To save lives, Ukrainian combat medics must stay alive.
So, deep in a position soldiers call “the black forest” in eastern Ukraine, the medical corps of the 63rd Mechanized Brigade tries to stay hidden. The zero line – where Russian and Ukrainian forces face each other in trench lines, within sight of each other – is only a mile or two apart.
The iconic red cross painted on the side of the team’s armored vehicle offers little protection against enemy fire. In fact, soldiers say, it makes them a target. They carefully camouflage the vehicle until it is needed – which is often the case these days as Russian forces increase waves of assaults.
The vehicle is located at the combat medical post, an essential link in the chain of care for wounded soldiers on the front. This is often the first stop before being sent to stabilization points further from the fighting, and then to advanced medical centers where more complex procedures, such as amputations, are performed.
Combat outpost medics provide basic trauma care, including setting bones, applying tourniquets, administer painkillers and, in some places, perform blood transfusions.
Physicians’ lives revolve around routine.
“There are only two options: either you are on duty or you are resting,” said Lieutenant Andriy, a 27-year-old dentist mobilized in the summer of 2022 and now the brigade’s chief doctor. Like other service members, he asked that his last name not be used in accordance with military protocol.
“You wake up in the morning, get ready and go,” he said. “Without thinking too much.”
As he spoke, an urgent message sounded over the radio.
“Two men on the ground. “Fly away.”
It was time to go. Vasyl, the driver on duty, looked up into the sky, searching for a Russian plane.
“Right now there are so many drones and suicide bombers,” he said. “They are chasing us.”
Fortunately for them, the clouds were low and heavy, limiting the range of vision.
Vasyl pulled the armored vehicle out of the bushes, the soldiers checked their equipment and left.
They didn’t know it while they were driving, but it wasn’t a rescue mission. The two Ukrainian soldiers died on the spot. Once arrived, the team could only wrap the bodies in black plastic bags and take them away.
“The best experience is saving a seriously injured soldier,” said Lt. Andriy. “And the worst is when you can’t help.”
“I can’t call it routine,” said Lieutenant Andriy. “It’s our duty. But you can’t get used to people’s pain.”
It can be difficult to gauge the scale and intensity of Ukraine’s war – which has ebbed and flowed over two years but rarely abated. Combat medics and their teams often see the worst.
“You can’t describe it in words,” Vasyl said.
A train driver before the war, he volunteered three days after the start of the full-scale Russian invasion in February 2022. Since spending 45 days in Bakhmut before it fell to the Russian forces, nothing really shocks him anymore.
“Arms and legs, body parts,” he said, trying to describe what he had seen. “I felt hatred towards the Russians. I was raised patriotic. I love Ukraine. I was ready to defend him. And that’s what’s happening now.
As the weapons used to kill have evolved from swords and muskets to explosive drones and thermobaric bombs, soldiers are dying as they have for centuries.
They are bleeding. Organ failure. Trauma makes it impossible to breathe. Time becomes the enemy.
Stabilization medics operate in what the U.S. military calls “the golden hour” – the period when a life is saved or lost. Just walking the short distance from their bunker to the zero line and back can take 30 minutes to an hour, often under devastating bombardment, Lt. Andriy said.
“Once, when we were leaving for a night evacuation, we accidentally headed towards the Russian positions,” Lieutenant Andriy said.
Russian is commonly spoken by Ukrainian soldiers, and they did not immediately realize they were in enemy territory.
“We asked them if they had any injuries,” he said. “They said they had their own transportation. We asked them to decide quickly if they needed help, as we had to leave. They started to surround our vehicle. “We knew something was wrong.”
The Ukrainians jumped into their vehicle and fled.
“The Russians were shooting at us,” he said. “But we managed to leave and even found our wounded soldiers who we had to evacuate.”
The Ukrainian military does not release detailed casualty information or statistics on wounded recovery, but about 70 percent of all Ukrainian combat deaths and injuries result from Russian artillery and rocket barrages, according to the Global Surgical and Medical Support Group, an American organization. non-governmental organization. The group has provided surgical support to Ukraine since Russia’s full-scale invasion began almost two years ago.
Sometimes the fighting is so fierce that medics cannot reach the front line to evacuate the wounded. They will wait to hear if they are needed elsewhere, then cross bumpy roads to load wounded soldiers into armored vehicles, treating head wounds and other injuries as they return to a stabilization point.
Electronic jamming and eavesdropping make it difficult to communicate the nature of injuries on the battlefield. According to Ukrainian doctors and the United Nations, Russia has repeatedly targeted medical facilities. Field hospitals must therefore be both hidden and located further from the front. Evacuation by air is impossible given the density of air defense near the front.
The treatment of wounded soldiers is also complicated by structural problems inherited from the Soviet system: poor management, lack of qualified instructors, tensions between field medics and general staff command, and dependence on volunteers to buy most of the wounded soldiers. supplies.
In November, President Volodymyr Zelensky fired medical force commander Tetyana Ostashchenko, replacing her with Anatoliy Kazmirchuk, director of a military hospital in kyiv.
“A fundamentally new level of medical support for our military is needed,” Mr. Zelensky said when announcing the change. “From high-quality tourniquets to full digitalization and transparency of supplies, from high-quality training to honest communication with combat medics of units that operate correctly and efficiently.”
Lt. Andriy said he was sometimes surprised by how much his team could accomplish given the circumstances.
“No matter how exhausted we are, we know what we are fighting for,” he said. “We are fighting for our homeland. Our families and our children are behind us. “They would like to live in peace, to prosper, to be happy. »
“We will stay as long as necessary,” he said.
