Aleksandr had only 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 became an amputee.
Learning to live without his left leg is taking much longer than two weeks.
“There was a lot of pain at the beginning,” said Aleksandr, 38, referred to only by his first name in accordance with military protocol. But, he added, “eventually, your brain just rewires itself and you get used to it.”
Aleksandr spoke in an interview at a sanitarium in the Moscow suburbs while a doctor refitted his prosthetic leg. He is one of hundreds of thousands of Russian soldiers returning home from a third year of war to government institutions and a society scrambling to provide for veterans at a time of sanctions, and to the parallel realities of the seemingly unaffected hustle and bustle of big cities and the hardships on the front.
The veterans have both visible and invisible needs that they bring back to their families, who 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 severely injured veterans, according to calculations by the independent Russian media outlets Mediazona and Meduza, as well as the BBC, which all use open source statistics to calculate the war’s toll of deaths and injuries. Since 2023, the authorities have made it more difficult to estimate the number of severely injured because they have designated so many statistics as classified, journalists said.
Aleksandr said that after being sent to the outskirts of Kupiansk, in Ukraine’s Kharkiv region, he had been commanded to dig trenches in an area where recruits had lain mines the day before. He doesn’t know whether the mine he stepped on was Ukrainian or Russian, but his left leg was amputated below the knee and he spent half a year being shuttled from hospital to hospital before he was fitted with an artificial limb.
Back at work as a welder in Russia, he now endures 12-hour shifts that require him to stand for the duration, even though amputees are advised not to wear their prostheses for more than a few hours at a time. Still, he is thankful to be alive and considers himself lucky.
Aleksandr’s prosthetist, Yuri A. Pogorelov, said that Rus Sanitarium, a health resort combining medical treatment and recreation where the former soldier was being treated, had 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 the prosthetics were for veterans of the war in Ukraine.
The sanitarium, built in Soviet days for the country’s political elite, offers a wide range of physical and psychological therapies. Demobilized veterans from all of Russia’s recent wars and their relatives can come for rest and treatment for two weeks per year. About 10 percent of patrons are Ukraine war veterans.
Late last year, Moscow estimated that Russians would need a record 70,000 prosthetic limbs yearly, a drastic increase. That number includes civilian victims and those who lost limbs from causes that were not conflict related. But a deputy labor minister estimated last year that more than half of injured veterans were amputees.
Aleksandr said he was grateful for the free medical assistance he has received, but he emphasized that he was not struggling psychologically.
“Thank God, I have preserved my mental health in my own way,” he said. “I’ve survived all these explosions and bombings, and I am normal.”
But many veterans do return with post-traumatic stress disorder, psychologists and experts say.
“Everyone here has a little bit of post-traumatic stress disorder, whether they are wounded or psychologically injured, or families whose siblings, sons and fathers died,” said Col. Andrei V. Demurenko, 69, who was the deputy commander of a volunteer brigade during the monthslong Battle for Bakhmut. In May 2023, after his skull was fractured, he returned to Moscow to find 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, understandable psychological recovery system,” he said.
At present, there are not enough professionals with the training to treat veterans or to provide regular consultations for them, said Svetlana Artemeva, who is working on a project to train dozens of therapists across 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 the Special Military Operation, a nonprofit group. “They need not to twitch at every rustle, not to shudder, not to be suspicious of everyone.”
At the Rus Sanitarium, Elena Khamaganova, a psychologist, said every soldier who fought in Ukraine undergoes a psychological screening upon arrival, and then attends group and individual counseling. Many will struggle for life, she said, mentioning a 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 be intimate with his wife; despite sharing a child, they were talking about divorce.
Once they leave the sanitarium, the veterans can visit other centers, but they are not eligible to revisit it for at least a year, meaning they will not see the same mental health professionals consistently.
“Rehabilitation cannot end with two, 10 or even 15 visits to a psychologist,” Ms. Artemeva said. “A person’s rehabilitation must last a lifetime, because the experience will echo for the rest of his life.”
Just convincing veterans to speak with therapists is a big part of the struggle. One machine gunner from the western Kursk region, who gave his call sign as Tuba, said he had bad experiences with two therapists and wasn’t keen to speak to any more.
Tuba, 34, was sweating profusely and seemed agitated during the interview. His mother and sister disagreed with his choice to volunteer for the army, 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 hardscrabble life as a soldier and what he considers the decadence of big cities, where daily life hardly seems affected by the fighting.
“I didn’t meet a single Muscovite over there,” he said derisively, referring to the front lines. “They’re busy having concerts — that’s rude and out of place.”
Some civilians have a different view, citing instances where 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 spoke recently of paying extra to sleep in female-only compartments, citing unpleasant experiences with drunk veterans who had made sexual advances and inappropriate comments.
At the sanitarium, many soldiers who fought in the Soviet incursion into Afghanistan or the wars in Chechnya said Russian society has become more accepting of veterans than in previous conflicts. In Afghanistan, men were mobilized — and returned in coffins — largely in secret, a major contrast to the way the Kremlin has sought to celebrate new veterans on television shows, billboards and in special leadership programs.
President Vladimir V. Putin has visited rehabilitation centers and instructed subordinates to create more opportunities for injured servicemen — a contrast, experts say, from previous Russian wars.
“The arrival home of a large number of Afghan soldiers came when the Soviet Union collapsed, and, to put it mildly, the whole society had no time for them,” said Mr. Pogorelov, the prosthetist who fit Aleksandr’s artificial leg.
“The economy was in ruins,” he said. “What kind of rehabilitation or pensions could there be in a country that waited for food donations from George Bush Sr. like manna from the heavens?”
But like some veterans, he said he was pleased that the Russian economy felt much more stable than it had in the tumultuous 1980s and 90s, allowing civilians to “go shopping even though the country is at war.”
Aleksandr was at the sanitarium with his father, Vyacheslav, who was wounded in Afghanistan. As his father expounded on what he claimed was Washington’s culpability for the Ukraine war, repeating the Kremlin’s narrative, Aleksandr made clear that he was not angry at Mr. Putin for the loss of his leg. Instead, the two men expressed gratitude for the leader who has been at the helm of Russia for 25 years.
“Thank God we have Putin,” Vyacheslav said, as his son nodded in agreement.
