LVIV, Ukraine — Vladislav Tkachenko grimaced, gripping a wooden balance rail and edging forward carefully. Then he lost his balance, and his metal leg, fitted with his old combat boot, hit the ground. Undeterred, he got back up and pushed forward, staring determinedly at his reflection in the mirror.
“In his mind, he is already back there, with his comrades,” said Victoria Oliikh, a prosthetics specialist, hovering behind him. She is helping fit Mr. Tkachenko, 23, with a limb he hopes will carry him back to the battlefield.
Mr. Tkachenko lost his left leg on the second day of Russia’s invasion of Ukraine, when an artillery shell blew it off and tore into his right thigh, leaving a web of dark red scars. He is among the first in what Ukrainian doctors fear could become a devastating surge of amputations as Ukrainian forces push to regain territory and the fighting in the east intensifies.
That expectation has sparked an international effort to shore up Ukraine’s supply of prosthetic limbs. But Narander Parashar, owner of a Kyiv-based prosthetics company, is worried. “There are already hundreds. The numbers are frightening,” he said, referring to the number of Ukrainian soldiers who have lost limbs.
“We are about to lose a lot more lives and limbs.”
Mr. Parashar, who came to Ukraine from India in the 1990s, studied computer science before starting a prosthetics import business. Dissatisfied by the quality of imports from China and eager to hone his craft, he began to disassemble and reassemble state-of-the-art German and Japanese artificial limbs. These days, he not only provides sockets for limbs made abroad, he also makes his own components in a factory in Kyiv, including hydraulic knees.
Ukrainians have gained expertise in the science and art of prosthetics out of necessity. After Russia seized the Crimean peninsula in 2014, and war injuries multiplied, the conflict spurred many to seek training at top institutions around the world.
But producing prosthetic limbs, an intricate and high-tech endeavor, is expensive. The Ukrainian government, which funds health care in the country, has struggled to keep up with the costs. As a result, some prosthetics manufacturers have gone bankrupt. Others like Mr. Parashar’s company are still waiting for payments.
Nevertheless, Mr. Parashar said he is expanding production at his factory in Kyiv, moving to double and triple shifts.
International volunteers are also helping to fill the gap.
Antonina Kumka, a Ukrainian-born Canadian, founded the Ukraine Prosthetic Assistance Project after the conflict in Crimea began in 2014. Supported by the U.S. charity Prosthetika, she is connecting Ukrainian doctors via videoconference with specialists around the world. She is also encouraging prosthetics manufacturers abroad to make donations.
“We don’t want funding to send patients abroad — we need them to donate components,” she said. “The specialists in Ukraine can do it here. It costs less and it is better for the patient.”
Russia-Ukraine War: Key Developments
On the ground. Fighting raged in Sievierodonetsk, the last city in the Luhansk region to remain outside Russian control since the war efforts shifted to the east of the country. Though most of the city’s civilian population has fled in the past few weeks, 12,000 people, many of them elderly, are said to be trapped there in appalling conditions.
But many patients, including Mr. Tkachenko, remain wary of Ukrainian prosthetics. He worries that local doctors are moving slowly to finish his prosthetic limb because they are helping him for free.
“I thought I would come here, and then one to two months later I would rejoin the fight,” he said. “But I see now it’s going to be a long process.”
Ms. Oliikh has tried to explain to him the need to be patient, that his body needs time to heal. The area where a limb was amputated changes shape and size in the months following a traumatic injury, a process that she said she has to let finish naturally.
Hoping to encourage him, Ms. Oliikh handed him a Parashar hydraulic knee for him to inspect. It would be added to his metal leg, she said, once his walking steadies. He poked and prodded it.
The type of knee did not matter, he said, as long as it helps him achieve his goal: “getting back to my brothers and fighting.”