Russia offers cash bonuses, frees prisoners and lures foreigners to replenish its troops in Ukraine

For average wage earners in Russia, it's a big payday. For criminals seeking to escape the harsh conditions and abuse in prison, it's a chance at freedom. For immigrants hoping for a better life, it's a simplified path to citizenship.

All they have to do is sign a contract to fight in Ukraine.

As Russia seeks to replenish its forces in nearly four years of war — and avoid an unpopular nationwide mobilization — it's pulling out all the stops to find new troops to send into the battlefield.

Some come from abroad to fight in what has become a bloody war of attrition. After signing a mutual defense treaty with Moscow in 2024, North Korea sent thousands of soldiers to help Russia defend its Kursk region from a Ukrainian incursion.

Men from South Asian countries, including India, Nepal and Bangladesh, complain of being duped into signing up to fight by recruiters promising jobs. Officials in Kenya, South Africa and Iraq say the same has happened to citizens from their countries.

President Vladimir Putin told his annual news conference last month that 700,000 Russian troops are fighting in Ukraine. He gave the same number in 2024, and a slightly lower figure – 617,000 – in December 2023. It's unclear if those numbers are accurate.

Still hidden are the numbers of military casualties, with Moscow having released limited official figures. The British Defense Ministry said last summer that more than 1 million Russian troops may have been killed or wounded.

Independent Russian news site Mediazona, together with the BBC and a team of volunteers, scoured news reports, social media and government websites and collected the names of over 160,000 troops killed. More than 550 of those were foreigners from over two dozen countries.

Unlike Ukraine, where martial law and nationwide mobilization has been in place since the start of Russia's full-scale invasion in February 2022, Putin has resisted ordering a broad call-up.

When a limited mobilization of 300,000 men was tried later that year, tens of thousands of people fled abroad. The effort stopped after a few weeks when the target was met, but a Putin decree left the door open for another call-up. It also made all military contracts effectively open-ended and barred soldiers from quitting service or being discharged, unless they reached certain age limits or were incapacitated by injuries.

Since then, Moscow has largely relied on what it describes as voluntary enlistment.

The flow of voluntary enlistees signing military contracts has remained strong, topping 400,000 last year, Putin said in December. It was not possible to independently verify the claim. Similar numbers were announced in 2024 and 2023.

Activists say these contracts often stipulate a fixed term of service, such as one year, leading some potential enlistees to believe the commitment is temporary. But contracts are automatically extended indefinitely, they say.

The government offers high pay and extensive benefits to enlistees. Regional authorities offer various enlistment bonuses, sometimes amounting to tens of thousands of dollars.

In the Khanty-Mansi region of central Russia, for example, an enlistee would get about $50,000 in various bonuses, according to the local government. That's more than twice the average annual income in the region, where monthly salaries in the first 10 months of 2025 were reported to be just over $1,600.

There also are tax breaks, debt relief and other perks.

Despite Kremlin claims of relying on voluntary enlistment, media reports and rights groups say conscripts — men aged 18-30 performing fixed-term mandatory military service and exempted from being sent to Ukraine — are often coerced by superiors into signing contracts that send them into battle.

Recruitment also extends to prisoners and those in pretrial detention centers, a practice led early in the war by the late mercenary chief Yevgeny Prigozhin and adopted by the Defense Ministry. Laws now allow recruitment of both convicts and suspects in criminal cases.

Foreigners also are recruiting targets, both inside Russia and abroad.

Laws were adopted offering accelerated Russian citizenship for enlistees. Russian media and activists also report that raids in areas where migrants typically live or work lead to them being pressuring into military service, with new citizens sent to enlistment offices to determine if they’re eligible for mandatory service.

In November, Putin decreed that military service was mandatory for certain foreigners seeking permanent residency.

Some reportedly are lured to Russia by trafficking rings promising jobs, then duping them into signing military contracts. Cuban authorities in 2023 identified and sought to dismantle one such ring operating from Russia.

Nepal’s Foreign Minister Narayan Prakash Saud told The Associated Press in 2024 that his country asked Russia to return hundreds of Nepali nationals who were recruited to fight in Ukraine, as well as to repatriate the remains of those killed in the war. Nepal has since barred citizens from traveling to Russia or Ukraine for work, citing recruitment efforts.

Also in 2024, India’s federal investigation agency said it broke up a network that lured at least 35 of its citizens to Russia under the pretext of employment. The men were trained for combat and deployed to Ukraine against their will, with some "grievously injured,” the agency said.

When Putin hosted Indian Prime Minister Narendra Modi for talks in 2024, New Delhi said its nationals who were “misled” into joining the Russian army would be discharged.

Iraqi officials say about 5,000 of its citizens have joined the Russian military along with an unspecified number who are fighting alongside Ukrainian forces. Officials in Baghdad cracked down on such recruiting networks, with one man convicted last year of human trafficking and sentenced to life in prison.

