Oleksii Prytula, a veteran who has had both his legs amputated, believes that you should know what to do after sustaining an injury even before you find yourself at a military enlistment office. While the Ukrainian government is working on reforming military medical exams and medical expert commissions, The Village Ukraine talks to Prytula about his journey through rehabilitation – from traveling to hospitals across Ukraine, to his quest to make sure that his paperwork is in order.

 

Before the full-scale war, Prytula lived and worked in Odesa. He was mobilized on June 5, 2022 and injured on September 30 of the same year after a cluster munition hit a group of soldiers that were being evacuated.  Both his legs were first amputated below the knee, but he has since had to undergo several additional procedures before being fitted with prostheses. Prytula received his prostheses from the Superhumans Center; he was one of the center’s first patients.

“Rehabilitation should’ve started the moment I left the ICU”

My legs were amputated by a cluster munition. I applied the tourniquets myself. By the time I was taken to the field hospital, all that was left of my legs were pieces of meat and torn tendons. They just removed everything that was hanging loose at the field hospital, carried out primary surgical procedures, and sent me to Kharkiv. 

In Kharkiv, I had another surgery; my wounds were cleaned, and then I was sent to Kyiv. At the Kyiv hospital, they treated my stumps and amputated my knee, too. A piece of shrapnel entered my knee right by the joint and was preventing the stump from healing. Then they treated fistulas [an abnormal, tunnel-like connection between two body parts that forms as a result of tissue death – ed.] and removed an abscess with the help of an expert from the Institute of Orthopedics.

 

I remained at the hospital in Kyiv between early October 2022 and late March 2023, nearly six months. I was very lucky with doctors and other medical personnel; they were all extremely helpful and sensitive and helped me a lot. I was lucky that I was on my own in my ward and my wife was by my side almost the entire time.

What was missing was rehabilitation. In my case, rehabilitation should’ve started the moment I left the ICU. You have to be prepared for what’s ahead of you. Yes, there was a gym at the hospital, but I only found out about it a month and a half after being hospitalized. This gym was only open for a couple hours each day, and you couldn’t get in unless it was overseen by the hospital staff.

There was one rehabilitation expert that would talk to me from time to time, but I had to exercise mostly on my own, right there in my bed. I’m a bit lazy by nature, I sometimes need incentives to do something – lots of people I met at the hospital were like that too. At least I can motivate myself; there were other guys you just had to force to do stuff. But no one bothered. There wasn’t a rehabilitation plan I could follow either. I think it could’ve been helpful to have concrete goals and assignments.

No one was talking about multidisciplinary [rehabilitation] teams in 2022 either. I only ever got to talk to surgeons. There wasn’t an expert in prosthetics who could advise how the stump should be molded to make wearing a prosthesis more comfortable down the line. The doctors I talked to had no clue what to do with me: the way they saw it was they had to treat me, and once my wounds had healed it wasn’t their job anymore.

It was frustrating, not knowing what was ahead of me. I was just told that I’d be transferred to a rehabilitation center, but when I asked which one, I was told they didn’t know. When I asked if I could choose a center myself, it turned out I couldn’t; all other hospitals were busy. I had a ton of time while I was there though, I could’ve chosen an option that suited me and made arrangements. Why not? It would’ve caused less stress for me and my family.

I was sent to a civilian hospital in the Chervonohrad district in Lviv Oblast, which was converted into a rehabilitation center a month or so before I got there. I watched aspects of the [accessibility] conversion process while I was there: I saw raised thresholds being removed to make the space accessible to wheelchair users.

One of the worst things was being unable to use the toilet by myself. I couldn’t get out of my wheelchair to use the toilet, so I had to relieve myself while remaining horizontal, using a bedpan or a bottle. It was humiliating, to put it mildly.

Soldiers with injuries like mine need help when they’re moved between hospitals, we need assistants. At the time, I was exclusively using a wheelchair, and my wife was always with me. She also needed somewhere to stay – either my ward should’ve slept two or provisions should’ve been made for her to stay elsewhere, but there are no rules or regulations around that, you’re not entitled to something like that.

