"Amputees Care Centre in Estonia" by Dr Heidi Gil, Head of Rehabilitation Clinic, East Tallinn Central Hospital, Estonia

1. Amputee Care Center in EST
Dr Heidi Gil
Head of Medical Rehabilitation Clinic

2. Europe, Estonia

3. Estonia

4. East Tallinn Central Hospital
• Diagnostic Clinic
• Surgery Clinic
• Women´s Clinic
• Eye Clinic
• Clinic of Internal Medicine
• Clinic of Medical Rehabilitation
• Long-Term Nursing Clinic

5. ETCH
is located in 6 different units
• Ravi
• Magdaleena
• Tõnismäe
• Järve
• Magasini
• Loksa

6. The Hospital in Numbers
Specialised medical care is provided in over 20 specialties
The number of outpatient consultations is 550 000 per year
The number of hospitalised patients is 30 000
There are all together 640 beds
Our hospital employs 2500 people (400 doctors, 900 nurses)

7. Medical Rehabilitation Clinic
(MRC)
*We provide outpatient and
inpatient medical
rehabilitation services.
*We are specialised in
neurological, orthopaedic,
rheumatologic,
cardiological, post-
amputation rehabilitation,
sport medicine (prevention
programm and trauma
rehabilitation)

8. MRC
Our goal is to help our patients achieve the
highest level of functional independence and
quality-of-life as possible.

9. MRC
* 10 000 outpatient visits per year
• 300 000 different procedures, therapys
• 1 200 hospitalised patients per year (2 inpatient
departments)
• 150 employees

10. Medical rehabilitation in EST
is team-focused.
The team includes doctors, physiotherapists, social workers,
occupational therapists, speech therapists, psychologists,
nurses, prosthetic technicians; dietitian.

11. MR team
PRM doctor: planning treatment, monitoring general health
Nurses:inpatient care; some have specialized in applying physical
medicine procedures
Physiotherapists:training in gym and pool
Occupational therapists:evaluating necessity of adaptive equipment
Psychologist:assessment of cognitive functions and emotional
problems
Social worker:planning help after hospital discharge
Good cooperation with universities.
Teaching clinic.

12. Civil – military cooperation

13. Brize Norton Kandahar 2007
Feb
The most integrated
health care model from
general health care and
prevention of illness to
primary care and high-
tech hospital.

14. Amputations and prosthetics
* Around 500 amputations are carried out in Estonia each year, 90% as a result
of disease or illness and 10% resulting from trauma
• Prosthetic limbs were manufactured by private companies. They didn´t had
the rehab.team.
• Our soldiers were being injured in Afg in 2007 and guaranteeing them the
treatment they needed in Est was complicated by the lack of available
options and a lack of skills and experience.
• The Estonian Defence Forces ordered prosthetics and specific rehabilitation
for amputees from Walter Reed in the United States and Headly Court in the
United Kingdom.

15. Agreement between Headquarters of the Estonian Defence
Forces and East Tallinn Central Hospital from 10.10.2008

16. Headly Court, UK
Our physiotherapists
and nurses got the
opportunity to attend
the injured at HC.
It helped to plan the
rehabilitation in EST

17. 2009
Chance to visit Walter Reed Army Medical Center in Washington DC and
Brooke Army Medical Center, San Antonio –dreaming started

18. 2009 Estonia –high level visits
The National Defence Committee
President of Est

19. 2011-2012
• Letter of support
• People with the
same goal (courses)
* US office of
Defence Cooperation

20. HUMANITARIAN
ASSISTANCE
EUCOM PROGRAM THAT PROVIDES GRANTS WHICH ENABLE THE US
ARMY CORPS OF ENGINEERS TO BUILD OR RENOVATE KEY FACILITIES
SUCH AS: HOSPITALS, SCHOOLS AND CLINICS
OHASIS Project Number:
EN-HA-2012-0010608
Amputee Care Center
Tallinn, Estonia

21. 2012

22. 2013

23. 2013-2014

24. In July 2014 we opened Amputee Care
Center that brings together medical care,
prosthesis making and rehabilitation.
Center is offering improved quality and
availability to help both military and civilian
patients in the need of amputee care.

25. Renovation of this Amputee Care Center was accomplished
as a partnership between the United States of America and
the Republic of Estonia, through the combined efforts of
the United States European Command, the U.S. Embassy’s
Office of Defense Cooperation and the government of
Estonia.
June 2014

26. Opening ceremony

27. Cooperation oak