An unknown number of Iraqis have been killed or gone missing while fighting in Ukraine. Some families have reported that relatives were lured to Russia under false pretenses and forced to enlist; in other cases, Iraqis have joined voluntarily for the salary and Russian citizenship.

Foreigners duped into fighting are especially vulnerable because they don’t speak Russian, have no military experience and are deemed “dispensable, to put it bluntly,” by military commanders, said Anton Gorbatsevich of the activist group Idite Lesom, or “Get Lost,” which helps men desert from the army.

This month, a Ukrainian agency for the treatment of prisoners of war said over 18,000 foreign nationals had fought or are fighting on the Russian side. Almost 3,400 have been killed, and hundreds of citizens of 40 countries are held in Ukraine as POWs.

If true, that represents a fraction of the 700,000 troops that Putin said are fighting for Russia in Ukraine.

Using foreigners is only one way to meet the constant demand, said Artyom Klyga, head of the legal department at the Movement of Conscientious Objectors, noting Russian recruitment efforts appear to be stable. Most of those seeking help from the group, which assists men in avoiding military service, are Russian citizens, he said.

Kateryna Stepanenko, a Russia researcher at the Washington-based Institute for the Study of War, said the Kremlin has gotten more “creative” in the last two years with attracting enlistees, including foreigners.

But recruitment efforts are becoming “extremely expensive” for Russia, which faces a slowing economy, she added.

—

Associated Press writers Gerald Imray in Cape Town, South Africa, and Qassim Abdul-Zahra in Baghdad contributed.

FILE - People walk past an army recruiting billboard with the words "Military service under contract in the armed forces," in St. Petersburg, Russia, March 24, 2023. (AP Photo, File)

FILE - Recruits carry their gear at a military recruitment center in Rostov-on-Don, Russia, Oct. 31, 2022. (AP Photo, File)

FILE- Recruits carry ammunition during training at a firing range in the Rostov-on-Don region of southern Russia, Tuesday, Oct. 4, 2022. (AP Photo, File)

FILE - A street performer walks past a patriotic billboard showing a Russian serviceman and the slogan "The Motherland that we defend" in St. Petersburg, Russia, March 14, 2023. (AP Photo, File)

FILE - Russian recruits take a train at a railway station in Prudboi in the Volgograd region of Russia, Sept. 29, 2022. (AP Photo, File)

CREIGHTON, Neb. (AP) — Rick and Jane Saint John chose to live in the small town of Creighton, Nebraska, for one main reason: its hospital.

The couple has a child with nonverbal autism and epilepsy who requires up to three hospital visits a week. And Creighton's critical access hospital has been a lifeline for Jane: not only is she employed there, but three years ago, doctors saved her life when she contracted bacterial pneumonia. If she had waited another day for care, doctors said, her organs would have begun to shut down.

“And if we had had to drive the hour to the Yankton (South Dakota) hospital," Rick Saint John said, his voice breaking with emotion, "it could have cost her her life.”

So the Saint Johns were shocked to hear that Avera Creighton Hospital faces financial peril. A $50 billion government fund meant to transform rural health care will do little to help. It's a problem that millions of Americans in rural areas are awakening to as they realize there's no windfall coming for the vulnerable hospitals near their homes.

Hundreds of rural hospitals across the country are facing closures after years of funding problems. The issue was compounded last summer by the Trump administration's massive cuts to Medicaid, the government's safety net for low-income Americans, whose reimbursements have long helped hospitals meet their bottom lines.

Outcry over the funding cuts prompted Republican lawmakers to create $50 billion in new rural health grants, but critics say that funding is intended for innovative health care delivery solutions — not propping up hospitals buckling under current pressures.

“It won’t pay to keep the lights on. And it won’t turn the lights back on once they’ve been turned off,” said Dr. Ben Young, an infectious disease specialist and policy expert with public health advocacy group Wellness Equity Alliance.

Rural Americans’ health care worries reflect broader national concerns about access and rising prices of care as the cost of living spikes — anxieties that could prove pivotal in this year’s midterm elections.

The $50 billion Rural Health Transformation Program included in President Donald Trump's tax-and-spending law last year was billed by Republicans as a way to help hospitals in rural areas. Last summer, Health Secretary Robert F. Kennedy Jr. touted it as the “biggest infusion in history” for rural hospitals and pledged it will “restore and revitalize these communities.”

Hospitals and health industry experts have warned that while the fund — $10 billion per year allocated across all states for five years — offers some support to struggling rural hospitals, it won’t save them. One reason is that the sum doesn't come close to offsetting the $137 billion that rural hospitals expect to lose over the next decade, according to health research nonprofit KFF. Millions of people are expected to lose Medicaid benefits as a result of new Medicaid work requirements going into effect in 2027 — changes the Trump administration has maintained will crack down on fraudsters rather than cut off eligible enrollees.

