First Voluntary Surgical Hospital (FVSH), Ivano-Frankivsk, Ukraine

The challenge

The First Voluntary Surgical Hospital (FVSH) in Ivano-Frankivsk, Ukraine, opened on March 7, 2022. This small hospital has 14 beds. Since opening, it has helped more than 1,200 wounded soldiers. The hospital offers free surgery and full rehabilitation, physical, mental, and social. Their motto is: “We try to treat not only injuries, but the person as a whole.”

FVSH’s facility and surgical team can perform two to three complex reconstructive operations per day. However, limited recovery and rehabilitation space restricts the hospital to only 250 procedures per year, a number far below demand. Referrals arrive constantly from frontline stabilisation points, regional hospitals, and military units across Ukraine.

The hospital regularly operates at full capacity or beyond, and staff struggle to find space for new patients. Its small size also makes it difficult to secure stable, long-term funding. The priority is therefore clear: to expand capacity rapidly while embedding an integrated, modern model of care that combines surgery, physiotherapy, mental health support, and long-term community reintegration.

Expansion also requires rethinking resilience: How do you design infrastructure that serves both during war and remains valuable in peacetime?

Throughout the process, the team balanced international standards with local economic pressures, ensuring the facility could adapt to changing healthcare needs. Modular planning, standardized rooms, and vertical stacking maximise site use and patient flow, supporting both urgent needs today and resilience for the future.

Integrated, adaptable rehabilitation for long-term recovery.

Archus partnered with Floyd Slaski Architects to prepare a feasibility study and brief for a facility that meets urgent wartime needs while remaining fit for peacetime healthcare delivery. The proposed facility increases total capacity from 14 to 54 beds. This surpasses the crucial 50-bed threshold required to unlock sustainable funding through the National Health Service of Ukraine, and raises annual patient numbers from 250 to around 750. In collaboration, we delivered:

• Clinical brief focused on holistic rehabilitation
• Comprehensive feasibility study for sustainable expansion
• Schedule of accommodation for a new 40-bed rehabilitation hospital alongside the existing surgical unit

Our approach combined strategic planning with adaptable design principles to ensure resilience and sustainability. The methodology included:

• Collaborative workshops with clinicians and stakeholders
• Mapping current and future patient flows to understand operational pressures
• Translating real-world constraints into a clinical brief and functional requirements for the new centre

This process revealed a dual operating model:

• Conflict mode – high-throughput inpatient rehabilitation supported by physiotherapy, outdoor recovery spaces, mental health services, and immediate surgical access
• Peacetime mode – outpatient-led services, community follow-up, and technology-enabled outreach, including virtual wards and repurposed military assets for community health

The resulting design integrates surgery aftercare, physiotherapy, mental health, and community outreach. Key features include two 18-bed rehabilitation wards, a 4-bed mental health ward, outpatient procedure rooms, and a gymnasium doubling as a shelter. Modular planning, standardised rooms, and vertical stacking maximise site utilisation and patient flow, while enabling future enhancements, such as hydrotherapy and prosthetics delivery. By embedding adaptability at its core, the facility ensures FVSH can respond to evolving healthcare needs and future emergencies without compromising patient dignity or continuity of care.

Impact

Alleviating system pressure: By increasing throughput and providing structured 21-day rehabilitation pathways, the centre relieves pressure on regional hospitals and frontline stabilisation points.

Access to longer-term sustainable funding: the feasibility and concept work provides FVSH with a robust plan for development that will secure its long-term future

Blueprint for post-war recovery: The centre serves as a model for rebuilding Ukraine’s healthcare landscape, with potential to support broader veteran and family programmes, outpatient services, and virtual care.