The war is traceable in soldiers' wounds.
It is not a mere metaphor, but a fact plainly visible to those who spend enough time in their company, like Natalia Liutikova. The consequences of what soldiers see at the front, from types of weapons to the changes of the seasons, are all visible in the rear to the physicians of the Doctors for Heroes humanitarian project. It works to repair the head and facial injuries of wounded Ukrainians.
Although the project works with both military and civilians, the majority of its patients are soldiers.
"The face, like the hands and feet, is an unprotected area and therefore often suffers the most on the frontlines," says Natalia, the project's founder. "There is a direct correlation with the intensity of hostilities: as soon as combat operations escalate in a particular sector, it becomes evident from our patients' conditions."
Natalia eagerly waits for the project to circulate itself, from the moment a patient with facial trauma is evacuated to them from the frontline until the recovery. However, the reality is that Natalia is involved in all stages of soldiers' treatment.
She even takes care of finding patients for her project to help.
"The evacuation route as it is now has to be changed. It does not take a patient's facial injury with bone destruction to attention.
The wounded are usually evacuated to any hospital so that any help can be provided. However, the problem is that they remain in that 'any' hospital afterward. Frequently, these hospitals do not have a maxillofacial surgeon, or their facial surgery department does not follow the latest methods for some reasons."
Imagine living with a jaw that opens only two centimeters wide. This is how many wounded defenders have had to spend months, waiting to somehow get better. Some of them had suffered the loss of some or all of their teeth.
"When a soldier suffers a jaw injury, they are unable to eat normally and must rely solely on liquid and crushed foods. This poor diet often results in inadequate nutrition, postponing their physical recovery. Then, individuals with such injuries arrive at a rehabilitation center underweight and lack the strength needed to perform essential exercises for restoring limb functionality (because a jaw injury rarely comes alone). However, without sufficient strength, progress is seriously hindered."
The main reason soldiers come to Doctors for Heroes is because maxillofacial surgery and prosthetics for the military are not covered by government-provided healthcare. A single implant can cost around $2,500, with the price varying based on its complexity and material. This is a serious amount of money for most Ukrainians, and it represents just the tip of the iceberg when it comes to the overall cost of such treatment.
However, Natalia says providing facial reconstruction is only the entry point for their patients.
"When we begin working with a person, we fully accompany them in everything they face.
First of all, facial trauma is often accompanied by other injuries, requiring consultations with additional specialists, which we coordinate. Secondly, soldiers may sometimes need legal consultations, which we also facilitate. In addition, our patients work closely with psychologists and psychiatrists.
We have established partnerships with numerous NGOs, charitable foundations, and rehabilitation centers to provide a whole complex of support for soldiers and veterans."
What Natalia has not listed here, however, is her personal attention and care have been shared with 180 servicemen already. Some of them had no one else except her around.
"I understand how they feel. My husband was wounded in combat before we met, back in the Soviet era. He lost an eye. One of the things he told me about that period was how terrifying it was to lie in the hospital, feeling forgotten and unwanted. And how crucial it was to have someone just to talk to while he was in this vulnerable state."
This is one of the reasons why Natalia has been so deeply involved in this work since 2014 when she was first advocating for the rights of wounded soldiers. Her organization's initial goal was to force the government to provide defenders with prostheses free of charge, which they successfully achieved.
Her team is now advocating for this cause again, particularly for soldiers requiring facial reconstruction, while simultaneously working to help the wounded. Psychologists coworking with the project have shared that people often find facial trauma to be more mentally challenging than the loss of limbs.
While some facial injuries may not impact a person's physical capabilities the same way as losing a limb, damage to the face is deeply connected to issues of self-identity and can trigger significant psychological distress. Thus, nobody should mistake the facial restoration these soldiers require for some sort of cosmetic indulgence.
The problem is that many soldiers who have not received proper facial treatment do not know that they can be helped in Ukraine. Some were excluded from military registration and now are sitting somewhere in their small town or village without any hope.
Natalia, the Ukrainian surgeons, and bioengineers who partner with her all work towards the same goal -- ameliorating the suffering and raising the confidence of those who have been wounded by the war. It provides those in the field with the hope that they will be taken care of if they are injured. Without this hope, Natalia says, Ukraine's sense of shared nationhood will collapse.
"One way or another, our society will be divided into those with a direct connection to the war---civilian war victims and their families, along with soldiers and their families---and those without these close ties. We must together overcome this distance and turn our faces to each other. This involves integrating healthy and capable people with hard experiences into society."
