Aleksandr had just two weeks of training in Russia before being sent to the front lines in Ukraine in the summer of 2023. About a month later, he was an amputee.
Learning to live without your left leg takes much longer than two weeks.
“At first there was a lot of pain,” said Aleksandr, 38, referred to only by his first name according to military protocol. But, he added, “eventually, your brain rewires itself and you get used to it.”
Aleksandr spoke in an interview at a sanatorium on the outskirts of Moscow as a doctor readjusted his prosthetic leg. He is one of hundreds of thousands of Russian soldiers returning home after a third year of war to rejoin government institutions and a society struggling to provide for veterans in a time of sanctions and the parallel realities of the seemingly unaffected hustle and bustle of big cities. and the difficulties on the front.
Veterans have both visible and invisible needs that they report back to their families, who have experienced the trauma of waiting for them to come home alive and now must learn to care for them.
There are at least 300,000 seriously wounded veterans, according to calculations by independent Russian media outlets Mediazona and Meduza, as well as the BBC, which use open source statistics to calculate the war’s death toll and injuries. Since 2023, authorities have made estimating the number of seriously injured people more difficult because they have classified many statistics as secret, journalists said.
Aleksandr said that after being sent to the outskirts of Kupiansk in Ukraine’s Kharkiv region, he was ordered to dig trenches in an area where recruits had placed mines the day before. He doesn’t know whether the landmine he stepped on was Ukrainian or Russian, but his left leg was amputated below the knee and he spent six months shuttling from hospital to hospital before an artificial limb was fitted.
Back at work as a welder in Russia, he now endures 12-hour shifts that require him to stand for the duration, although amputees are advised not to wear prosthetics for more than a few hours at a time. However, he is grateful to be alive and considers himself lucky.
Aleksandr’s prosthetist, Yuri A. Pogorelov, said the Rus Sanitarium, a wellness center combining medical care and recreational activities where the former soldier was treated, has made about 100 prosthetic limbs in the past year, relying on imported materials from Germany, as well as some homegrown technology. Only a handful of prosthetics were intended for veterans of the war in Ukraine.
The sanatorium, built in Soviet times for the country’s political elite, offers a wide range of physical and psychological therapies. Demobilized veterans of all recent Russian wars and their relatives can come for rest and treatment for two weeks a year. About 10% of the patrons are Ukrainian war veterans.
Late last year, Moscow estimated that Russians would need a record 70,000 prosthetic limbs a year, a drastic increase. That number includes civilian casualties and those who lost limbs to causes unrelated to the conflict. But a deputy labor secretary estimated last year that more than half of injured veterans were amputees.
Aleksandr said he was grateful for the free medical care he received, but stressed that he has no psychological problems.
“Thank God, I preserved my mental health in my own way,” he said. “I survived all these explosions and bombings and I’m normal.”
But many veterans return with post-traumatic stress disorder, psychologists and experts say.
“Everyone here suffers a little bit of PTSD, whether they are wounded or psychologically wounded, or families whose brothers, sons and fathers have died,” said Col. Andrei V. Demurenko, 69, who was the deputy commander of a volunteer brigade during the months-long Battle of Bakhmut. In May 2023, after his skull was fractured, he returned to Moscow and found that psychological help for veterans was sorely lacking.
“Unfortunately we don’t have a system, at least not an orderly one, built on an organized and understandable psychological recovery system,” he said.
There are currently not enough professionals with the training to treat veterans or provide them with regular consultations, said Svetlana Artemeva, who is working on a project to train dozens of therapists in 16 Russian regions to help soldiers struggling with post-traumatic stress. .
“You have to teach them how to live from scratch; they need to relearn how to sleep because they don’t sleep at night,” said Ms. Artemeva, who works with the Union of Veterans of Special Military Operations, a nonprofit group. “They need not to jump at every rustle, not to tremble, not to suspect everyone.”
At Sanitarium Rus, Elena Khamaganova, a psychologist, said that every soldier who fought in Ukraine undergoes a psychological screening upon arrival, and then attends group and individual counseling. Many will fight for their lives, he said, citing one recent patient, a veteran with a spinal injury, who will have to urinate into a bag for the rest of his life. The man struggled to have intimacy with his wife; Even though they had a child, they were talking about divorce.
Once they leave the sanatorium, veterans can visit other facilities, but they are not eligible to visit it again for at least a year, meaning they won’t consistently see the same mental health professionals.
“Rehabilitation cannot end with two, 10 or even 15 visits to a psychologist,” Artemeva said. “A person’s rehabilitation must last a lifetime, because the experience will have an echo for the rest of their life.”
Just getting veterans to talk to therapists is a big part of the fight. A machine gunner from the western Kursk region, who gave his name as Tuba, said he had had bad experiences with two therapists and no longer wanted to talk to them.
Tuba, 34, was sweating profusely and appeared agitated during the interview. His mother and sister did not agree with his choice to volunteer in the military, and he was not in a romantic relationship. All he wanted, he said, was to heal his arm, injured by a drone in Ukraine’s Zaporizhzhia region, so he could return to his comrades in the trenches. He said he didn’t like the contrast between his harsh life as a soldier and what he sees as the decadence of big cities, where daily life hardly seems affected by fighting.
“I didn’t meet a single Muscovite over there,” he said derisively, referring to the front. “They are busy playing concerts – it is rude and out of place.”
Some civilians take a different view, citing cases in which returning veterans – some of them former prisoners freed to fight in Ukraine – have committed heinous crimes.
On a train from the western city of Rostov, a hub for soldiers transiting from the long front line, women recently talked about paying extra to sleep in women-only compartments, citing unpleasant experiences with drunken veterans who had propositioned them. sexual and inappropriate comments.
In the sanatorium, many soldiers who fought in the Soviet incursion into Afghanistan or the wars in Chechnya said Russian society has become more open to accepting veterans than in previous conflicts. In Afghanistan, the men were mobilized — and returned in coffins — largely in secret, in stark contrast to the way the Kremlin has sought to celebrate new veterans on television shows, billboards and special leadership programs.
President Vladimir V. Putin has visited rehabilitation centers and instructed subordinates to create more opportunities for wounded servicemen — a contrast, experts say, to previous Russian wars.
“The arrival home of a large number of Afghan soldiers occurred when the Soviet Union collapsed and, to put it mildly, the whole society had no time for them,” said Pogorelov, the prosthetist who adapted the artificial leg by Alexander.
“The economy was in ruins,” he said. “What kind of rehabilitation or pensions could there be in a country that was waiting for food donations from George Bush Sr. as manna from heaven?”
But like some veterans, he said he was glad that Russia’s economy has seemed much more stable than in the tumultuous 1980s and 1990s, allowing civilians to “go shopping even if the country is at war.”
Aleksandr was at the sanatorium with his father, Vyacheslav, who was wounded in Afghanistan. As his father explained what he believed was Washington’s culpability for the war in Ukraine, repeating the Kremlin’s narrative, Aleksandr made it clear that he was not angry at Putin for the loss of his leg. The two instead expressed gratitude for the leader who has led Russia for 25 years.
“Thank God we have Putin,” Vyacheslav said, as his son nodded in agreement.