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The Protez Foundation, supported by Direct Relief, will incorporate a prosthetics training workshop for amputees in its third center to be opened in Ukraine. (Nick Allen/Direct Relief)
As Ukraine unofficially counts as many as 100,000 amputations among its population since Russia’s full-scale invasion in 2022, a uniquely experienced next generation of prosthetics specialists and supporters is stepping up to tackle this challenge.
They are veterans who overcame the loss of limbs and found a new vocation after regular soldiering became hard or impossible. Today, the life-changing events they endured enable them to help others with similar injuries, both military and civilian, along the road to recovery and a fresh start.
“When we started our work, we realized that for the guys who are new amputees, it’s very difficult to adapt and understand what’s going on and what they can expect from life going ahead,” said Kyiv-based surgeon Oleksandra Mostepan.
Her NGO, U+ System, an emerging partner of Direct Relief, has trained and employed two amputee veterans to great effect, with two more now starting the process: “When a technician is an amputee himself it’s easier to share this negative experience and [help the patients] realize how he or she can recover after such a trauma.”
Mostepan, who works at a large hospital in the capital, operated on some future trainees herself after their evacuation from the front. Through frequent doctor-patient interaction she not only saw their potential as individuals, but also for the sector’s overall development if they are integrated into existing teams of prosthetists.
After all, no one understands the issues of functionality and comfort of an artificial limb like a user, as her team found while fitting more than 350 prosthetics for war-injured patients.
“This cooperation between amputee technicians and experienced technicians working together will be a great achievement in prosthetics fitting,” said the surgeon. “I think it’s the future of prosthetics in Ukraine.”
A Growing Trend of Inclusivity
Other organizations supported by Direct Relief seem to have come to the same realization. The U.S.-based Protez Foundation, established in 2022 by Ukrainian surgeon Yakov Gradinar and its CEO Yury Aroshidze, has launched a new “veteran direction” at its two prosthetics clinics in Ukraine.
“We are attracting military veterans to the project to work as points of contact and event organizers for veterans,” said Aroshidze. “We already have two veterans working, Danyl and Mykola. Danyl had four amputations and was in [Russian] captivity. Also, in our new clinic project, we are equipping workplaces for the disabled so that our military personnel who have undergone prosthetics can become prosthetists.”
The gravitation of amputees to the prosthetics field will quickly become the norm in Ukraine as patient numbers continue to soar, predicts Lasse Madsen, co-founder of the Danish prosthetics company Levitate: “I’ve been in more than 600 clinics globally. And I’ve never in my life anywhere seen anything like this in terms of the amount of people [needing prosthetics].”
“We’ve been visiting other clinics as well in Ukraine and it’s not uncommon that you see that one of the technicians doing sockets or something similar who is an amputee,” said Madsen, who lost a leg in an accident at the age of 14 and went on to become a prosthetist. “You can see they’re so fired up to learn more and train and go to different places to learn.”
A Bigger Challenge Than Just the Prosthetics
Co-founder of Danish organization Levitate, Lasse Madsen, fits a shoe to a new “everyday foot” built for Ukrainian soldier Volodymyr, who lost his right foot in combat in Summer 2023. Volodymyr was the first recipient of a high-intensity prosthetic (“running blade”) from Levitate when it expanded its operations to Ukraine later that year. Direct Relief has supported rehabilitation services since the beginning of the war. (Nick Allen/Direct Relief)
At the same time, Madsen stresses the need to build networks for all of Ukraine’s new amputees, having himself experienced a deep sense of isolation after his injury two decades ago.
“Having a network of people that you can talk to who are in the same situation as you can be equally as important as actually talking to a specialist,” said Madsen, whose enterprise helps to build such resources through its regular sporting events for amputees in Ukraine.
Someone he sees as a great fit is Volodymyr Rudkovskyi, a 32-year-old infantryman who lost his right leg below the knee in combat in June 2023. Volodymyr became the second Ukrainian to receive a running blade from Levitate when it came to the country later that year, and he regularly participates in events organized with local partners.
As well as being a motivator for amputees at the Unbroken National Rehabilitation Center in Lviv, also a partner of Direct Relief, Volodymyr is a voluntary ambassador for this area of disability, performing various types of advocacy work.
“This includes trips to different forums, not only in Ukraine but also abroad, to different events, where people who are not involved in military matters would like to hear about how to treat veterans, military personnel, and their families,” Volodymyr said of his new role.
