Na kolenke. Documentary photographer

na kolenke

“Na kolenke” (translated as “on the knee”) in Russian means something done in a makeshift manner using available resources.

Kristina Tseveleva is 23 years old, studying to become a medical technician at the institute. She used to work in a production facility making prosthetics. Recently, she became a volunteer doctor at a Charity Hospital for the Homeless in St. Petersburg, Russia. The Charity Hospital has been operating since 2018, providing assistance to the homeless, refugees, and anyone in need. In 2023, the Charity Hospital opened a full-fledged clinic where they can admit patients and provide quality medical care using medical equipment. Prior to this, volunteer doctors would make nightly visits to different areas of the city to treat patients in the back of a bus.

Kristina’s first patient was a man named Andrey. Andrey is originally from Transnistria. He came to Russia for work and worked on construction sites. Soon after the start of the war in Ukraine, the Russian Ministry of Defense announced that foreigners who signed contracts with the army could obtain citizenship through a simplified system. In Russian citizenship and a good salary, Andrey saw opportunities for himself.

However, things turned out differently. In September, Andrey drank with a friend and ended up getting hit by a train while intoxicated. After being discharged, he couldn’t return to work and ended up in a homeless shelter. The lack of citizenship limited Andrey’s access to medical treatment. He also couldn’t afford to buy a prosthesis for himself. The price of a prosthesis is around $5000.

Kristina took on the task of making the prosthesis herself, at her home. She rents a small apartment on the outskirts of St. Petersburg. There’s a workbench with a large number of tools in the hallway. Kristina did the entire production cycle herself, which usually involves a huge number of people and expensive tools.

Eugene Shalnov charity documentary photograher

Kristina is in the office of the Сharitable clinic before seeing the patient.

Andrey is at an appointment in the Сharitable clinic. Andrey's case has attracted a lot of attention from the clinic's doctors; many have gathered to see how Kristina works. This meeting marked the beginning of a long process of making a prosthesis.

Kristina is making a cast of the limb to create a replica that she will work with at home. Before applying the plaster and bandages to the leg, a thick string is placed, along which, after the plaster sets, Kristina cuts the resulting cast. The cast is cut to make it easier to remove, while the string protects the leg from cuts.

Check the cast.

The workbench where Kristina works is at home. She rents a small apartment on the outskirts of St. Petersburg together with her partner and two dogs. There is a small kitchen and two rooms, one of which is locked. The workbench is located in the corridor, right by the entrance. There are many tools on it, and underneath it are protruding parts from other prostheses.

The pouring of plaster into the mold taken from Andrey's limb.

Baking the obtained plaster cast. Large-scale productions use specialized ovens for each stage of prosthetic manufacturing. However, Kristina only has an old Soviet gas oven. It cannot be set to a specific temperature or any other parameters; everything has to be done based solely on her own senses.

The production of a soft padding inside the prosthesis.

Kristina decided to make the attachment of the prosthesis to the leg from plastic. To do this, she melted a plastic sheet in the oven and wrapped the plaster mold with it. Then, using a construction hairdryer, she heated the plastic to smooth it out and give it the desired shape.

Andrey is at the first fitting of the prosthesis at the charitable clinic. In addition to making the prosthesis, volunteer doctors are treating Andrey's wound that remained after the surgery.

Preparation of the prosthesis for fitting.

Kristina is cutting a metal tube to shorten the prosthesis to match Andrey's height.

The first fitting of the prosthesis. During this appointment at the clinic, Andrey tried wearing the leg prosthesis for the first time. He shared his sensations so that Kristina could improve the design of the prosthesis for comfort. It is crucial for the prosthesis to be securely and comfortably attached to the leg without causing any injury.

Kristina is redesigning the prosthesis. After the first fitting, Kristina concluded that the plastic attachment is not suitable for the prosthesis. It turned out to be too fragile. She decided to make a new attachment using carbon and epoxy resin.

Cutting the carbon fiber.

Layer by layer, Kristina applies epoxy resin and carbon.

The final fitting at the Charitable Clinic. Andrey is examining his new prosthesis.

Kristina assists Andrey in putting on the prosthesis.

The final adjustments to the prosthesis for improved comfort during wear.

Kristina adjusts the prosthesis before Andrey takes his first steps with his new leg.

After observing how Andrey walks and the difficulties he faces, Kristina continues to adjust the prosthesis to improve walking comfort.

Kristina explains to Andrey how to properly use the prosthesis, how it differs from a real leg, and what exercises will help him adapt faster and avoid injuring his leg. The first steps were a bit challenging for Andrey. He himself mentioned that he started to forget how to walk on two legs. However, within a few minutes of walking, Andrey moved around without major issues.

“I became a volunteer at the Charity Hospital because I find the problem of inaccessible medical care, food, warmth, and other basic things for the homeless and migrants acute. It’s strange that even in our time, many people are left to deal with adversity alone, especially when it comes to health issues. Well, if something in the world around us doesn’t seem right, you have to try to change it even a little. Besides, I have skills, albeit specific ones, that I need to use for good, ” says Kristina.