The Russian Ministry of Defense has classified the number of its soldiers disabled during the “Special Military Operation” (SMO), but the count is all but certainly in the tens of thousands — and it continues to rise. The country’s healthcare system is overwhelmed: returning soldiers face months-long waits for treatment, prosthetics are scarce, some parts are unavailable due to sanctions, and the quality is often poor. Many newly fitted prosthetics become unusable within weeks. In Ukraine, the situation is somewhat better; soldiers can undergo rehabilitation and receive high-quality prosthetics in the West. However, they still encounter bureaucratic obstacles that are hardly different from those in Russia. Meanwhile, Israel, with its decades of experience of conflict, has successfully developed a system to support disabled soldiers.
Semyon K. (name changed), a member of the Wagner PMC, lost his leg in the war in Ukraine. He and several other wounded soldiers were evacuated to St. Petersburg, where, according to his wife, he “waited for a prosthetic leg” for two months, staying in one of Yevgeny Prigozhin's apartments on Vasilyevsky Island. After finally receiving the prosthesis, Semyon went to the city of Anapa on the Black Sea coast, where the artificial limb had to be adjusted multiple times. “Either the socket would break, or the rubber liner meant to secure the socket to his leg was too large. And then, when Wagner disbanded, there was no place left to fix the prosthesis,” Semyon’s wife told The Insider.
After several months of filing down the prosthesis himself and wearing socks over his shrinking stump, Semyon was finally received at the Southern Regional Prosthetics Center in Krasnodar. There, the doctor who examined his leg found that the prosthetic socket was homemade, and the German liner was two sizes too big. The doctor concluded that a new prosthesis was necessary.
The doctor who examined his leg found that the prosthetic socket was homemade, and the German liner was two sizes too big
Judging by the group chat for relatives of Wagner PMC members, many fighters who have lost limbs are still waiting to receive proper assistance. “They gave me prosthetics — complete garbage. I used them for about a month and a half, and then they failed. Now I can't even take a step, and I have to jump on my knees,” writes a user with the nickname “Antokha.” Another participant, “O,” responds: “Did the PMC provide those? We got one from a Moscow hospital, and it almost fell apart too. When we went back to have it remade under the certificate program, the prosthetist saw it and said, 'Three more days, and you would have lost your foot.'”
Furthermore, after the PMC was disbanded, its former members often struggle to prove to the state that they participated in the “SMO.”
A law passed in October of 2023 equated Wagner members with those of volunteer formations, but many relatives of the deceased are still unable to obtain certificates from the Ministry of Defense confirming that their loved ones died in combat. “The Ministry of Defense told us they have nothing to do with them. To get any assistance, you need a certificate of participation in the 'SMO.' I submitted the paperwork to the military registration and enlistment office back in April, but I haven't received any response,” says Olga Kachashkina, the mother of Artem Kozin, a Wagner PMC member from Novgorod who died in 2022. Many who fought with the “DNR”or “LNR” militias are also caught in this legal limbo.
“When a soldier with an amputation leaves military service due to injury, he is handled by the social security system,” says a top manager at one of Russia's major prosthetic companies, who requested anonymity for safety reasons. “You have to go through a commission that issues an individual rehabilitation program and determines what type of prosthesis you're entitled to. However, some participants in the SMO didn't come through the Ministry of Defense, so the system often knows nothing about them, including Wagner members. Some of them still haven’t received prosthetics.”
Another Wagner PMC member, known by the call sign “Warsaw,” from Tula, mentioned that issues with prosthetics arise only for those who “didn't manage to make themselves known”:
“You see, if someone lacks initiative, they return from the war, don't want anything, and start drinking. Naturally, they won’t get a prosthesis because they don't pursue it. You have to take action to get what you need. I have two prostheses, work out in a gym twice a week — I'm taken there by a social taxi — and my apartment was upgraded under the 'Smart Home' program.”
When asked by The Insider whether the disability assistance system should be organized so that people don't have to “fight for the result,” “Warsaw” responded that, “The state is doing what it can.”
However, it's not just Wagner members who struggle to get adequate help — regular servicemen face the same challenges. Alexander B. (name changed), a participant in the “SMO” from Luhansk, was wounded by shrapnel from a Ukrainian mine near Mariupol in March 2022. He received a prosthesis, but his rehabilitation ended there.
