Oleksandr is 24 and has one leg. When the Russians assaulted his frontline position, he was wounded by a one-way drone. Tying a tourniquet around his right thigh, he fought on for two hours. It took even longer to get him to a medical facility.
“By the time I got to the doctors, I knew I was going to lose my leg,” he said. “It was just too late. But hey, at least I got out alive.”
This isn’t just a story about the suffering of men like Oleksandr, although that’s important and their determination is humbling. It’s a story about how Ukraine copes with an epidemic of limblessness because the costs and the implications are enormous and will echo through the coming decades of Ukrainian life.
The numbers are staggering, though hard to determine with any precision. The Health Ministry said that in the first half of 2023, some 15,000 people lost limbs. That helps explain estimates of more than 50,000 amputees, but the numbers are probably much higher.
In the 1990s, when I visited a Croatian facility for limbless servicemen, the technology was fairly straightforward and not very good. The hospital was filled with angry young men, one of them spinning manically in endless circles in his wheelchair. The mood was bleak.
There’s some of that in Ukraine too. CEPA Fellow Lera Burlakova tells of one woman, a fellow soldier, who lost both legs and now refuses to leave her house. And of another comrade who lost his legs and took to drink, before sorting himself out. He’s now a teacher with a young family.
But one thing that has really changed is the technology. Valentyn Posokhov, chief executive of Prosthetics.Pro, a recently opened Ukrainian-German joint venture in Kyiv, says the new prosthetics drastically improve the quality of life for those with amputations.
Adjusting still requires an enormous amount of determination from the recipient, and many soldiers are angry and depressed when they arrive. Learning to walk and pick up objects with a new limb is extremely hard. It’s painful and takes time. The three amputees we meet at the prosthetics company in central Kyiv are cheery and seem philosophical, but it’s inevitable that many others are not.
Those with the determination will have their freedom of movement restored. But they will also cost a huge amount of money to the state budget.
Of course, every amputee returned to functioning status repays the state through the work they undertake and the taxes they pay, and through the joy of a life restored.
But a foot alone costs $6,000-$7,000, Posokhov says, and the more advanced the device the higher the price.
The Ukrainian government pays as much as $20,000 for mechanical limbs, while the best state-of-the-art prosthetics can cost around $100,000 per limb. The latter sum is too high to be covered by the state, but it reflects how much needs to be fundraised if a veteran seeks a return to combat, which requires especially strong and reliable prosthetics.
Some help is available from Ukrainian sources and some from foreign philanthropists like Howard Buffett’s foundation, the pop singer, Sting, and other donors.
Ukraine’s prosthetics businesses are privately run, which causes some serious issues for service personnel looking for help.
They have to do the research themselves to find the right provider, often relying on word of mouth. Anatolii, 29, who lost his right leg in a drone attack, said he’d found his provider partly by avoiding bigger companies used by friends who had bad experiences. But while it’s possible to shop around in big cities like Kyiv, that is much harder in remote areas where there may only be one option.
Inevitably perhaps, some firms behave badly. Companies have been caught buying low-cost limbs and then selling them at ever-increasing prices through shell companies to maximize profit.
Finding qualified staff is also a major issue as demand rises. Experts are highly skilled and expect to receive conscription exemption certificates but as a new company, Prosthetics.Pro does not yet offer these. That makes it hard to scale up production of its tailor-made limbs, engineered on advanced German machinery in a backroom.
How much time does the company spend trying to recruit and to fix bureaucratic issues like the exemption certificates? Posokhov smiles. “A lot,” he says. He has a company presence on 35 group chats as he works to scale up the business.
Like a growing number of prosthetics providers, his company provides a full-package service of psychological support, transportation, general information, and medical backup, says Andriy Honcharov
The work will stretch into the coming decades, certainly for as long as these men and women live.
There’s some good news here. Honcharov says the war “has made Ukrainian society more tolerant and understanding of disability.”
Francis Harris is Managing Editor at the Center for European Policy Analysis (CEPA) and oversees Europe’s Edge. He was a foreign correspondent with the Daily Telegraph and served in Prague, London, New York, and Washington.
Europe’s Edge is CEPA’s online journal covering critical topics on the foreign policy docket across Europe and North America. All opinions expressed on Europe’s Edge are those of the author alone and may not represent those of the institutions they represent or the Center for European Policy Analysis. CEPA maintains a strict intellectual independence policy across all its projects and publications.
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