At this hospital in Lviv Oblast, I started working with a rehabilitation expert who used to work with people who’d had strokes or occupational injuries but had since learned to work specifically with people from the military. He helped a lot.

 

“They took really good care of me, which is very important to veterans, many of whom joined the military to fight for these values and these people”

In late November or early December 2023, one of my colleagues – all of whom supported me greatly during that time – told me about the plans to open the Superhumans Center in Ukraine. It didn’t even have a website at that point, I was just given a phone number. No one knew when they would open, it was supposed to be at some point in spring. They asked me for some information and promised to call me back. Then they disappeared for a while. My wife and I started thinking about our other options, but didn’t apply for anything else.

In April 2023, three or four months after my phone call, I was invited to come for an initial assessment. After the medical examination, they promised to call me again in two weeks, but I didn’t get a call – I was really upset about it. Later, however, they did transfer me from Sosnivka, where I was undergoing rehabilitation at the time. They put me and my wife up at a hospital near the Superhumans Center. They rented several wards there while the center was still being built. That’s where the best time of my life started.

They took really good care of me, which is very important to veterans, many of whom joined the military to fight for these values and these people, and who have lost things they will never be able to get back. I felt like people there understood that.

 

They took my measurements for prostheses during the first few hours I was there, and within a few days I could already stand on my two new feet. My sessions with a rehabilitation expert started pretty soon too; at first I’d spend between 09:00 and 15:00 every day working with them. There was an entire multidisciplinary team there to support me.

During the first stage, I had mechanical prostheses fitted. Many people just use those, but I wanted a microprocessor-controlled knee. I had both my legs amputated, so I would’ve struggled a lot more with a mechanical one. I can’t say I’m naturally very active, but I still need to be able to go up and down stairs and to use public transport.

My wife and I even started putting money aside for the microprocessor knee; we didn’t know that I’d be able to get one for free at the Superhumans Center. I was also surprised to find out that the center doesn’t rely on government funding. The government pays me as a person with a double amputation, but that money wouldn’t have been enough to cover a microprocessor-controlled knee. One of those costs 2.5 million hryvnias (approximately US$61,700), and each of my prostheses costs US$5,000 on top of that. My wife and I donated the money we raised to fund my prosthesis to the Superhumans Center, hopefully making it possible for them to buy a prosthesis for someone else who needs it. We have had a total of 1.5 million hryvnias donated to us for my prosthesis, and that’s been an important source of support.

The center hosted frequent events: they took us to a climbing wall, kayaking, and even hiking in the mountains, for those who could manage. They made sure we always had something to do and someone to talk to. I spent two months going to the center everyday. After I was officially discharged, I became their ambassador.

Everyone who ends up there undergoes a transformation. People in hospitals usually look grim and sullen, they’re tired all the time. I don’t like the “superhuman” narrative that much, but at the center they give you your life back. Now I’m content with my life even despite all the difficulties. I don’t want to sound like a walking advertisement for Superhumans, but I want every rehabilitation center to be like the Superhumans Center.

I was one of their first patients. At first they didn’t have that many. Before I got there, I had no idea what a rehabilitation center should look like. I thought of them as hubs for people with disabilities. Now I still go to the center pretty often. The atmosphere there has changed, it’s busier now, but the quality of care has not gone downhill. They just scaled up.

 

“The first time I heard about military medical exams and medical expert commissions was at the hospital”

When you get to the hospital, you understand that you’re going to get help, but you also have no idea what will happen next. I think before you join the military, you should get a set of instructions on what to do in case you’re injured. Now there’s more information about what happens to people in the military, take Pryntsyp (Principle) for example [an NGO that focuses on advocating for the rights of military personnel – ed.]. But this information simply wasn’t there in September 2022, and we had no idea what we were supposed to do. We just knew that we were on our own when it came to getting the paperwork done.