“I waited six months for the first prosthesis through social services. But when I arrived at the Luhansk Prosthetics Center, the treatment was… They handed me a prosthesis right in the corridor and told me to go home. No fitting, nothing. I got home, threw the prosthesis on the balcony, and never touched it again. I just used crutches,” says Alexander.
“They handed me a prosthesis right in the corridor and told me to go home. No fitting, nothing”
The state is deliberately concealing the number of soldiers who have lost limbs. However, the scale can be inferred through indirect indicators. In June, the publication TakieDela reported that the number of Russians registered for prosthetic limbs had increased by over 20,000 people, or nearly 40%, in 2023, according to the Ministry of Labor and Social Protection. Before the war in Ukraine, the annual increase was no more than 7%. However, this data has since disappeared from the Rosstat website.
In October 2023, Deputy Minister of Labor and Social Protection Alexey Vovchenko informed the Federation Council that more than half of the soldiers applying for disability status had undergone amputations.
While the demand for prosthetics has surged, the supply has dwindled due to sanctions. One of the largest prosthetics manufacturers in the Russian market until 2022, the Icelandic company Ossur, has exited Russia. As a result, Russian manufacturers have been forced to adapt to the sharply increased demand while simultaneously navigating challenges related to component supply shortages.
“We're coping better than expected under these conditions,” says a representative from a major prosthetics company, admitting that delivery times for imports have significantly increased — sometimes by several months:
“Components from Germany are now transported overland through Poland, Lithuania, and Belarus. What used to take two weeks now takes an average of two months. An order sent in January didn't arrive until June.”
But delays are only part of the problem. Some components are being turned back at the EU border as sanctioned “dual-use”goods, according to an employee of a Russian prosthetics manufacturer who spoke with The Insider:
“The vacuum valve we use for attaching lower limb prostheses is listed in customs declarations as a valve for the gas processing industry. They stopped supplying it. The Germans are, of course, adapting. Some goods are bypassing sanctions through countries like Kazakhstan.”
The Germans referenced by The Insider's source are from the company Ottobock, one of Europe's largest prosthetics manufacturers. Ottobock is active in both Ukraine and Russia, though it avoids publicizing its business in Russia.
During a phone call with the company's Moscow office, a representative who declined to give his name responded to inquiries about the company's involvement in fitting prosthetics for war participants by saying, “We are not involved in anything like that.” However, at the Yekaterinburg office, The Insider was informed that SMO participants are being fitted with prostheses at the company’s Moscow and St. Petersburg branches “at the expense of the Ministry of Defense.”
“Warsaw” from Tula also received an Ottobock prosthesis. When asked whether the company is involved in providing prosthetics to Russian military personnel, the press office of the company's headquarters in Germany replied simply that, “After consulting with experts, we have decided to refrain from commenting.”
The number of Ukrainians who have lost one or more limbs since the start of the full-scale war is also likely in the tens of thousands. Last November, The Wall Street Journal cited representatives from the aforementioned German company Ottobock, who, based on “data from government and medical partners,” estimated the figure at 50,000. The Ottobock press office declined The Insider's request for more current statistics.
Other organizations working in Ukraine have reported lower figures — around 20,000 people. Like Russia, Ukraine does not release official statistics on war casualties.
Bohdan (name changed at his request, to avoid being mentioned alongside Russian soldiers), a volunteer who went to the front on February 25, 2022, was injured near Bakhmut in May 2023. He was evacuated under fire and, when he woke up two days later in a hospital in Dnipro, he was missing both legs below the knee.
“As I understood it, theoretically, they could have saved the second leg, but it would have required a long operation, and the hospital was overcrowded,” says Bohdan. “In essence, saving my leg would have meant leaving two seriously wounded people without help. The doctors decided that two graves were not worth one leg. I think, given the situation, they just patted me on the head.”
“The doctors decided that two graves were not worth one leg”
Bohdan now works at his hometown's mayor's office, assisting other wounded soldiers who, like him, need amputations and must navigate “seven circles of bureaucratic hell” to receive proper medical care.
“Among the authorities, the attitude seems to be that you're only needed while you can still hold a machine gun,” says the former soldier. “They shuffle you from one place to another, and you constantly need to get new papers that expire before you can reach the next step.”
