Where Ukraine’s army of amputees go to repair their lives

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Orla Guerin visits a hospital and clinic in Ukraine, where 15,000 lost limbs in the first half of 2023.

As Ukraine’s counter-offensive grinds on – with limited gains and no decisive breakthrough – the number of amputees in the country is soaring.

There were 15,000 in the first half of this year alone, according to the Department of Health in Kyiv. The ministry won’t disclose how many are soldiers. The authorities guard casualty figures closely, but the vast majority are likely to be military.

That’s more amputees in six months than the UK had in the six years of World War II, when 12,000 of its servicemen and women lost limbs.

There may be many more to come in Europe’s newest war. Ukraine is the most heavily mined country in the world, according to the country’s former defence minister, Oleksii Reznikov.

Russia’s war is creating an army of amputees here, a conveyor belt of broken bodies.

We meet some of them at a rehabilitation clinic in the capital, Kyiv, and a hospital in south-east Ukraine.

Alina Smolenska’s only thought when her husband Andrii was wounded was to get to his bedside. “I just wanted to be with him, to touch him, to say that he’s not alone,” she says. “In situations like this, when a person needs support, I would touch their hand.”

But when she reached him in hospital that was impossible.

“I saw that Andrii really didn’t have his hands, so I just touched his leg and started to talk to him,” she says.

“I said: ‘We are a family. Don’t worry. Of course, there will be some harsh moments, but we are together’.”

Hours earlier, Andrii Smolenskyi had been commanding a small reconnaissance unit on Ukraine’s southern front.

As the 27-year-old started climbing out of a trench, an explosion ripped through earth and sky. His next memory is of waking up in hospital.

“It felt like a dream,” he says, “everything was so dark.”

Slowly, he realised he couldn’t move his hands, and that something was on his eyes, covering them.

Andrii lost his sight, most of his hearing, and both of his arms – one amputated above the elbow, the other below. Shrapnel was embedded deep under his skin. His face had to be rebuilt.

Four months on, we meet at a clinic in Kyiv where he’s having rehabilitation, along with other war veterans.

Andrii is tall and lean, with ready humour, and a slightly rasping voice. His latest surgery was to remove a breathing tube from his neck.

Alina sits by his side, on his hospital bed, her head nestling on his shoulder, her hand resting on his knee. Their words, and their laughter, often overlap. She is also 27 – petite and blonde and a tower of strength.

“My wife is incredible,” Andrii says. “She’s my hero, with me 100%.”

Alina has supported him through his injury and his battle to adjust, through physiotherapy and 20 operations (there will be more). When he’s thirsty she gently lifts a straw to his lips. He now sees the world through her eyes.

Andrii is “grateful to God” to have escaped any brain injury. His call sign in the army was “the apostle”, and he believes his survival was miraculous.

“Psychologically it was hard to get through that, but when I accepted my new body, I would say I felt good,” he says. “Challenge accepted.”

Doctors expected him to be in a coma for three days after he was injured. He was conscious in one. Alina says he’s “stubborn, in a good meaning of that word”.

When they met on a summer evening in 2018, she was smitten from the start. “I realised he was an exceptional person,” she says,” extremely intelligent, and thoughtful.”

They shared a love of the outdoors, and hiking in the Carpathian Mountains. Four years ago this month, they married.

Adversity has drawn them closer still.

“In the past three months I think I started to even love him more,” Alina says with a laugh, “because he gave me so much motivation, so much inspiration”.

The couple want to show that life goes on after life-changing injuries. “We will do everything possible to deal with it,” says Alina, “and with our example to show everyone that everything is possible”.

Andrii was an unlikely soldier – a financial consultant and self-confessed nerd, who sang in church and liked to talk about philosophy.

But he volunteered soon after Russia’s full-scale invasion in February 2022. For him it was a battle of good versus evil, “a war of values”.

Now his battle is in the gym – where he trains two hours a day – rebuilding his strength and working on his balance. And he has taken on a new mission – to help those who may come after him.

“Ukraine has never had such a big number of amputees, and people blinded by the war,” he says.

“Our medical system is not ready in some ways. Some veterans come in with really complex cases.”

And Ukraine’s legion of amputees is growing – mine by mine, and shell by shell.

Far from Kyiv, closer to the front lines, we see some of the most recent casualties at a hospital in the south-east.

After darkness falls, ambulances started arriving, carrying Ukraine’s young generation.

One is wrapped in a gold foil blanket to prevent hypothermia. Another has a bandaged stump in place of a leg. The amputation was done hurriedly near the battlefield to save his life.

On arrival, a number is written on the upper body of every casualty. There is no chaos, no shouting.

The staff here know the drill. Since the war began, they have treated 20,000 wounded soldiers – and counting.

“This is our front line,” says Dr Oksana, an anaesthesiologist.

“We are doing what we must do. These are our men, our husbands, fathers, brothers, and sons.”

In the intensive care unit, we meet Oleksii, his military dog tag still around his neck. He’s 38 and the father of a teenager. Just days before he lost both legs.

“I remember I got into a trench, and I think there was a tripwire”, he says. “I stepped on it. I remember a big explosion and friends trying to take me out.”

The hospital director Dr Serhii – a fatherly figure – holds his hand and tells him he is a hero.

“We will do everything possible so you can get prostheses quickly and run,” he says.

I ask Dr Serhii if he ever feels overwhelmed by the flood of maimed soldiers.

“As a rule, this feeling comes every night,” he tells me.

“When you see all this grief, all the wounded that arrive at the hospital. During the war we have seen more than 2,000 like Oleksii.”

Back in Kyiv, Andrii and Alina keep the darker moments to themselves.

He’s battling on, surprising doctors. They didn’t think he could walk with a white stick because he couldn’t hold it. But he found a way by clenching the cord at the top of the stick between his teeth.

His voice is getting stronger. He hopes he will be able to sing in church again and return to the mountains with Alina.

She dreams that new technology will restore his sight one day. “I also hope for some kids,” she says with a laugh, “and for our house in a peaceful Ukraine”.

Alina is trying to arrange treatment abroad, possibly in the United States, where specialists have more experience with complex needs like her husband’s.

Andrii grows quiet when asked what the hardest thing is now.

It was not his injuries, he says, but that he did not get to finish what he started and win the war.

Outside the clinic, a few of his fellow patients gather to smoke and share stories of the trenches. All have lost legs. Their wheelchairs form a sunlit semi-circle. One says the government is downplaying the number of amputees. He asks us not to use his name.

“There are at least three times as many as they say,” he insists.

“They want to hide us away. They don’t want people to know how many there really are. They are worried about getting people to join up and fight.”

He still gets a small salary from the military. “Enough for eight packets of cigarettes,” he says with a bitter laugh.

How long can Ukraine sustain these losses, and continue to fight? And how well can the growing ranks of amputees fit back into civilian life?

These are hard questions as a second winter of war approaches.

“We definitely are not ready, as a country, for a big number of people with disabilities on the streets,” says Olga Rudneva, chief executive officer of the Superhumans rehabilitation centre. “People will need to learn to interact. It will take years.”

Her new state-of-the art facility – in the relative safety of Western Ukraine – provides prosthetics for soldiers and civilians, free of charge.

Olga wants amputees to be visible, and she wants a new definition of beauty in Ukraine.

“This is our new normal,” she says. “They lost their limbs fighting for Ukraine and for our freedom.”

Additional reporting by Wietske Burema and Natalka Sosnytska

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