I didn’t even know if someone from my military unit would get in touch with me or if I should get in touch with them. I knew the company commander, but not the battalion commander. I found out scraps of information by contacting my brothers-in-arms, and sometimes people I didn’t even know, on Instagram. Any information I found was accidental. It’s so frustrating: My legs were fucking blown off, and I still need a piece of paper saying that I took part in combat?

I’m a confident Internet user, but some of the guys I know don’t even have smartphones – they have no way to find out what’s going to happen to them next. It would be great if hospitals had a designated member of staff who would visit soldiers with injuries and explain everything to them. I know lawyers and other volunteers do stuff like that, but I’ve never come across it. I later heard about the idea of a “veteran’s assistant” – someone from the Ministry for Veteran Affairs mentioned it at an event, but it all sounded very vague, which is off-putting. I still have no clue how it works.

Veteran’s assistant is a job for extremely empathetic people. I know how annoying I can be. But I can also do a lot of things on my own. Meanwhile, there are people who need to have everything explained to them. I think there should be a dedicated state agency: yes, it would add another layer of bureaucracy, but we need to have lawyers and accountants who can process our paperwork for us for a reasonable price. It might be naive, but I think it’s realistic. We used to have volunteer legal services where students and social workers worked for free.

My wife helped me a lot. She was the one trying to find out everything we needed to know during the first month or month and a half. She’d tell me what I had to ask for and from whom whenever I felt better.

I’m a civilian, not a professional soldier. Even when I joined the military, I remained a civilian who was plunged into military circumstances; I didn’t know all the ins and outs. The first time I heard about military medical exams and medical expert commissions was at the hospital. Is a military medical examination something that will extend my hospital treatment or something that can assess whether I’m fit to rejoin the military or not? Military medical exams are used in both cases, but a hospital-based military medical exam is just an interim step.

While in the ICU, I only had form no. 100 with me. That’s the document you get right off the bat; that for me was in Kharkiv. It describes your injuries. In Kyiv I received medical reports describing the surgeries I underwent.

For the first month and a half I felt unwell, to put it mildly. My wife found out that I needed an additional document describing the circumstances of my injury – that’s one of the most important documents, because it describes the circumstances in which I was injured and confirms that I was really defending Ukraine and not hanging out somewhere drunk and high. My military unit said they still didn’t have my paperwork – it was still only a week since my injury. I wrote to my company commander, he submitted the information to the unit’s administration, and they sent me my paperwork within the next couple of days. To be honest, it didn’t take that much time.

The same thing happened with the certificate confirming I took part in hostilities: at no point did I need to prove anything (which sets me apart from some of the others from the same military unit) – though I did have to wait for a long time. I don’t think it’s the central government’s problem, I think the problem is what happens at the local offices. There are good people who just do their work, but there are others too. 

 

“One of the women who worked at the office handed me a piece of paper and told me to go up two floors to get it signed, even though she saw I was using crutches. Interactions like that are extremely frustrating.”

I had my military medical examination after undergoing rehabilitation at the Superhumans Center, in August 2023. By law, I was supposed to return to the unit and undergo the examination there, but I called and asked to do it near my place of residence, in Lviv.

During a military medical examination, you have to see around 10 different doctors, who then have to assess the state of my health and decide whether you can return to service (the head of the military medical exam committee is involved in making this decision, too). It’s a decent process: you get a number which tells you when to come in, but it’s really impossible to get it all done in one day. I was lucky because when I came I really stood out: I was the only one with no legs, and most doctors tried to help me; I managed to get through most of my exams without having to queue much. The entire process took me three days, which is quite fast.

 

Of course, there were issues there too. For example, the elevator in their building only went up to some floors. Once, one of the women who worked at the office handed me a piece of paper and told me to go up two floors to get it signed, even though she saw I was using crutches. Interactions like that are extremely frustrating. Why can’t she go get the signature herself? I struggle with going upstairs even if there’s an elevator. But ultimately that wasn’t the worst that could’ve happened. I kept hearing horror stories about people’s experiences with medical examinations during that time, in 2023.

