They miss the front line, not their legs. A Ukrainian woman gives new life to soldiers who won't give up

Matěj Skalický talks with Olga Rudneva, the CEO of the Superhumans Center in Lviv


00:00 / 00:00


8. 6. 2024 | Prague/Lviv

They escaped death. Superheroes. Mines took parts of their bodies, but not the love for their country. Ukrainian war veterans. They have lost arms, legs, their sight or hearing, yet their determination to return to the frontlines and fight remains strong. Olga Rudneva, the CEO of the Superhumans Center in Lviv knows how the second life of soldiers is born.

Edited by: Kateřina Pospíšilová
Sound design: Jaroslav Pokorný
Researched by: Tereza Zajíčková
Podcast in text: Tereza Jonášová
Music: Martin Hůla, Damiana Smetanová

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Rehabilitační středisko ve Lvově Superhumans Center | Foto: Anastasiia Smolienko | Zdroj: Ukrinform/Sipa USA via Reuters Connect

Olga Rudněvová, CEO Superhumans Center | Foto: Matěj Skalický | Zdroj: Vinohradská 12

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Olga Rudneva accepted the invitation from the Prague Civil Society Centre to speak at the Unlock 2024 conference.

Give Ukrainians the superhero life they deserve. That's the motto of your rehabilitation center. Who are your superhumans?
Well, we help people who were injured on the front lines. Mainly mine and blast trauma. People who stepped on mines, people who picked up a bomb, and so on. We have one patient who picked up a mine from a civilian, and he lost an arm and his vision and hearing. Also, we help civilians, those people who stayed close to the front lines and were hit by shelling. There are some children in our center, but the majority are young people, 25 to 40 years old, who are at the beginning of their lives, and they have lost limbs. We are dealing with double, triple amputations. There are some patients with quadruple amputations in our center. And we also provide services in reconstructive surgery. It's basically facial reconstruction.

Plastic surgery?
It's facial reconstruction. Plastic surgery sounds too soft for Ukrainian reality now. Basically, it's people who lost their facial function and aesthetics, people who can't breathe, people who can't swallow. We have a patient who couldn’t close his eyes for six months, so he slept with open eyes. You need to restore the function first and then restore the aesthetics.

How are they doing mentally? Do you also deal with people who struggle with post-traumatic syndrome?
We have a full service, starting from psychological evaluation. A psychologist goes through everything with our patient for the duration of  their stay, and when the patient is discharged, we keep him or her on psychological monitoring. Surprisingly, we have a very low level of PTSD, post-traumatic stress disorder. Which is truly surprising. Only 6%. But what our patients are dealing with is moral injury, which is when you do something that is against your values. For example, you couldn't get your comrade off the battlefield for some reasons, and that’s what troubles you. Or, for example, one of our patients was complaining that he feels guilty that he lost his leg and he can't continue his service. He said: I feel like I'm a loser, I should have been better prepared for this war. So that kind of trauma. Psychologists work with our patients to help them to go through their emotional experiences, because war is a very tough experience for some people, those who are not prepared for it. But, in the end, I guess no one is prepared for a war of this intensity.

So the people don't pity themselves, but they are struggling with the fact that they can't be useful for their society during the time they are hospitalized.
Yes, that's exactly what is happening. And most of our superhumans, they don't feel destroyed, they don't feel pity and they don't regret their lost limbs. Some of them say: well we don't have medals, so our prostheses are our medals. They know what they were fighting for. They were fighting for independence, for freedom, for their territory. So there is no regret about losing a limb. But there is a lot of pain when you can't continue serving your country.

Are they superheroes? Or do you make superheroes at your center?
They are. They are. They just come to us as superheroes. And we know not all of them understand that. Most of them say: I just did what I had to do. And about 80 % of them are not servicemen, they are not military. They had to go to the front lines when the full scale invasion started. So they were not prepared, they were not ready for the war. But the war made heroes out of them.

What kind of experts do you need at your center?
We track a lot of international experience, and we are especially looking for specialists in upper limb prosthetics, because people normally don't lose upper limbs. Normally they lose lower limbs. And in Ukraine, 45% of all cases are upper limb loss. So we are lacking prosthetists. Around the world, there are not enough prosthetists for upper limbs. So we are looking for these specialists. We have a fantastic group of surgeons coming from the Czech Republic. They are working at Superhumans and at governmental facilities. They do face reconstruction and they do surgeries on reamputation. We are very satisfied with the results. And we are looking for high quality experts in the fields of face reconstruction, hearing aid, vision restoration and cranioplasty.

You mentioned prosthetics. You have your own prosthetic manufacturing facility, is that right?
We produced sockets, so-called sockets. It refers to the stump holder, the most sensitive part of the prosthesis. That's where you put your stump and it is individually created for each patient.

So you custom make them?
Yes. And the components of prosthesis we buy, because that’s a large scale, very expensive, very high tech production.

