The true casualty toll in Russia from its invasion of Ukraine is an enduring secret of the war. The Kremlin maintains a policy of silence, and many Russians do not speak publicly for fear of repercussions.

But the number of Russians wounded in combat is believed to be staggering.

The Pentagon puts the Russian death toll at about 60,000, with the wounded three or four times that, totaling roughly 300,000 casualties, said a U.S. official speaking on the condition of anonymity.

What Russians say

One senior Russian official estimated that amputees represented more than half of those seriously wounded.

The New York Times interviewed five wounded Russian soldiers and the relatives of others to learn more about what happens to the vast numbers of injured, coming home to inconsistent treatment and little discussion of them.

One has a microprocessor to move the fingers on his prosthetic arm, but only a simple mechanical elbow: He can hold a glass, but not lift it. The arm, he said, was “more cosmetic than working.”

Another soldier lost part of his brain, and relies on his wife for care. She turned to crowdfunding, writing, “I feel like I’m putting my loved one together like a puzzle.”

A Russian who visited his brother-in-law in a Moscow hospital said the six soldiers on the ward mostly still wore battlefield fatigues, so he brought them new clothes, soap, toothbrushes and a warm meal.

Accounts of erratic care

Some laud the medical care available while others described an overwhelmed system, with shortages of everything from medicine to adult diapers.

The wounded are often pushed to return to the front quickly.

A soldier who suffered shrapnel wounds said he was told to report back to the front six days after his hospital discharge.

“It was a conveyor belt,” he said of his crowded ward.

Official praise, unofficial dismay

The wounded are not entirely hidden. President Vladimir V. Putin has made a few hospital visits, sometimes handing out medals, and state media often portrays wounded veterans as heroes.

Anton Filimonov, who lost a leg stepping on a mine, has become one such symbol in Russia of an amputee overcoming adversity.

He has said publicly that Russians were “not ready” to see amputees, and some medical workers have noted a distinct lack of public compassion, with amputees seen begging on the streets.

Read more about these soldiers here.

Alina Lobzina, Oleg Matsnev and Helene Cooper contributed reporting.