The small group of soldiers gather outside to share cigarettes and war stories, sometimes reluctantly and sometimes with a degree of stubbornness about dodgy memories of their last day fighting, the day the war took their limbs.
Some clearly remember the moment when they were hit by anti-tank mines, aerial bombs, a missile, a projectile. For others, the memory gaps are huge.
Vitaliy Bilyak’s lean body is a web of scars, ending with an above-knee amputation. For six weeks in a coma, Bilyak was subjected to more than 10 operations, including jaw, hand and heelto recover from the injuries he received on April 22 when he ran over a couple of anti-tank mines.
“When I woke up, I felt as if I had been reborn and returned from the afterlife,” said Bilyak, who has just started his path to rehabilitation. He does not yet know when he will receive a prosthesis, which must be individually fitted 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 on the front lines. Europe had not lived Nothing like it since WWIand 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 put him on a ladder and walked for an hour until they were safe. The only thing he could think about at the moment, he said, was to finish it off with a grenade. A doctor refused to part with him and held his hand the entire time as he fell unconscious.
When he woke up in the intensive care unit, the doctor was still there.
“Thank you for holding my hand,” Yurchuk told him.
“Well, I was afraid you would pull the ring,” 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 balance, 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. Her new hand and leg are black.
Yurchuk himself has become the main motivator for the new arrivals from the front lines, pushing 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.
“His entire locomotor system has to be reoriented. They have to redistribute the weight. It’s a really difficult adjustment to make and it has to be done with another human being,” says Dr Emily Mayhew, a historian of medicine at Imperial College specializing in blast injuries.
According to Olha Rudneva, director of the Superhumans Center for the Rehabilitation of Ukrainian Military Amputees, in Ukraine there are not enough specialists in prosthetics to meet the growing needs. Before the war, only five people in all of Ukraine had formal training in rehabilitation of people with arm or hand amputations, which under normal circumstances are less common than legs and feet, as they are sometimes amputated due to complications from 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 blasts are among the most common in a war with a long front line.
The Unbroken and Superhumans rehabilitation centers provide prosthetics to Ukrainian soldiers with funds provided by donor countries, charities and private Ukrainian companies. “Some donors are not willing to provide military aid to Ukraine, but are willing to finance humanitarian projects.”Rudneva says.
Some of the men in rehab they regret getting out of the warsuch as Yurchuk and Valentyn Lytvynchuk.
Lytvynchuk, a former battalion commander, draws strength from his family, especially his 4-year-old daughter, who carved a unicorn on his prosthetic leg.
He recently went to a military boot camp to see what i could still do. “I realized that it is 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,” she said. Then, after a moment, he added: “Also, the prosthesis falls off.”
The most difficult thing for many amputees is learn to live with pain— the pain from the prosthesis, the pain from the injury itself, the pain from the lingering effects of the blast wave, said Mayhew, who has spoken to several hundred military amputees throughout his career. Many face disfigurement and consequent cosmetic surgery.
The comorbidity of the disorder posttraumatic stress, blast injuries and pain is very difficult to unravel”, he explains. When a person has a physical injury and a psychological one, they can never be separated.”
For the seriously injured, rehabilitation could last longer than the war finally lasts.
Cosmetic surgeries are crucial for soldiers to feel comfortable in society. Many are so disfigured that it’s all they think anyone sees in them.
“We are not one year old, not two,” says Dr. Natalia Komashko, a facial surgeon. “We have to do this like it was yesterday.”
Bilyak, the soldier who ran over anti-tank mines, is still sometimes found dreaming of battle.
“I am lying alone in the bed in the ward and people I do not know approach me. I realize that they are russians and they start shooting me at point blank range in the head with pistols, rifles,” he said. “They start to get nervous because their bullets are running out, and I’m alive, I show them the middle finger and laugh at them.”
(With information from AP)