Neighborhood development integrated with a healthcare and rehabilitation facilities
I. Genesis
After the start of russian full-scale invasion of Ukraine in February 2022 the city of Lviv has become a humanitarian hub for 5 million refugees from other regions of Ukraine – many of them demanded qualified medical help after surviving through military attacks. To face this challenge Lviv municipality initiated a transformation of one neighborhood at the northern part of the city to a rehabilitation hub and with the support of partners all around the globe launched the UNBROKEN project. The Integrated Urban Development Concept helped the city to implement it successfully setting the right priorities and developing sustainable solutions.
UNBROKEN was called “the ecosystem of humanity” because of its values and the scale. Its main goal is to provide physical and psychological rehabilitation to military and civilians, as well as their further socialization and reintegration. For now, the project comprises the National Rehabilitation Center UNBROKEN, UNBROKEN Mothers Center, Prosthetics Workshop, centers for Mental Health in every district, and the project “The City Cures”. Most of the project’s components are placed nearby, in one neighborhood, to create a full cycle of rehabilitation. The UNBROKEN ecosystem demonstrates that the city of Lviv adopted a new holistic approach of thinking about urban issues, having in mind principles of sustainability and resilience, and covering complexity of them while developing solutions.
The neighborhood of the UNBROKEN ecosystem is mostly built by soviet architecture of XX century, which disrupted the historic structure of the city planning introducing micro districts with huge distances between housing blocks and wide roads between them. Consequently, community coherence in that part of the city became a challenge for many years ahead. The UNBROKEN ecosystem transformed this neighborhood into a medical hub, where innovative solutions both from the sphere of medical care and integrated urban development are emerging.
UNBROKEN brought attention to the neighborhood in the northern outskirts of Lviv and further projects applying an integrated urban development approach were launched there in 2022. The glass bridge connecting the UNBROKEN buildings, the rehabilitation building constructed by the famous Japanese architect Shigeru Ban, the Mazepa street reconstruction project, the Recovery gardens are just a few of the initiatives at various stages of implementation that have been created to face the consequences of war and which resulted in intensive development of the northern neighborhood of lviv based on principles of integrated development.
II. Triggers
Due to russian full-scale invasion of Ukraine, Lviv became a hub for 5 million internally displaced persons and nearly 150 thousand of them settled in the city. Moreover, some of Lviv’s residents were mobilized into the ranks of the Defense Forces of Ukraine. Moreover, the city suffers from missile strikes which cause numerous casualties and destruction of both critical infrastructure and civil one. Ukraine’s medical infrastructure was improved as a result of Covid-19 pandemic but the military threat placed a completely different task of healing severely injured people who often needed prosthetics and further rehabilitation. The need for a large rehabilitation center far from the frontline was obvious and Lviv took responsibility for meeting this challenge. Existing medical infrastructure showed its limited capacity to heal large numbers of patients during the COVID-19 pandemic, thus new facilities must have been built.
The demographic shift caused by 150 thousand IDPs who settled in Lviv triggered discourse on housing policy. Northern part of the city, in contrast to some other city areas, obtains enough free space for new developmental projects. Developers of commercial housing were the first who reacted to the growing need of new living spaces and who started projects in the north. Some of them are already in use by inhabitants, most – under development. New housing projects were pushing the city to rethink its vision for this part of the city development. Additionally, housing is an essential part of the healing process, thus the UNBROKEN project set a goal to build municipal housing in the neighborhood for patients who need continuous support.
The choice of the site for the project was triggered by the centralized city structure which causes an overload of the city center by people and vehicles. The Integrated urban development concept considers this challenge and proposes a decentralized logic for city development. In the case of the UNBROKEN ecosystem, it meant that new medical facilities must have been placed in the neighborhood that is at some distance from the city center in the area that has the potential to become the city’s sub-center. The neighborhood in the northern outskirts of Lviv was chosen for this project. In terms of integrated development, the neighborhood transformation project faced the need to find a solution to the lack of transport infrastructure in the area, thus the Department of Mobility ensured development of the project of the Mykolaichuka street reconstruction with continuation of a tram line.
