Ukraine: More than 20,000 amputees face trauma unprecedented since World War I

The small group of soldiers gathers outdoors to share cigarettes and war stories, sometimes with indifference and sometimes with some irritation at memories that their last day of combat, the day the war took their limbs, has little returned. reliable.

Some clearly remember the moment when they were hit by anti-tank mines, aerial bombs, a missile, a projectile. For others, the gaps in memory are enormous.

Vitaliy Bilyak’s lean body is a web of scars, ending with an above-knee amputation. During six weeks in a coma, Bilyak underwent more than ten operations, including on his jaw, hand and heel, to recover from the injuries he received on April 22 when his vehicle ran over a pair of anti-tank mines.

“When I woke up, I felt like I had been reborn and returned from the afterlife,” said Bilyak, who has just started on the path to rehabilitation. He does not yet know when he will receive a prosthesis, which must be individually tailored to each patient.

Ukraine faces a future with more than 20,000 amputees, many of them soldiers who also suffer psychological trauma from their time at the front. Europe had not experienced anything like it since World War I, and the United States since the Civil War.

Mykhailo Yurchuk, a paratrooper, was wounded in the first weeks of the war near the city of Izium. His companions carried him on a ladder and walked for an hour until he was safe. The only thing he could think about at that moment, he said, was ending everything with a grenade. A doctor refused to leave his side and held his hand the entire time as he lost consciousness.

When he woke up in the intensive care unit, the doctor was still there.

Stas Tkachenko, nicknamed Kipish, a Ukrainian soldier, uses a wheelchair at St. Panteleimon hospital in Lviv, Ukraine. AP Photo

“Thank you for holding my hand,” Yurchuk told him.

“Well, I was afraid you would pull the pin on the grenade,” replied the doctor. Yurchuk had lost his left arm below the elbow and his right leg above the knee.

In the 18 months since then, Yurchuk has regained his footing, both mentally and physically. He met his future wife at the rehabilitation hospital, where she was a volunteer. He now he cradles her daughter and takes her for a walk without the slightest hesitation from her. She has a new black hand and leg.

Yurchuk himself has become the main motivator for the newcomers from the front, encouraging them as they heal from their wounds and teaching them as they learn to live and move with their new disabilities. That kind of connection will have to be replicated throughout Ukraine, formally and informally, for thousands of amputees.

“Their entire musculoskeletal system has to be reoriented. They have to redistribute the weight. It’s a very complicated adaptation to make and it has to be done with another human being,” explained Dr. Emily Mayhew, a medical historian at Imperial College who specializes in blast injuries. .

Hennadiy Techyna, another of those who has suffered mutilation. Photo AP

According to Olha Rudneva, director of the Superhumans center for the rehabilitation of Ukrainian military amputees, there are not enough prosthetic specialists in Ukraine to meet the growing needs. Before the war, only five people in all of Ukraine had official training in rehabilitation of people with amputations of arms or hands, which under normal circumstances are less common than those of legs and feet, since these are sometimes amputated due to complications of diabetes or other diseases.

Rudneva estimates that 20,000 Ukrainians have suffered at least one amputation since the war began. The government does not say how many of them are soldiers, but injuries from explosions are the most common in a war with a long front line.

Unbroken and Superhumans rehabilitation centers provide prosthetics to Ukrainian soldiers with funds provided by donor countries, charities and Ukrainian private companies.

“Some donors are not willing to provide military aid to Ukraine, but are willing to finance humanitarian projects,” Rudneva said.

Some of the men in rehabilitation regret leaving the war, like Yurchuk and Valentyn Lytvynchuk.

The family

Lytvynchuk, a former battalion commander, draws strength from his family, especially his 4-year-old daughter, who carved a unicorn into his prosthetic leg.

He recently went to boot camp to see what he could still do.

“I realized it’s not realistic. I can jump into a trench, but I need four-wheel drive to get out of it. And when I move ‘fast’ a child could catch up with me,” he said. Then, after a moment, he added, “Also, the prosthesis falls off.”

The hardest thing for many amputees is learning to live with the pain: pain from the prosthesis, pain from the injury itself, pain from the lingering effects of the blast wave from the explosion, said Mayhew, who has spoken to several hundred military amputees. throughout his career. Many have been disfigured and must undergo cosmetic surgery.

“The comorbidity of PTSD with blast injuries and pain is very difficult to disentangle,” he said. “When a person has a physical injury and a psychological injury, they can never be separated.”

In the case of the seriously wounded, rehabilitation could last longer than the war ultimately lasts.

Cosmetic surgeries are crucial for soldiers to feel comfortable in society. Many are so disfigured that it is the only thing they think anyone sees in them.

“We don’t have one year, not two,” said Dr. Natalia Komashko, a facial surgeon. “We have to do this like it was yesterday.”

Bilyak, the soldier who ran over anti-tank mines, still sometimes dreams of battle.

“I’m lying alone on the bed in the ward and people I don’t know approach me. I realize they are Russians and they start shooting me point-blank in the head with pistols, rifles,” he says. “They start to get nervous because they’re out of bullets and I’m alive, I put up my middle finger and laugh at them.”