“We also take part in sporting events to promote the idea that everything should be barrier-free, that we should think about veterans, about the boys and girls who experienced the worst of this war.”
Painful Experience Shared
Two other injured veterans shared detailed accounts of their journey from combatant to casualty to prosthetist. Oleksandr Kushnerenko, 21, joined the army after school in 2020 and fought against Moscow-backed separatists in eastern Ukraine before the full-scale Russian invasion in February 2022. He was then sent east again and was injured in heavy fighting for the city of Bakhmut.
On September 27 of that year, a Russian tank that his unit had observed in the distance suddenly reappeared at close quarters and began shelling their position. Oleksandr suffered fragmentation injuries to his lower left leg and his right arm and was evacuated first to the city of Dnipro and then to Kyiv. There, Mostepan operated on his leg, which had to be amputated below the knee. She was able to save his arm, which has since regained full function.
Oleksandr Kushnerenko (Photo courtesy of U+)
In 2023, Oleksandr met his surgeon again in Lviv at an event hosted by U+ System and Levitate. At the time, he was considering returning to active duty. Seeing his suitability for a different role, Mostepan invited him to train as a prosthetist with her NGO.
“I wasn’t against the idea and a month later I was already working in Oleksandra’s team,” he said. “I studied and went on some prosthetics courses and started my practical at various prosthetic centers, and now I work at U+ System.”
Oleksandr has since helped fit sports prosthetics for more than 100 male and female amputees. “I have simply found the thing that I love doing,” he says of this change of course. “As for what happened to me, I almost don’t think about it now.”
His advice for others facing life after amputation: “Keep moving and don’t get fixated on the thought that you lost a limb.”
Elyor Abdulaev, 27, completed his two-year military service in 2021, after which he worked briefly according to his earlier training as a chef’s assistant. When Russia invaded, he served as an infantry squad commander in eastern Ukraine. He was injured on December 3, 2022, near Kreminna, where an anti-personnel mine blew off his left foot. “I remember everything up to the point when they got me in an ambulance, where I could finally relax. From the loss of blood, I just wanted to sleep,” he said.
Elyor Abdulaev at a sports event organized by U+ System and Levitate. (Photo courtesy of U+)
Two months of surgeries ensued as doctors at different hospitals battled a persistent infection that could have resulted in the loss of his knee. Finally, in Lviv, after the sixth surgery to open and cleanse the wound, the limb was ready to receive a prosthetic.
When Elyor was sufficiently healed he returned to his family in Dnipro, where he chose a local organization, Bez Obmezhen’ (Without Limits), to manage his prosthetic treatment. Two weeks later he received his first artificial limb and an hour later he was standing again.
“I thought it would be painful,” he said. “I took my first steps while supporting myself against some logs and found that it didn’t hurt. I can’t describe that feeling of knowing that you are on two legs again and can move without hopping or using a wheelchair.”
After building up resilience he can now wear a prosthetic almost all day long. In March, Elyor received a running blade from Levitate as well as an upgraded daily wear foot. “I’m very grateful that they decided to donate two prosthetics to me. The first time I used a sports blade I was over the moon that I could run again,” he said. Then it was time to find his new path in life. He already knew that he would not work again as a chef’s assistant.
Despite his newfound agility, it would be “too much running back and forth for 12 hours.” In spring 2024, after six months of assembling children’s furniture, he was also thinking of returning to the army when Bez Obmezhen’ invited him to work for them. Elyor has since been learning to make artificial limb sockets and will soon start formal training as a prosthetic technician.
“In the future, I will be a prosthetist, there is a big demand, and I will study and work – there’s a lot to learn,” he said.
For now, he is focusing on the intricacies of his own artificial limb type and will progress from there: “When I understand that fully I will progress to the upper leg, then to the arms and on to sports prosthetics.”
His advice to other amputees: “I told myself then and I tell everyone now, don’t give up, life goes on, prosthetics are growing and improving all the time. People live with this, do sports and even win in Olympic events. Do not give up!”
Direct Relief has provided over $1.4 billion in medical and financial assistance to Ukraine since Feb. 2022. The organization has supported rehabilitation efforts, including those of U+System, the Protez Foundation, Levitate, and Unbroken National Rehabilitation Center, the four groups mentioned in this story. Read more about Direct Relief’s work in Ukraine.
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