and children in Ukraine can join the program under the same conditions. They need to have a medical certificate or confirmation from a military medical commission (for soldiers) proving that the injury is not domestic but war-related. Then, they need to register for the program.

How does it work?

The program treats post-traumatic scars, including burn scars, blast injuries, and scars from surgeries on large tissue defects caused by war injuries. The treatment involves laser therapy, microneedling radiofrequency technology, polynucleotide injections, and soothing topical products that aid recovery.

After submitting the registration form, a manager contacts the patient to help choose the nearest clinic and schedule an initial consultation. There, the doctor creates a personalized treatment plan and selects the procedures.

"I found out about this program only a year after the tragedy happened to us. One day, I stumbled upon their Instagram page, saw the 'before and after' photos, and burst into tears," says Nadiia Oksiuta. "That was when I realized not everything was lost, that something could still be changed. The program also needed to help children because I wanted my daughter and I to go through this together."

The next day, Nadiia filled out the form, received a call, and went to their first consultation with her daughter Alisa.

Alisa underwent preparation for laser resurfacing, and recently, she had her first procedure. Since the treatment is painful, Nadiia prepared her daughter in advance, sharing her own experience. She said she didn't sugarcoat it for Alisa because her child needed to know what was ahead. Nadiia also tried not to scare her daughter, focusing on the results and how it would change her appearance.

"This openness may have helped Alisa accept the treatment. Of course, she's afraid, but my husband and I support her. I hold one of her hands during the procedures, and my husband holds the other. The most important thing is support and understanding why we're doing this. And we always remind her that we love her exactly as she is," says Nadiia.

Oleksandr Turkevych, Neopalymi director, adds that the procedures are performed under general anesthesia if the injuries are severe. That was the case for Anhelina, says her foster mother, Zoia Lavrykova. During one session, doctors managed to remove more than 70% of the scars on Anhelina's face.

Although Anhelina was very nervous before the procedure, she eagerly awaited this moment. Her foster mother says she went through it like a true fighter. The rehabilitation went quickly, and the scars on Anhelina's face faded — only the ones on her legs took a little longer to heal.

"The most important result of the treatment is how Anhelina sees herself now. She used to catch unwanted, sometimes pitying glances. Now she feels like an ordinary girl. She's happy, trying on the clothes she didn't care about before — and she looks in the mirror and smiles!" says Zoia.

How to help a child accept their appearance?

Children whose appearance has changed due to injuries or trauma face many challenges. On one hand, peer environments can be harsh, as children are often prone to teasing and bullying, says Alina Kasilova, a psychologist with the Neopalymi program.

On the other hand, curious or pitying looks from adults and specific beauty standards perpetuated by the media can also affect people's self-esteem, especially children's. This is also true for teenagers, for whom peer acceptance is so important.

The role of the environment. Any change in appearance can cause anxiety, and how intensely a child feels it depends on the reaction of those around them — family, friends, classmates. If teasing is common in a group, a child will subconsciously fear becoming the target. In a supportive environment, anxiety decreases.

The way parents and relatives perceive the child is equally important. Things are much easier if the family supports the child, explains what is happening, and helps them adapt. In contrast, attempts to hide the child's features — like suggesting long sleeves to cover scars or using makeup to mask them — can make the child feel ashamed, as if something is wrong with them.

"Remarks like 'She was so pretty before…' or pitying words or questions about what happened can only deepen feelings of isolation and insecurity," says Alina Kasilova. "Asking too many questions can retraumatize the child."

For school-age children, Kasilova recommends having a conversation before returning to school about how to respond to questions from classmates:

• Explain that curiosity doesn't always come from a bad place — sometimes people just want to understand.
• Emphasize that the child has the right not to answer if they don't feel ready. There's nothing wrong with saying, "I don't want to talk about it."

"Teachers' behaviour also plays an important role. In primary school, teachers are authority figures. Children often copy their behavior. If a teacher treats a child as they always have — without pity, involving them in activities, not avoiding them — it sets the tone for the whole class," Kasilova says.

Leading by example. Children also learn from their parents. If adults avoid talking about appearance or react to others' differences with fear or disdain, children pick up on that. Parents can model empathy and a neutral attitude toward differences in appearance or health.

How parents see themselves matters, too. If a parent constantly complains about their appearance, says Kasilova, the child might adopt that same self-critical outlook.

Building trust. When children prepare for medical procedures, trust between them and the adults around them will help them deal with fear. Kasilova recommends explaining what will happen in a way the child can understand.

"You can read books together or watch videos about skin and how wounds heal — but always choose materials appropriate for their age. Younger kids might respond better to simple explanations or games. This helps dispel fear and ease anxiety. It's also important for kids to know they can speak up if they're in pain, and that no one will force them to endure something against their will," says the Neopalymi psychologist.

Parents should avoid mixed messages. If they used to emphasize appearance — telling a daughter she should always look pretty — but suddenly say looks don't matter, the child might not believe them. Support needs to be consistent, not just during hard times, but every day, helping the child feel valued no matter how they look.

"To parents going through this with their children, I want to say: the most important thing is not to give up," says Nadiia Oksiuta, who has been undergoing treatment for over a year along with her daughter. "If parents lose faith, children feel it too. The right mindset and belief that everything will be okay make all the difference."