Ivan Gen, a physiotherapist at the Rehabilitation Center in Lutsk, which opened in 2019, believes the state is struggling to provide prosthetics to everyone in need due to bureaucratic delays. “Red tape slows everything down,” he says. The center currently has 30 beds, “but even if there were 100, they would all be occupied,” the doctor explains. Following the start of the war and the surge in demand for prosthetics, all massage rooms at the center were converted into wards — yet there are still not enough hospital beds.
Volunteers and donors from abroad are stepping in to support the struggling state system. Since the war began, two major prosthetics centers have opened in Ukraine, both in Lviv: “SuperHumans” and “Unbroken,” which rely on private donations and grants from international organizations and European governments.
Volunteers and donors from abroad are stepping in to support the struggling state system
In both centers, several dozen patients are simultaneously undergoing prosthetics and related rehabilitation. “Unbroken,” co-financed by the German government, is currently the only prosthetics center in Ukraine situated within a large hospital complex, facilitating the collaboration of all necessary medical specialists. Since the war began, around 15,000 people have received rehabilitative care there. The center not only manufactures and fits prostheses, but also trains specialists — who also remain in short supply.
Another private initiative, ProtezHub, which operates in collaboration with the Ukrainian Ministry of Health, has developed and approved a professional standard for “prosthetic-orthotic doctors.” Starting this academic year, several Ukrainian universities will offer master's programs in this field. According to Ivan Gen, “currently, there are only one or two high-class specialists in each region.”
Soldiers with the most complex amputations — typically those involving higher limb amputations — are often treated abroad. Pavlo Sokolenko, a territorial defense volunteer from Kryvyi Rih, was injured during tank shelling in Donbas in July of last year. After being evacuated to the rear, he initially had his leg amputated below the knee in Dnipro, but later required a re-amputation in Lutsk, removing the leg up to his mid-thigh. Volunteers from the Protez Foundation then arranged for him to receive treatment in the United States, where he was fitted with a bionic prosthesis controlled by a phone app. With this prosthesis, Pavlo can walk, run, and ride a bicycle.
In addition to the spacious gym for rehabilitation and the attentive care he received from doctors, Pavlo fondly remembers the warm reception he received during his trip. In Detroit, an African-American police officer approached him on the street, saluted him, and expressed admiration upon learning he was a soldier from Ukraine.
“The first time I was truly moved to tears was when the pilot on the flight from Warsaw announced, 'We have Ukrainian soldiers on board who are fighting for the freedom of their country.' And then everyone applauded,” Pavlo recounts.
In Ukraine, Pavlo receives a second-group disability pension, which amounts to about $200 per month. However, taxi drivers often offer him free rides upon seeing his prosthesis, and the state has promised assistance with purchasing a car equipped with an automatic transmission. Pavlo plans to return to the army: “I might not be able to fight anymore, but I can handle tasks like keeping log books, issuing and receiving equipment — I’ll still be useful.”
Israel, with its extensive history of conflict, has been particularly successful in rehabilitating its wounded soldiers. Advances in military medicine have enabled Israel to save a higher proportion of wounded on the battlefield compared to previous wars: during the Gaza conflict, the percentage of those killed from wounds was about 6.5%, compared to 13-15% during the Second Lebanon War in 2006. This improvement means that among survivors, there is a higher percentage with severe injuries, including those requiring amputations. Since the latest war began on October 7, Israel has seen about 60 soldiers with amputated limbs (not including civilians injured in the Hamas attacks).
Nearly all of these soldiers receive prosthetic care at the Rehabilitation Center in Tel Aviv’s Sheba Hospital. By October 8, just a day after the attacks, the center had expanded its capacity by reallocating beds from other hospital departments. Ten days into the conflict, a new department was opened, and a month and a half later, the number of rehabilitation beds was doubled.
By October 8, the center had installed additional beds; ten days later it opened a new department, and a month and a half later doubled the number of rehabilitation beds
“The foundation for expansion was already in place. We quickly carried out repairs and brought in medical staff — some from other departments and institutions, and others who volunteered. We had doctors who are currently working abroad fly in, and retired professionals return to service,” Professor Israel Dudkevich, director of the Rehabilitation Center, said in an interview with The Insider. “To date, we have opened three new departments. We purchased all the necessary equipment without waiting for state approval. We may get reimbursed or receive donations later, but for now, the hospital has been covering the costs by itself.”
