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In Ukraine, limbs lost and lives devastated in an instant; every day, ‘some new type of pain’

Yana Stepanenko, 11, is carried by a doctor at a public hospital in Lviv, Ukraine. Yana and her mother Natasha, 43, were injured April 8 by shelling at the train station of the eastern city of Kramatorsk, where they traveled with Yana’s twin brother Yarik from their village near the Russian war on Ukraine’s front line. They were planning to catch an evacuation train west, they hoped to safety. (Emilio Morenatti / AP)

KYIV, Ukraine — There is a cost to war — to the countries that wage it, to the soldiers who fight it, to the civilians who endure it.

For nations, territory is gained and lost, then sometimes regained and lost again.

But some losses are permanent. Lost lives never can be regained. Nor can limbs.

And so it is in Ukraine.

The stories of people who undergo amputations during war are as varied as their wounds, as are their journeys of reconciliation with their injuries. For some, losing a part of their bodies can be akin to a death of sorts and coming to terms with it a type of rebirth.

For soldiers wounded defending their country, the sense of purpose and belief in the cause they were fighting for sometimes can help them cope psychologically with amputation.

For some civilians, maimed while merely going about their lives amid a war that already terrified them, the struggle can be much harder.

For these men, women and children who have lost limbs in the Russian war on Ukraine, now in its third month, that journey is just beginning.

OLENA VITER, 45

Olena Viter, 45, is moved to a stretcher before being taken to undergo more surgery at a public hospital in Kyiv, Ukraine. The explosion that took her left leg also killed her son Ivan, a 14-year-old , budding musician already playing in a small orchestra. Her husband Volodymyr buried him and another boy killed in the same blast under a guelder-rose bush in their garden. (Emilio Morenatti / AP)

The explosion that took Olena Viter’s left leg also killed her son Ivan, a 14-year-old budding musician. Her husband Volodymyr buried him and another boy killed in the same blast under a guelder rose bush in their garden. Amid the fighting, they couldn’t get to the cemetery.

“How am I going to live without Ivan?” the mother said. “He will remain in my heart forever, like the fragment that hit him.”

Ivan and four others were killed when bombs rained down March 14 on their village of Rozvazhiv in the Kyiv region. Olena was one of about 20 who were wounded.

At first, says Viter, 45, “I was thinking, ‘Why did God leave me alive?’ ”

Hearing that her son was dead, she begged a neighbor to get his rifle. She wanted him to shoot her.

But her husband pleaded, telling her he couldn’t live without her.

Now, she endures the devastation of the loss of her child and the loss of her leg, cut below the knee.

“Every day, I get used to some new type of pain,” Viter says. “I am thinking: What kind of new pain will I see in the future?

“I am still not accepting myself as I am now,” she says. “I really liked to dance. I was doing sports. I don’t know, I need to learn.”

She can’t yet imagine what it will be like to walk again.

Viter thinks maybe her life was spared because she is still meant to do something, to help others, perhaps as a volunteer or through donations to a music school in Ivan’s memory.

“At the moment, I don’t know what I would want to do. I should keep searching. ... I must learn how to live. How? I do not know yet.”

YANA, 11, AND NATASHA STEPANENKO, 43

Natasha Stepanenko, 43, sits on her hospital bed with her daughter Yana, 11, in Lviv, Ukraine. (Emilio Morenatti / AP)

Devastation fell from a clear blue sky for Yana Stepanenko and her mother Natasha Stepanenko.

On April 8, the 11-year-old went to the eastern city of Kramatorsk with her mother and twin brother Yarik to board an evacuation train.

Yarik stayed in the station to guard their luggage while Yana and her mother went outside to buy tea.

Then, a missile hit. The world went black and silent.

The mother fell. She couldn’t stand up. She looked over and saw her little girl, her leggings dangling where her feet should be, blood everywhere.

“Mom, I’m dying,” Yana cried.

Yana lost both legs, one just above the ankle, the other higher up her shin. Her mother lost her left leg below the knee.

Yarik was uninjured and has been reunited with his mother and sister. The children’s father died of cancer several years ago, and their stepfather is fighting at the front. So now the little boy cares for his mother and sister, chasing around the hospital corridors, fetching wheelchairs, bringing food.

“Sometimes,” Natasha Stepanenko says, “it seems like it happened not to us.”

She worries most about her daughter. “I cannot help her as a mother. I cannot pick her up or help her move. I can only support her with my words from my bed.”

Yana misses her home and friends and is looking forward to getting prosthetics.

“I really do want to run,” she says.

SASHA HOROKHIVSKYI, 38

Sasha Horokhivskyi, 38, does stair-climbing exercises at a public hospital in Kyiv, Ukraine. He. Sasha lost his leg above the knee on March 22 after being shot in the calf by a territorial defense member who mistook him for a spy. (Emilio Morenatti / AP)

Alexander Horokhivskyi, known as Sasha, is in pain. And he is angry. He winces as he rubs the stump of his left thigh where his leg was amputated on April 4, nearly two weeks after he was injured.

Horokhivskyi, 38, was shot in the calf by his own side. A territorial defense member mistook him for a spy because he was snapping photos of bombed buildings near his home in Bobrovytsya, a city in the Chernihiv region, after emerging from a bomb shelter.

He was questioned for about 90 minutes at a police station before being taken to an overwhelmed hospital.

Days later, he was moved to a hospital in the capital city of Kyiv, where doctors decided they had to take his leg to save his life.

An avid table tennis player, he found out about the amputation only when he awakened after surgery.

“How did they dare do all that without my consent?” he says.

Between the drugs and the pain, he doesn’t remember much. “I swore a lot.”

He worries whether he’ll be able to play sports again or travel.

“I try to understand how it could happen. Especially during the first week, I couldn’t think about anything else.”

It would be different were he wounded while fighting, he says, “but to be injured in such a way was very hard.”

He has spoken with a psychologist and has come a long way from those initial dark days.

“It does not make sense to return to this moment,” he says. “Because you can’t change anything.”

EDITOR’S NOTE: AP photojournalist Emilio Morenatti lost his left leg while covering the war in Afghanistan in 2009. “When a part of your body is amputated, you cross over into the disabled community, and a camaraderie inevitably develops,” he says. “My need to access this group is above any kind of impediment. I’m fascinated by comparing experiences, amputee to amputee. This is why I’m no longer interested in covering the war from the front line but rather from behind the front lines, where the only thing that remains is the raw testimony of the cruelty marked by this damned war.”