But you have a facility for making the part of the prosthetics that’s individually suited to each patient.
Yes. We have a lab.

You need a lab for that?
You need a lab. Ours is 450 square meters. And it's a big production. First you need to measure the patient. Then you have to produce the mold, the exact copy of your stump. And then out of that, you have to make a stump holder. It's like a shoe, something that should be very comfortable, because even a blister can prevent you from using your prosthesis. You can have amazing components, but if it's not comfortable, you won’t be wearing your prosthesis. So that's what we produce. And we just got our 3D printer, so we might be 3D printing some parts like fingers, stump holders, or torsos. We'll be doing that in-house.

What material do you use for the stump holders? Is it plastic?
It's plastic and carbon fiber. The first one, which is temporary, is plastic and the black one, the cool one, is carbon fiber.

Do you also work with bionic prosthetics?
We do. Myoelectric prosthesis. It's something that you can actually manage with your muscles. You have to have the signal in your muscles. For example, for the hand, we find the signal and that's where we put the special parts of the prosthesis. And then you have to remember what muscles you have to actually exercise to do different movements.

Beg your pardon – you can control the prosthetic with your mind
No, with your muscles.

But you control your muscles with your mind.
In reality, yes, that's how it actually happens. But right now, it’s very much in development and there is a lot of R&D in figuring out how to directly control it with your mind without thinking what kind of muscles you have to actually work to pick up a glass of water. Because it's actually 30 muscles that you need to pick up a glass of water or to shake a hand. So you have to learn and remember that. And then it becomes automatic. But as a matter of fact, yes, you control it with your mind.

Psychological help, prosthetic lab. What else, what other rooms can I find in your center?
Rehabilitation. It spans a whole floor. Also an ergotherapy kitchen. That's where you learn how to cook, how to clean. There is also an ergotherapy bathroom, where you learn how to get to the bathroom by yourself, how to take a shower, how to manage washing procedures. We have hydrotherapy in a swimming pool, because the water relieves up to 80% of your weight. Then there is a hearing aid department, because every third patient has problems with their hearing.

And a vision therapy room?
Not yet, but we are getting there. We have a 3D department where we have our amazing 3D printers; an in-patient department with 70 beds; surgery rooms, two very cool surgery rooms; an intensive care unit rooms where people stay after surgery; and some small tennis courts because we do a lot of sport activities.

That's part of rehabilitation, right?
Yeah. And the boys room, which is where the guys hide from us when they're sick and tired of rehabilitation.

…and play PlayStation.

Rehabilitation – that's the key for returning to a normal life?
It is. You can have the best prosthesis, but if you don't know how to walk and how to operate with the prosthesis, you probably won't want to wear it. 60% of those people who have their prosthesis never use them because they are either uncomfortable or they've never been taught how to walk, how to operate the prosthesis. So rehabilitation is a very big part of the whole process, during which we basically reteach people how to walk, how to grab a glass of water, how to hug the person they love, how to make a proposal to their girlfriend.

How long is that journey for people who suffered an injury?
It depends. If it's an easy amputation, as we call it, below the knee or below the elbow – because it's great when the elbow is saved or the knee is saved – it's two, three weeks. It's quite quick. And these people walk better than I do. Some guys in the center say they basically came to us to pick up new shoes.

That surprises me.
Yes, but with triple, double amputation, with high amputations, it can take up to four months for the person to learn how to walk, how to be independent, how to do everything by themselves.

According to the Ukrainian Ministry of Social Policy, since February 2022, the number of Ukrainians with disabilities has risen by 300,000. How many people have you helped since February 2022?
We are quite small. The number of people who lost limbs is 40,000 in Ukraine as of February 2023, but it's 60,000 limbs. So it's double, triple amputations. We discharged 500 patients, which is, you know, we are the biggest center in Ukraine that provides prosthesis. But in terms of the whole Ukraine, it's a very small number. We have 700 people in line for our services, and we are working six days per week to provide more people with prostheses, rehabilitation and psychological support. And we are scaling up to two more regions so we can help more patients per month, because the demand is so high.

Can you be more specific about the areas that your patients come from?
Well we can feel each wave at the front lines. So we had a wave from Bakhmut when we had a lot of patients from there. We still have patients from Mariupol who were injured at Azovstal, and they were in the medical facilities for two years because of infection, re-amputation and different complications with their amputations. Right now it's the Kharkov region, which is being shelled intensively, as well as the Donetsk region. We are very much dependent on the situation at the front line: where the biggest fights are happening, that is where the patients are coming from.

You also have people who have been injured in other ways than combat, right? What kind of injuries are we talking about?
Much the same: amputations, people who lost their limbs, people who have disfigured faces due to mine and blast trauma, kids who lost their limbs due to shelling. So basically it's civilians who didn't leave their houses and were very close to the front lines or civilians from the Kharkiv Oblast, from Vuhledar, from parts where there’s been a lot of shellings. We also provide prosthesis for the foreign legions because they're not covered by insurance in their own country and they are not provided with prostheses by the Ukrainian government, because they're not Ukrainian citizens. So we have guys from Columbia, Georgia, Poland, United States, from all over the world.