Considering that the city of Lviv suffers from such symptoms of climate change as an imbalance of precipitation during the year, which due to poor wastewater infrastructure results in floods during the rainy season, the northern neighborhood with its links to the natural assets provides possibilities for development of innovative solutions to climate-related issues. As far as the rehabilitation challenge often faces the need to work with human-nature interaction, those assets’ value was reflected in the projects within the UNBROKEN ecosystem. Therapeutic route, the Recovery garden, link to Zamarstynivski park – are just some of the projects in the neighborhood aimed at both mitigation of climate change and holistic rehabilitation.
III. Transformational context
Thinking of solutions to address the challenges
By implementing pilot projects Lviv demonstrated the high value of IUDC principles and approaches to spatial planning for nearly 10 years. One of the first urban projects which adopted an integrated approach was “Street fo all” (ukr. “Vulytsya dlya vsikh”). It took place in 2016-2018 and was aimed at participatory reconstructing part of the street with the active involvement of citizens and all relevant stakeholders. Thanks to effective adoption of principles of civic participation, sustainability and integral development, multi-stakeholder cooperation was becoming an essential part of every municipal project.
When the russian full-scale invasion of Ukraine started, the city of Lviv acknowledged its safety mission – it took responsibility for taking care of those who suffered from russian military attacks in other Ukrainian cities closer to the frontline. Many Ukrainians from every part of the country, still coming to Lviv being often both physically and mentally wounded, so the project team’s priority goal is to create a safe, inclusive environment where everyone can be sure that specialists care about their needs. The Integrated Development Concept: Lviv 2030 also contributed to this by linking values to specific urban planning principles.
How the Challenges are Being Addressed
First steps of transforming the northern neighborhood into a medical hub were taken before russian full-scale invasion when in 2021, following the integrated approach, the First Medical Unit was established on the basis of three hospitals in Lviv and renamed the Multidisciplinary Clinical Hospital of Intensive Care and Emergency Medical Care (First TMC). Later, the UNBROKEN National Rehabilitation Center, the Center for Medical Rehabilitation, and the Center for Transplantation (which were the first parts of the UNBROKEN ecosystem) were established as part of the association.
In order to focus on densification of the city and avoid further enlargement, the UNBROKEN ecosystem has been developed on the bases of existing medical infrastructure – the First Medical Unit of Lviv. All projects within the UNBROKEN ecosystem such as municipal housing or manufacture of prosthetics also try to meet this challenge, keeping close distances between all facilities and building needed infrastructure in between. Consequently the northern neighborhood was transformed into a rehabilitation hub.
Approaches for Addressing Future Challenges
In 2023-2024 within the project “Integrated Urban Development in Lviv” the City Institute, the municipal institution within Lviv City Council, together with the Department of Architecture and Urbanism conducted an integrated analysis of the neighborhood, bringing together diverse city stakeholders and residents to critically reflect on the ongoing process of the neighborhood development. The analysis added a data-based perspective on the process of its development based on results of the spatial analysis, polls and discussions with stakeholders.
Collected information enabled generation of the central features of the neighborhood that should be nourished and which must be considered in the strategic documents of spatial development. Thus, the project team has started work on recommendations for the Concept of integrated development for Lviv community, which development has started this year, for it to consider priorities of the nother neighborhood development.
IV. Action journey
Neighborhood transformation implies a number of spatio-social initiatives that all were based on a holistic approach to rehabilitation challenges and urban development. These initiatives, driven by innovation and collaboration, promise to not only elevate the urban landscape and medical services but also nurture a resilient, more coherent community.