Administrators say the new $50 billion fund is not meant to shore up ailing rural hospitals or maintain the status quo, but to transform rural health care through tech, workforce and other innovations. Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz in a December video said it “gives states the tools to design solutions that last, not Band-Aids that fail.”

The White House echoed that Wednesday, saying the fund is intended to fund “big ideas” to improve rural health care access long-term.

“Decades of mismanagement by career politicians in Washington have left rural communities with limited care options," White House spokesman Kush Desai said.

State applications show a wide range of proposals. Some pitches sought to improve emergency medical services and modernize rural facilities, while others looked to make school lunches healthier, expand physical fitness programs, beef up telehealth and expand AI-driven technologies to help monitor patients.

Avera Creighton Hospital CEO Theresa Guenther argues her hospital is not in danger of closing. but conceded that Medicaid cuts will be painful — a sentiment shared by most rural hospitals, she said.

“Medicaid cuts will have an impact to us, and we — as well as many others — will have to figure out what that looks like moving forward,” she said. Her hospital hopes to get a piece of the $50 billion fund to help manage patients' chronic diseases — like diabetes — and to help cover workforce costs.

Nebraska, which received $218 million for the rural health grants' first installment, plans to spend some $90 million on healthier food options at schools, recruiting more health care workers and mobile sensors to remotely monitor chronically ill patients in rural areas, among other things. But for rural critical access hospitals at risk of closing, it offers $10 million to “right size” them by getting rid of inpatient care, where bed occupancy is typically low.

Republican state Sen. Barry DeKay said hospitals like Creighton's are vital, despite it's low occupancy rate. The hospital is in his district; even his mother received life-extending care there following a hip replacement. He's worried that the Medicaid cuts could hurt all the state's rural hospitals.

“I'll try to be working as hard as I can to get as much money to rural hospitals — whether it's in my district or any other rural district in the state,” he said.

Rick Saint John acknowledged he knows little about how Nebraska will use the federal funds, but he thinks it should go to helping hospitals like Creighton’s remain intact.

“The hospital is very important to this community, and for more than just medical care,” he said, citing job losses if the hospital loses services or closes.

The fund has seen pushback from hospital groups over an issue that's shaping up as important for 2026 voters.

The Colorado Hospital Association sent a letter in December to state lawmakers accusing them of ignoring input from rural hospitals during the application process.

The Nebraska Hospital Association, which endorsed Republican U.S. Sen. Deb Fischer’s 2024 reelection bid based on her advocacy for rural health care, has criticized both the cuts and the $50 billion fund. Fischer voted last summer for the Medicaid cuts.

That and other efforts by the state to limit Medicaid spending sends a message “that access to health care is not a priority," the group said.

Some Republican state lawmakers across the country have expressed unease with parts of the fund and have sought ways to use it to help struggling rural hospitals.

Under pressure, some rural states are making their own moves to help.

Wyoming enacted a law allowing rural hospitals to file Chapter 9 bankruptcy, normally reserved for financially stressed cities to reorganize debts and repay creditors while protecting them from legal action.

In North Dakota, during a special session to allocate the state’s federal rural health funds, the Republican-led Legislature passed an unrelated bill that aims to rescue a rural hospital with a low-interest loan of up to $5 million administered through the state-owned bank.

It's hoped the plan will keep the hospital open in a vast rural area where it employs 5% of the surrounding county's residents, hospital board member Matt Hager said.

Young, the expert with Wellness Equity Alliance, sees dark days ahead for rural hospitals.

“I am not optimistic in the short term,” he said. “Because these hospitals are facing immediate financial shortfalls, are barely financially operating currently, and they need operating support now.”

Swenson reported from New York. Associated Press writer Jack Dura contributed to this report from Bismarck, North Dakota.

Avera Creighton Hospital CEO Theresa Guenther is seen in her office, Feb. 24, 2026, in Creighton, Neb. (AP Photo/Margery A. Beck)

Nebraska State Sen. Barry DeKay, R-Niobrara, is seen on the floor of the Nebraska State Capitol, Feb. 5, 2026, in Lincoln, Neb. (AP Photo/Margery A. Beck)

Jane and Rick Saint John hold hands on Feb. 24, 2026, as they recall how Jane received life-saving care three years ago at Avera Creighton Hospital, in rural Creighton, Neb. (AP Photo/Margery A. Beck)

Jane and Rick Saint John discuss how important their local hospital, Avera Creighton Hospital, is in their rural community, Feb. 24, 2026, in Creighton, Neb. (AP Photo/Margery A. Beck)

Avera Creighton Hospital is seen on Feb. 24, 2026, in Creighton, Neb. (AP Photo/Margery A. Beck)