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The Protez Foundation, supported by Direct Relief, creates prosthetics for amputees and has operations in the U.S. and Ukraine. (Nick Allen/Direct Relief)
Oleksiy races down the arena in Kyiv before consulting a stopwatch, intent on breaking his 100-metre sprint record of 13.6 seconds achieved on a sports prosthetic in 2023. Then he must better his 3km record of 12 minutes 40 seconds.
“There’s nothing terrible about losing a leg, you just have to get used to it,” the 27-year-old officer from Odesa said stoically of his recovery after intense combat in eastern Ukraine. But for Oleksiy and other military and civilian war casualties, such injuries are invariably life-changing.
According to unofficial sources, there were between 50,000 and 100,000 amputations among Ukraine’s population since the full-scale Russian invasion in February 2022, with many patients losing more than one limb.
In collaboration with three specialist organizations, Direct Relief has made prosthetics and rehabilitation a central pillar of its Ukraine response, providing funding to strengthen local resources – clinics, training programs, and workshops – rather than simply shipping finished prosthetic devices.
Latest milestones include a $1 million grant for the creation of a dedicated university attached to the UNBROKEN National Rehabilitation Center in Lviv, and the co-funded construction by the Minnesota-based Protez Foundation of its third prosthetics clinic in Ukraine.
In October, a group of leaders from UNBROKEN, Protez Foundation, and the Consulate General of Ukraine in San Francisco visited Direct Relief’s headquarters in Santa Barbara, along with several children and young adults who had received prosthetics after losing limbs in the war.
Later that month, Direct Relief also supported Protez in hosting its third annual amputee rehabilitation summit in Kyiv, bringing together medical specialists, service providers, and manufacturers, as well as individual beneficiaries.
This helped create “a truly collaborative environment that connects multiple rehabilitation centers across Ukraine,” said Yura Aroshidze, CEO and co-founder of the organization, together with Ukrainian prosthetic surgeon Yakov Gradinar.
On the Road Back to Active Life
Ukrainian infantryman Volodymyr Rudkovskyi, who lost his right foot in combat in June 2023, spars on a sports prosthetic at a boxing event for amputees in Lviv. He now works as a motivator, mentor, and advocate for injured war victims. (Nick Allen/Direct Relief)
Since 2022, lines of support to the partners helped several thousand people take their first post-injury steps or regain upper limb dexterity after receiving prosthetics, and regain their direction in life after the physical and mental trauma.
“At the beginning, it was…” said Oleh, a civilian from the eastern city of Bakhmut, grasping for words to describe the trauma of losing his leg in an explosion by his home in 2023. He was evacuated and underwent amputation before receiving a full-leg prosthetic at the UNBROKEN center. “Now it is getting a little easier … I know I must live, work, and build a family.”
The end goal is to build up Direct Relief’s partner organizations’ capacities and sustainability so they can help thousands more amputees like Oleh rebuild independence and purpose well into the future. The third member of the trio is the Kyiv-based U+ System, set up by Ukrainian surgeon Oleksandra Mostepan, who herself operated on many of the organization’s patients.
“Since its founding in 2023, U+ System has provided assistance to over 3,000 people, both veterans and civilians affected by the war,” said Mostepan, who was working in a hospital in Monte Carlo when the war broke out and quickly returned home to help.
The organization’s patients included more than 1,000 individuals who received limb prostheses and another 2,000 who completed physical, auditory, or psychological rehabilitation programs: “These are not just numbers – they represent personal stories of people who have returned to active life, sports, work, and family,” said the surgeon.
Some who lost limbs and were treated by Mostepan, like former soldier Oleksandr Kushnerenko, went on to become prosthetists themselves, finding a new calling amid the turmoil that overtook their lives and their country.
Badly injured in the leg and arm by an exploding tank round in 2022, Oleksandr since helped fit prosthetics for more than 100 male and female amputees. Showing the same determination as the major from Odesa, his advice for others facing life after amputation is: “Keep moving and don’t get fixated on the thought that you lost a limb.”
Breaking New Ground
Ukraine’s Ministry of Social Policy manages the bulk of the amputee patients through state clinics. But Direct Relief’s partners are taking a growing number and setting new benchmarks of excellence. “We are treating cases that have not been managed before, either in Ukraine or the U.S.,” said Aroshidze of Protez Foundation. “Protez has a focus on addressing complex, high-level amputations, both upper and lower extremity, and especially those resulting from tourniquet injuries.”
By October 2025, it had fitted more than 2,000 prosthetic limbs among just over 1,000 patients. “By combining the expertise of American specialists with the knowledge and dedication of our Ukrainian team, we are able to help these most challenging cases and raise the standard of care in Ukraine and around the world,” said Aroshidze.
A Protez Foundation specialist helps a soldier who lost his arm in combat learn how to control a bionic hand by tensing the same muscles which are used to open and close a biological hand. (Nick Allen/Direct Relief)
Together with the Interior Ministry and with support from Direct Relief, the foundation this year broke ground for a new clinic outside the Ukrainian capital that will provide comprehensive prosthetics services when it starts operating in 2026. While enlarging Protez’s own capacity, this also reflects Direct Relief’s goal of supplementing and enhancing state programs.
But recovery does not end with the fitting of artificial limbs. Mental trauma management and rehabilitation are essential for many patients. The partners provide extensive psycho-social services – none more so than UNBROKEN, which has a large mental health center with a range of therapies for neural conditions, from post-traumatic stress disorder (PTSD) to trauma-related concussion and epilepsy. This required new paths of groundbreaking research and treatment that can be applied beyond the end of the war in Ukraine and for the common good, said the center’s director, Oleh Berezyuk.
“We are doing this not because of the additional knowledge, we are doing this because of our survival instinct,” he said. “We must do this to survive. Of course, if we do, we will be happy to share our tactics and our knowledge with others.”
Looking Ahead
As the fighting continues in Ukraine, the number of amputees keeps rising. However, with continued external support, the partners can help drive the development of the overall prosthetics sector, sharing advancements in technology and therapeutic care inside and outside of Ukraine.
To this end, Protez Foundation is developing a horizontal platform that brings together specialists in various disciplines, from physical therapists, occupational therapists, prosthetists, and surgeons, to share their cumulative strength and experience in amputee care.
U+ System is focusing on a holistic approach with a broad regional span, starting with the opening this summer of a large new center in Kyiv, where all services are provided under one roof.
“U+ System was designed as an integrated structure where prosthetics, hearing care, physical, psychological, and social rehabilitation function not as separate services, but as a single, coordinated recovery process,” said Mostepan.
The year also saw the launch of outreach programs to make rehabilitation accessible to people in their local communities, without the need to travel to the capital. For all three partners, a crucial element in the recovery process is the broader public acceptance of war amputees, rather than them being marginalized and excluded, as often happened in past conflicts that affected Ukraine and other former Soviet republics.
At UNBROKEN, patients have regular sports and social activities, including excursions to do archery, horse riding, and bowling. As well as being fun group activities to build confidence and stamina, the outings simply make the patients visible: “Our society needs to see them, understand that this is a [person] with a prosthesis, and accept them as part of that society,” said Solomiya Yakubechko, the head of administration at UNBROKEN.
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