St. Petersburg Times, Feb. 9, 1999

It was in Grozny in June 1995, at the height of the war in Chechnya, that 8-year-old Gennady stepped on the land mine which took off one of his arms and half a leg. For him and his family it was another gruesome tragedy: Only a few months earlier, Gennady's father had also been injured by a mine; he died later when gangrene set into his wounds. But somehow the boy survived, and he, his mother and his elder brother fled to Georgyevsk, near Stavropol, where they now live in a hostel for refugees.

It was there that Gennady's luck began to turn. In June 1998, a team of American and St. Petersburg doctors created a new international program aimed at the rehabilitation of land mine victims, and found in Gennady an ideal candidate to be its first beneficiary.

On Friday, Gennady, now 12, was recovering at the St. Petersburg Research Institute of Prosthetics from the operations which had given him new limbs. Small for his age, dark-haired and running a slight temperature, Gennady's face was a mask of superhuman concentration as he slowly picked up a toy truck and complied with doctors' requests to transfer it from one hand to the other, grimacing from the discomfort of his artificial arm. He walked back and forth in a new pair of sneakers, his trouser legs rolled up so that a video camera could record his movements.

"He writes with his left hand now," said his mother, reassuring Gennady that he would soon be free from such constant scrutiny. "He's right-handed, but I think that writing with the prosthetic hand will be more difficult."

Later in the day, Gennady walked out of the institute unaided - an achievement that might not have been realized had it not been for the vision of Dr. Mark Pitkin and the remarkable developments at the prosthetics institute.

For 15 years, the institute was the workplace of the Russian-born Pitkin, until he left for the Tufts University School of Medicine in Boston in 1989, where he is now a research assistant professor of physical medicine and rehabilitation. Having worked in both countries, Pitkin saw a way to link U.S. technology and finances with Russian experience and expertise, by founding the International Institute for the Prosthetic Rehabilitation of Land Mine Survivors. The ambitious project set out to fund the transportation of mine victims to St. Petersburg, where they could receive surgery, therapeutic training and U.S.-made prosthetics.

Last year, Pitkin invited Anatoly Keyer, director of the St. Petersburg institute, and a team of his doctors to a conference at the New England Sinai Hospital in Massachusetts to discuss the establishment of the project. Five months later, Gennady was flown to St. Petersburg as their first patient.

"The money we raised was divided into two portions," said Pitkin. "The first was used to buy equipment for St. Petersburg for joint and socket pressure measurements. And the second was spent on Gennady's prosthetics. He was a very good example of our target population; he had stump complications, and like 60 percent of land mine survivors, he needed reconstructive surgery."

Aside from the medical questions, the case of Gennady illustrates how people have banded together for the project, as Pitkin explains. "His new leg was donated by the Ohio Willow Wood Company, his arm by Liberty Technologies of Massachusetts. The Michael and Helen Schaffer Foundation made two donations ... and support from the St. Petersburg Legislative Assembly was essential [to clear] customs barriers."

Founded a century ago, the prosthetics institute's current home is a large, run-down building on Bestuzhevskaya Ulitsa. The list of major conflicts which has sent patients to the institute is lengthy. Director Keyer numbered them off: "The Japanese war, two world wars, the civil war, the fighting in Afghanistan and Chechnya. ..."

These days, the doctors have gone a long time without pay, and run mostly on their evident and enormous enthusiasm for the job. There is little room for sentimentality here, when one is dealing every day with children crippled through no fault of their own. But the doctors perform their rounds with an impressive mixture of kindness, good humor and authority.

"Prosthetics technology is developing all the time," says Keyer. "Even the most principal, the most fundamental things are changing. Patients on this program won't receive the most advanced prosthetic limbs for the obvious reason - cost. But the cheaper cost is one of the best things about the program." The $5,000 spent on Gennady covered air fares for him and his mother, a three-month stay at the institute, rehabilitative training, the manufacture and transport of his prostheses, and surgery.

This is no small package, especially considering the complexity of the surgery. "In Gennady's case, we had an overgrowth of the fibula bone penetrating the skin," said Konstantin Shcherbina, chief of the prosthetic lower-limb department. "It was no use just cutting the bone, because it would just grow again." Solving the problem took some highly sophisticated microsurgery to "tuck up" the stump, as well as to heal the scars he acquired on his other leg in the explosion. In the United States, the price tag - including accommodation, surgery and prostheses, would have totaled around $32,000.

"This cooperation benefits everybody," says Kudryavtsev. "First, it obviously benefits the patient. Secondly, it benefits us, because the money came to us directly and we could do our work. And finally it benefits the institute in America, because they obtain information from our work."

Pitkin's program looks set to be of extraordinary benefit to at least hundreds of victims. With an estimated 110 million mines still scattered worldwide, it's a modest triumph - but for children like Gennady, an immeasurable one.