- The First Medical Union of Lviv
As was mentioned previously the First Medical Union is the Multidisciplinary Clinical Hospital of Intensive Care and Emergency Medical Care (the First TMO). It included St. Panteleimon Hospital (formerly the Emergency Clinical Hospital), St. Luke’s Hospital (the 8th hospital), and St. Nicholas Hospital (the City Children’s Clinical Hospital). The First TMO was officially registered on 26th November 2021. At those days Covid-19 pandemic was believed to be the main threat for the Lviv community and this theesome integration was aimed to optimize the medicale care service system. The success of this project enabled efficient, fast response to the consequences of russian full-scale invasion of Ukraine on 22d February 2022. Russian military attacks resulted in numerous casualties among both soldiers and civilians and the number of those in need for medical care skyrocketed. Thus the creation of the First TMO contributed to the city’s resilience to diverse hazards and was the first of its kind in Ukraine.
- The project of Mykolaichuka Street reconstruction
The project of Mykolaichuka Street reconstruction by the Municipal institution “Institute of Spatial Development” won the architectural contest in April 2022. The project aimed to transform mobility in the neighborhood by making it more safe and accessible by public transport. Apart from extension of tram line No. 6 it aimed to reach the following objectives:
- Reconstruction of a key radial highway in the northern district of Lviv
- Connecting the northern and southern parts of the city
- Direct transport connection between the city center and the Unbroken rehabilitation center
- The connection between all elements of the Unbroken project: rehabilitation center, housing for rehabilitated people, prosthesis production
- Improvement of transport services in the northern residential area of the city
- Comprehensive implementation of the improvement of the neighborhood adjacent to the Unbroken center
- National Rehabilitation Center UNBROKEN
The heart of the UNBROKEN ecosystem is the National Rehabilitation Center UNBROKEN which operates on the basis of the First Medical Unit of Lviv. It has expertise in surgery, including reconstructive surgery, orthopedics, and robotic prosthetics. The center not only fits prostheses to war victims but also manufactures them. The Center also provides physical, psychological, and psychosocial rehabilitation. All medical care is provided free of charge. The social impact of UNBROKEN rehabilitation center can’t be underestimated: as of the beginning of 2024, more than 16,000 patients have undergone treatment and rehabilitation there.
- The UNBROKEN Cities Network
Neighborhood transformation is following the logic of a self-organizing system, and the UNBROKEN ecosystem is aiming to become as self-sufficient as possible, which stimulats innovative solutions and help to build resilience. The establishment of The First Medical Unit of Lviv and Unbroken project was done by the municipal government without investments from the central government. It became possible due to wise international networking of Lviv highest officials. The UNBROKEN Cities Network is an association of cities from all over the world to support and develop rehabilitation in Ukraine. Manchester, Liverpool and Lviv became the founding cities and first members of the international network. The UNBROKEN Cities Network provides strategic and technical support to Lviv and other Ukrainian cities affected by the Russian-Ukrainian war. Such cooperation strengthens the city’s resilience.
- The Surgical center
St. Panteleimon’s Hospital, the core medical institution in the neighborhood and within the First Medical Unit of Lviv needs to expand to meet the need for medical treatment, which rapidly increased since the start of the full-scale invasion. So back in 2022, negotiations began on the creation of a new surgical center. Since 2023, it has been known that the center will be designed by the world-famous Japanese architect Shigeru Ban, and the building will be constructed of glued laminated timber (CLT) – innovative sustainable technology. The choice of the material will help to reduce the carbon emissions during the construction works while the prefabricated panels enable fast construction, leading to reduced labor and on-site disruptions. Negotiations on the project implementation are currently underway to secure support for the project from Japanese businesses and government agencies.