Another problem is that you’re never given the number of copies of all the documents that you need. For example, you’re given two copies of the original assessment produced by the military medical exam committee. Meanwhile, you have to send one to your military unit, one to the military enlistment office, and one to the medical expert commission – and all of them want the original. I was told I could get notarized copies at a lawyer’s office; the lawyer I went to made five copies for me and didn’t charge me anything for them. A small gesture, but those are the things you remember.

I got the final decision from the military medical examination board 15 or 20 days after going through all the examinations; it took a long time, but that’s how it’s supposed to be. I was still undergoing rehabilitation at the time, so I sent my paperwork – and my military ID – to my military unit. You also have to travel to your military unit to return your weapons and equipment. Lots of guys had all of their stuff destroyed when they were injured, but they still officially have to return it – because no one saw it happen.

 

I was very lucky, I wasn’t charged for what I owed. In fact they even paid me for the uniform I was never given. I also got my wages and bonuses during all the time I spent in hospitals and rehabilitation centers, there were never any delays, even though that’s something lots of people struggle with.

Then I came back to Odesa. That same day, I went to the military enlistment office – I had to register as unfit for military service within five days of arriving. And for fucks sake, here too I didn’t have the right paperwork, they needed more originals. Once I got that sorted, I went to my family doctor, who, it turned out, had already prepared a whole pile of documents I needed and explained what was what. He’s a great doctor.

Once you get through your military medical examination, you need to get through a medical expert commission, where you get assessed by the same kinds of specialists but at a civilian hospital. There was nothing new I could tell them. The commission met in a spooky building with dark, narrow, and dirty hallways, in an industrial neighborhood. It was a two-storey building with doctors’ offices on both floors, and I had no idea which one of them I had to go to first. Lots of civilians were also there when I came.

The commission opens at 08:00. We got there for 07:00, and there were already at least 30 people waiting outside. I was already using my prostheses at the time, but there was another soldier there in a wheelchair. Someone told me the doctors would come down to talk to him.

The staff were all quite old, but kept going. Every other one was rude. Yes, I can be rude too, but while I was going through the commission I tried to be as calm as possible. I knew I wanted to get out. Lots of people speak Russian there, even though it’s a state agency. Things like that trigger me a lot.

 

Once again, it took me only a couple hours to see all the doctors I had to see. I know other soldiers who ended up spending three or four days at this hospital; most of them didn’t have health issues as obvious as mine. I’m sure though that if I wore long pants instead of the shorts I had on, no one would help me, even though I was using crutches. The commission declared me disabled, group I [the most severe out of the three disability groups in Ukraine, group I designates persons who are “completely disabled and require constant care” – ed.].

The red tape continued after the medical expert commission. For example, now I’m working to get my pension payments. As someone who served in the military, I can’t appeal to the state pension provider; the military enlistment office has to mediate. I have to submit all the paperwork I’ve already submitted, it takes a ton of time. There’s an army post service in Ukraine. While Nova Poshta delivers parcels within a day, Ukrposhta [Ukraine’s state postal service – ed.] delivers them within a week, at the army post you are at the mercy of fate: they keep losing stuff, as if they use horse-drawn carriages to deliver mail and take a three- or four-day break somewhere in the middle of deliveries.

I waited for three or four months. When I finally called the military unit, they told me to call the week after. Then they told me it wasn’t something they could help me with – and that they couldn’t put me in touch with someone who could. That’s the only time when I ran into difficulties in communications with my unit. In the end, the military enlistment center submitted another request and received the documents a couple of weeks later. That’s not the end of this saga though, because now the military enlistment office has to forward the paperwork for processing to a municipal office, which will take another month or two.

 

You just have no idea when you’ll finally be able to start receiving pension payments and whether you even have the documents you need. I tried calling the state pension provider.  One day I ended up calling them every half hour for six hours, but every time the line was either busy or switched off. It was like trying to get in touch with any kind of government officials during the 90s. All those people just keep working the way they’ve spent their entire lives working.

