00:00In Ukraine, as the war grinds into its fourth year, a devastating and often unseen human toll
00:17is emerging far from the front lines. Tens of thousands of Ukrainian soldiers have returned
00:24home missing limbs. Victims not only of the relentless fighting but also in some cases of life-saving
00:31medical procedures gone wrong. The images are haunting. Young men in their 20s and 30s, many of
00:37them fit, strong and patriotic, now facing life as double or even triple amputees. Their injuries tell
00:45a story of bravery and sacrifice but also of the brutal realities of a war that has no clear end
00:52in sight. According to Ukraine's chief military surgeon, as many as one in four amputations
00:57among wounded soldiers are not caused directly by enemy fire but by the improper use of one of the
01:03simplest pieces of battlefield equipment, the tourniquet. Tourniquets are meant to save lives.
01:10They're used to stop bleeding fast when a soldier suffers a catastrophic injury to a limb.
01:15But in Ukraine, thousands of those life-saving devices are being misused,
01:20applied to the wrong type of wound or left on for too long, causing tissue death that makes
01:25amputation inevitable. Captain Rom Stevens, a former U.S. Navy doctor who regularly volunteers
01:31in Ukraine, told The Telegraph's Battle Lines X Global Health Security podcast that the problem
01:38began when the U.S. combat medical system was copied wholesale into Ukraine's defense forces.
01:44When the full-scale Russian invasion occurred in 2022, he said,
01:47all the American Tactical Combat Casualty Care, or TCC, guidelines were translated into Ukrainian,
01:54but they were written for a different war. Those American guidelines were based on experiences in
02:00Iraq and Afghanistan, conflicts dominated by fast-moving hit-and-run attacks and helicopter evacuations
02:07that could whisk the wounded to hospitals in under an hour. Ukraine's war, however, is very different.
02:14It's a war of attrition. A grinding, positional battle fought across vast trenches and devastated cities
02:20where evacuations can take many hours, sometimes even days. The psychological cost is immense.
02:28Many of these men were conscripts. Ordinary citizens called up to defend their country.
02:33They were teachers, construction workers, shopkeepers, now thrust into a brutal front line where medical
02:40errors can have lifelong consequences. The scale of amputations among working-age men
02:45will reshape Ukraine's post-war reality. Thousands of families are now living with disability,
02:51trauma and financial strain. Rehabilitation centers are full and the demand for prosthetics has skyrocketed.
02:59Many of these men will require support for the rest of their lives.
03:02As Ukraine continues its long and bloody defense against Russia, the war's most enduring wounds may
03:08not be on the battlefield, but in the hospitals, rehabilitation centers and homes where thousands
03:14of amputees struggle to rebuild their lives. This is a generation that will carry the physical and
03:20emotional scars of war for decades. And as the conflict drags on, their suffering is a stark reminder
03:27that even in survival, there can be tragedy. And that the cost of this war extends far beyond the front lines.
03:43There are also some strong that have happened over the right led by the challenge to be found in a
03:49mantenital imprisoned envisioned.
03:50Other than people are just behind on the walls.
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