And is it different to treat a soldier and a civilian?
It is. The motivation is different. Soldiers are more motivated. They are open to work hard. They are younger and a lot of them dream of returning to the front lines. Not all of them will be able to. Most of them won't be able to return to the front lines, but it's much easier to work with them psychologically.

I get that. In an interview with The Gaze, you mentioned that your patients laugh when someone says get well soon. Why is that?
Well, because you can't regrow your leg, you can't regrow your arm. No one is sick in our center. We don't deal with sick people. We deal with people who lost their abilities and our work is to bring back their lost abilities. So we often say that we are not a medical entity. We are a center that returns people their lost abilities. You're not in a hospital, you're not sick. So you can't get well. You are well already. You're fine.

Right, but am I a patient? You know, after all, if I'm not sick, I'm not a patient.
No. You're not. Well, that's what we're trying to say. You're not sick. And you don't act like a sick person. You act like an active person who wants to come back to an active life. It's a philosophy.

You refer to the people you treat and help in your center as prototypes of the future.
Yeah, they are. Listen, if we want to live long, and we do, like a hundred years, our body won't be able to actually stand it because our body is very fragile. So we'll start substituting parts of our body with prostheses. And it's already happening with joints, for example. Joints are also prostheses, we just don't see them. So it's our future. They are testing the future. So I believe that in 50 years, we'll see a lot of people with a prosthesis just because it's more efficient to have a prosthetic instead of your tired leg. So we have a lot of jokes about that. But it's about longevity, first of all. And there’s a lot of money going into the prosthetic field because it's about longevity. It's about the fact that we all want to live longer and our body resists. So let's change that. Let's hack our bodies.

Do you joke about it often?
Yeah, we have a lot of jokes in Superhumans.

Is it easier to deal with what you're dealing with at the center with some humor?
The thing is, when the person starts joking about his or her trauma, that means that he or she already digested the trauma. He can speak freely about that. When the person is crying over a lost leg, that means he's not at the point when he is ready to, you know, to renovate. So in the center, there are a lot of jokes. Black humor is our favorite. But you know, you lost your leg. What can you do about that? You can laugh about it. And that's it.

You're still alive.
Yeah, that's the most important part.

Is there anything you can't do?
I can't bring back Irina, who was killed yesterday on the front lines. And we talked with her and she told me that Superhumans gave her hope that if she lost her leg, we would help her. And then yesterday she was killed. So I can't help her. And I can't help people who will never be vertical again, who have spinal injuries. We do not work with these patients, who are going to be paralyzed for the rest of their life. I can't help them. I can't help those people who don't want to walk. And there are some of those. We are all different. Not everyone wants prostheses, not everyone wants an active life. And there are some people who are OK in a wheelchair, OK drinking at home. I can't help them. You know, they have to be the first initiators of their change. They have to come to me and say, listen, I want to walk. I want to hug my child. I want to play basketball again. I want to travel the world. I want to go back to the front lines. They have to bring this motivation and this desire to me. And I will do everything I can to assist them. But if they don't want to do it themselves, no one can do that for them.

What's life like for your superhumans once they leave your center?
It depends what they choose to do. We have a couple of guys who opened their own business, and these are guys with double amputations of upper limbs. Some guys just had families, kids, and that's amazing. We welcome them from maternity houses with their wives. And it's amazing to see new superhumans born. They travel the world because they start treasuring their limbs. They often say: listen, I never treasured my limbs, because they were given to me. I took them for granted as a normal thing that goes with you always, and you don't use it, because it's always with you. When you lose it, you start appreciating that. So they're becoming very active. Three of our superhumans went to the United States for the Air Force competition, and they brought 11 medals from there and a girl. So they are very active. They play golf. We have our own kayaking team. We do mountain climbing. They go fishing every Saturday. They do horse riding. So for some of them, their life became more interesting. Your second life starts when the first one is finished. And for them, the first one was finished when they lost their limbs, when they were saved from the front lines. And now they are more appreciative of what they have.

Do you have people who return back to your center after they've already left it?
Yeah, they return every three months. If they change weight, they change the dimension of their stumps. And that does happen in the first year because when you start walking intensively, you start losing weight. So they have to come to us to change the stump holder. So we see them every three months and we know where they are, what they are doing. So we follow our patients, we know what they are up to. And some of them return to the front lines. We don't like when they go to the front lines, but we always tell them, if you lose your other arm, you know where to go. And they laugh.

Thank you very much for what you're doing.
We do it for our country. And it brings us a lot of joy and pleasure because we see the results of what we do and we know what we're doing and for whom.

Matěj Skalický

Související témata: Ruský vpád na Ukrajinu, Vinohradská 12, Vinohradská 12 in english, Matěj Skalický