On the one hand, I get it: there should be a person or even a call-center that can process these requests and deal with these issues. I know that the state pension provider is under a lot of stress right now. But they just tell you your name is not in their system. When you ask them to look for it, they say they have no time. Normally I don’t pull the veteran card, but this time I couldn’t take it anymore, the situation was driving me nuts. They relented and promised to look for it and call me back within an hour. When they did, it turned out they found my folder with more than 50 different documents in it.

They just started processing those documents, so I’ll have to wait until June or July before I can get my pension [this article was written in early May – ed.]. It’s so frustrating you can’t just do these things online. I had to start getting pension payments in November, when I was officially discharged from service. I’m lucky because I have savings. Imagine what would happen if I was a guy from a small village, with no savings, no family or friends who can help me, nothing. I don’t think I’m in any way better than someone like that.

I received a certificate stating that my disability was caused by the war. To get it, I had to submit the certificate confirming I took part in hostilities at the place where I was registered; for me, that’s Izmail, 250 kilometers away from Odesa. Why can’t everything be done at the oblast administrative center, Odesa? I had to issue a power of attorney to my wife so that she could go and submit the documents, and then go again to collect the certificate. This certificate gives you access to benefits like free travel on public transport and an exemption from utility charges if you own a flat. But no one tells you about these benefits at any point.

I think that a guide for people with injuries, like the one designed by Principle, should be issued to everyone at a military enlistment office or at their military unit. People have to know about everything that could happen to them, and their families have to know how to act in the event of an injury, too. Red tape is extremely daunting.

 

“How we treat our veterans is what should distinguish us from Russians”

I’m 43 and I know that it will become more difficult to use the prostheses as I grow older. I’ll have to use a wheelchair. Using prostheses is a lot of work. I have to sit down and rest after every kilometer or so of walking. You get tired from even just standing. Fortunately, my work is sedentary.

Right now I exclusively use my prostheses, in part because I live in a tiny rental flat where I physically wouldn’t be able to use a wheelchair. I wouldn’t even be able to use it to go to the bathroom. So whether they hurt or not, I have to put the prostheses on. When I lived in a bigger apartment in Lviv, I alternated between the prostheses and the wheelchair.

 

I liked the Superhumans Center because I was surrounded by people I didn’t have to explain anything to; they all shared similar, or even the same, experiences. It was like I was still with my brothers-in-arms, except everyone had injuries. Out in the city, however, I’m outside of my comfort zone. I never liked crowds, but now I feel particularly triggered by seeing lots of men of mobilization age. I understand that there might be soldiers in civilian clothes among them, or fathers of three or more children, or sons looking after parents with disabilities – but for the most part, that’s not the case. People just don’t care (or at least that’s how it seems to me). They’re just queueing to buy a new iPhone. I have erected an imaginary wall around myself and try to just ignore those things.

After my injury, I initially thought I’d be able to rejoin the military. I’ve actually only taken part in hostilities for around two months – though eventful, that wasn’t a particularly long period of time. I felt like I’ve not done enough, and I felt embarrassed by that. Now I understand I’d just be a burden, but I still try to stay involved in the military.

 

I’ve not suffered any severe mental health issues. I was able to talk about my experience with my wife and friends, but I didn’t really like talking to a therapist; I’ve not met a single one I’d really want to share things with. They tried to help, but it wasn’t my cup of tea – though I’ve met people who really needed to work with a therapist.

Of course I was apprehensive about going back to work and having to spend time with civilians. I still am. But I went back to work in early January. My fear wasn’t related to the team I’m working with; they fully supported me. The firm’s director joined the territorial defense forces during the first days of the full-scale war; I didn’t need to explain anything to him. They made sure my office was suitable for me, and if I was using a wheelchair, they’d make sure I could use my wheelchair at the office. It’s so important to know that I’m welcome here. I know this is the case now at my job.

How we treat our veterans is what should distinguish us from Russians. People who fight for their country – fight, get injured, die – are a fucking elite; they’ve proven their right to be the citizens of this country. Everyone has to understand this, from government officials, to regular civilians. I rarely encounter negative attitudes when I’m out, but I do sometimes on social media – that could be Russians though. But I know people who have been mistreated, and I know their stories are true.