- The residential campus on Mykolaychuka Street
Considering the social aspect of rehabilitation, the UNBROKEN project took responsibility for constructing municipal housing. The residential campus on Mykolaychuka Street will serve as a temporary residence for patients of the UNBROKEN Rehabilitation Center. The concept of the residential complex was selected during a competition and is currently supported by “Nefco in Ukraine” as part of a joint project between Lviv and the European Union. The eight residential buildings will accommodate about 700 people. All residential units will be fully accessible to meet the needs of people with reduced mobility
- The Prosthetics workshop
Following the logic of maintaining a self-sufficient resilient ecosystem of UNBROKEN a new prosthetics workshop was built in April 2024 in the northern neighborhood of Lviv. It is situated next to St. Panteleimon Hospital and aimed to complement the smaller workshop on the hospital’s premises. The new workshop covers an area of 1000 m2 and, in addition to its production function, will also perform an educational function: prosthetists from all over the world will train future specialists from all over Ukraine. This space creates opportunities for innovations through cooperation between specialists within Ukraine and other countries in the world.
- Projects in Zamarstyniv Park
Zamarstiniv park is a large green area linked to the northern neighborhood from the west, which provides important ecosystem services for the city such as reducing heat stress, air pollution, and regulating water balance. Apart from that it enables projects based on human-nature interaction. Since the medical facilities of the First Medical Association and the Unbroken Rehabilitation Center are nearby, the park’s reconstruction projects include accessibility for people with various injuries and are aimed at their complex rehabilitation. For instance the project of a therapeutic garden in Zamarstynivka Park is planned to create the necessary barrier-free infrastructure for the rehabilitation of the wounded.
- Updating the IUDC: Lviv 2030
In September 2023 City Institute, municipal institution within Lviv City Council together with Department for Architecture started implementing the project aimed to investigate economic, environmental, social and spatial features of the Northern part of the city with the focus on neighborhood, where the UNBROKEN ecosystem is developing. What prompted the project “Integrated urban development in Lviv”, especially its third activity “Updating the IUDC: Lviv 2030”, which directly concerned northern neighborhood, were:
1) the city faced challenges in implementation of Integrated urban development Concept on district and neighborhood level
2) the city acknowledged that huge economic, environmental and social potential of the territory of Northern part of the city should be wisely estimated
3) consequences of the full-scale invasion challenged former urban strategies and those needed to be rethought.
Information collected during 2023-2024 years within this project, conducted analysis and discussions with stakeholders have made a significant contribution to the future redevelopment of the area, questioning outdated planning practices and reinforcing modern approaches, including the integrated development concept. At the same time, the project made it clear how the process of localizing the goals of the Concept at the level of the district and the neighborhood can be. The key to this question is the integrated approach itself that implies multi-actor and multi-level cooperation which enables exchange of knowledge about challenges and solutions and further development of sustainable solutions. The projects of the UNBROKEN ecosystem described above are also effectively adapting these principles which led to holistic, resilient, sustainable development of the northern neighborhood.
V. Future
Comprehensive Plan for Spatial Development, which every Ukrainian city is obliged to comprise according to law. It is both urban planning documentation at the local level and land management documentation developed to ensure sustainable development of the territory. Although in the context of the development of the Lviv territorial community, the integrated concept is focused on the spatial development of the city of Lviv as the center of the territorial community, it also offers many tools to improve the structure at the agglomeration level.
The neighborhood where the National Rehabilitation Center UNBROKEN is situated, became the site of focus of further projects of integrated urban development. City Institute together with Technische Universität Dresden is developing a participatory instrument for urban change – Scenerii, that is expected to enable visualization of potential transformation of the areas and collect feedback and ideas from citizens. This tool might be a useful instrument for new approaches of neighborhood management. City Institute are now communicating with the heads of Lviv districts on potential cooperation within the projects on integrated neighborhood management. City Institute is also exchanging knowledge on neighborhood management with representatives of the city of Freiburg, which is Lviv’s sister-city in Germany within the “Dialog for Urban Change” network, supported by the Federal Ministry for Housing, Urban Development and Building. This cooperation enables Lviv to test best European practices at the neighborhood scale.
Annex I: Additional Links
Unbroken: the resilient spirit of Ukraine
https://abmk.ua/projects/unbroken/
https://hmarochos.kiev.ua/2023/09/04/yak-czentr-reabilitacziyi-nezlamni-zminyuye-pivnich-lvova/
