To the hum of grinding machinery and the smell of resin, workers at the Stetsenko prosthetics centre in Kiev’s Podil district bustle around with plaster casts and artificial limbs.
“We haven’t counted how much more work we got but it was a lot,” its founder and lead engineer Olexandr Stetsenko says about the change in pace since Russia’s full-scale invasion of Ukraine in February last year.
As military and civilian casualty numbers continue to grow, demand for prostheses for amputees has also spiralled. But exact figures are hard to come by because numbers of wounded are a state secret.
In an adjoining room, client and former soldier Anatoly Bassenko waits patiently amid the hustle and bustle, sitting on a couch.
“He already has a prosthesis, but we have to redo it because he has put on weight,” Stetsenko says as he brings Bassenko a new left leg socket to try out.
The 29-year-old walks a few laps in the corridor and is satisfied. He has come a long way since losing full mobility last year. Bassenko was among the first injured defenders of the Azovstal steelworks in Mariupol to be released from captivity in June 2022.
At the outbreak of war, he had volunteered as a veteran and was transferred to Mariupol, where his unit came under fire while retreating to the steelworks.
“A mortar shell landed and tore off my leg and a comrade’s arm,” recalls the trained electrician. Four soldiers were unhurt and three were killed.
He then lay in the field hospital in the steelworks bunker until the garrison was taken prisoner after weeks of valiant resistance. His captivity was spent in a hospital in the Russian-occupied eastern city of Donetsk.
“What can I say about that? I’m alive, I’ve lost weight,” says Bassenko, who had to learn to tie off the amputation stump so that it would retain its shape and could have a prosthesis fitted later.
He received a temporary limb after his release from captivity early last August. “I am now getting a permanent prosthesis and am in rehab,” says the ex-soldier.
Rehab here consists of a preparation phase, prosthesis manufacture and fitting, and subsequent training with the artificial limb.
According to Ernest Skibinskyi, head of the employers’ association of the country’s orthopaedic sector, this aftercare process is relatively new for Ukraine. In the Soviet Union, which was dissolved in 1991, scant attention was paid to rehabilitation, despite large numbers of amputees from the war in Afghanistan.
“A total of about 100 companies work in our sector, of which 30 are united in the employers’ association,” Skibinskyi says about the sector, which employs more than 2,000 people.
With the outbreak of hostilities in Ukraine, the orthopaedic industry, like other parts of the economy, had great difficulty importing individual parts.
“This was a problem at the start of the war because the large logistics companies were particularly afraid,” he says.
But importing materials is currently not a problem anymore, according to Skibinskyi.
Entrepreneur Stetsenko describes it a little differently: “There is a very long wait right now for some parts, especially for arms,” says the 62-year-old.
Sometimes the waiting time is up to half a year. And since everything is transported overland, it takes longer than before the war, mainly because of the risks.
The main question now is who takes responsibility for the cargo. There is no insurance that covers the risks of transportation to Ukraine, all of which is now considered a war zone. Whether a prosthesis can be supplied therefore doesn’t only depend on whether the materials are available or the qualified orthopaedic technicians.
“Every patient has his or her own story,” Skibinskyi says. The amputee’s physical condition is very important. Sometimes, follow-up amputations are necessary because quick emergency surgery in field hospitals leave unsuitable residual limbs.
Stetsenko says the work already changed a lot for him and his 14 staff since the start of the original armed conflict in eastern Ukraine almost nine years ago: “Young people have been injured. You want to help them in the best possible way.”
At the prosthetics centre in Kiev, a working day means constant calls and new requests, which is also psychologically stressful for the staff. But the German-trained technician understands that, “the boys want a prosthesis as soon as possible”.
The situation is also challenging from a business point of view, even though the Ukrainian state and charitable organisations pay for the prostheses.
Stetsenko says he sometimes doesn’t know where to find the funds, as months can pass between the arrival of the individual parts and the fitting of the prosthesis after the invoice was settled: “Sometimes you have to put money aside for the deposit, as some companies require payment in advance,” he says.
For the wider orthopaedic industry, Skibinskyi would especially like to receive outside help in training new technicians: “We have good young people who are willing to learn and who know English.” However, the more than year-long training in Germany is too costly, he says.
“Help with this would be much more important than financial aid,” he stresses. “The main thing is to train orthopaedic technicians.”
Asked about his future, veteran Bassenko says he doesn’t think about it too much at the moment. A lot of time is taken up by rehabilitation and dealing with formalities like leaving the army and applying for a disability pension.
“My brother offered me to come to him in the US,” he says. There he can become a truck driver in trucks with automatic transmission, even with only one leg. “I can still accelerate with my right,” he says with a grin. But he will decide about that later. First he has to get used to the new life with the prosthetic leg. – dpa/Andreas Stein
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