The Rehabilitation Center becomes a temporary home for soldiers undergoing prosthetics, with stays ranging from a few weeks to six months. “We provide more than just medicine, physiotherapy, or psychological support,” says Professor Dudkevich. “Our goal is to create an environment where soldiers can start to return to normal life right here in the hospital. We’ve designed the space to facilitate social interaction and family visits, with game consoles, music systems, yoga, and even therapy dogs. We address both physical and emotional needs, and everything in between.”
“We didn’t plan it deliberately, but the atmosphere in the department itself seems to play a big role in the rapid rehabilitation of the wounded,” says Dr. Uri Openheim, the former head of the prosthetics department, who retired two years ago but returned as a volunteer on October 8 and has been there every day since. “Being among peers helps them come to terms with their situation faster. The guys are young; they laugh and sing songs.”
Army and Ministry of Defense representatives work closely with the Rehabilitation Center. “As soon as patients are stable enough, we try to send them home for weekends,” explains Professor Dudkevich. “We notify Ministry of Defense representatives in advance, and they arrange transportation. If returning home is not feasible due to accessibility issues, they find alternative temporary housing for the soldier and their family, ensuring they can receive intravenous antibiotics even outside the hospital.” Essentially, Ministry of Defense representatives carry out tasks as directed by the doctors overseeing rehabilitation.
Soldiers receive prostheses made in Israel at the expense of the Ministry of Defense, manufactured to order by a private enterprise.
“In any prosthesis, there's a part that directly connects to the remaining limb, and it's always custom-made for a specific patient,” says Dr. Openheim. “Doctors select the actual prosthesis according to the needs and capabilities of the wounded. All our patients receive functional, not just cosmetic prostheses: we believe that the limb should work. And each of them has its own tasks. For example, one soldier desperately wanted to be able to do push-ups, and he had an amputated arm. So they made him a device so he could do push-ups.”
All patients receive functional, not just cosmetic prostheses, so that the limb can work
Another soldier, Openheim recounts, suffered not only an amputated arm but also a severe neurological injury that impaired his ability to walk. To address this, they designed and built a custom engineering solution that connected his arm prosthesis to a walker.
The Ministry of Defense covers the costs for necessary car modifications so that soldiers with prostheses can drive, and it also funds housing adaptations. Bureaucratic procedures have been streamlined: while obtaining permission for a prosthesis used to take up to two weeks, soldiers now typically receive it within a day.
Amit Shaked (name changed), a soldier stationed at a post opposite Kibbutz Be'eri, witnessed the death of nearly all his comrades on October 7 and miraculously survived, albeit with the loss of a leg. After several months at the Sheba Rehabilitation Center, he founded the “Resurrection”organization. Within weeks, the organization raised 350,000 shekels ($95,000) to support the various needs of Israeli army soldiers: purchasing heaters for some, protective glasses for others. For one soldier from Argentina, they even bought a ticket home for a brief visit with his parents during his leave.
“This was my way of continuing to contribute to the war effort when I could no longer participate physically,” Amit told The Insider. “I wanted to avenge my comrades and the horrors I witnessed on October 7. It wasn’t just the killing of civilians; it was a massacre… It consumed me while I was in the hospital. I had hundreds of visitors, which even disrupted some of my medical procedures. I wanted to find a way to be useful to other soldiers who are still on the front lines.”
After being discharged from the hospital, soldiers can continue their rehabilitation at one of the four centers run by the non-profit organization “Warrior's House,” an official partner of the Ministry of Defense. These centers offer swimming pools, gyms, and classes in various sports adapted for people with amputations.
Founded in the 1960s by Israeli war veterans, the organization is now led by lawyer Idan Kleiman. Kleiman, who was injured in Khan Yunis in southern Gaza in 1992, is paralyzed from the waist down and uses a wheelchair.
“We’re not just focused on physiotherapy or swimming,” says Kleiman. “We collaborate with universities and various NGOs. Our care extends beyond the soldiers to their families as well. We have a national duty to help veterans of Israeli wars return to a full life.”
According to Kleiman, about 70% of soldiers with severe disabilities successfully reintegrate into society, as defined by having a family and a job. However, for 30%, even one of the best medical care systems in the world and a society that deeply values its soldiers may not be enough.
About 70% of soldiers with severe disabilities successfully reintegrate into society, as defined by having a family and a job
Before last October, the organization had recognized 52,500 veterans of Israeli wars as disabled. Based on projections of the ongoing conflict with Hamas, “Warrior's House” estimates that this number could increase by 50% in the coming year.