Risking their lives, teams of medics help wounded civilians and military personnel on the front line.
Minutes separated them from the end of the day. 45-year-old Olena and her husband, 44-year-old Artur, were standing in the yard in front of their house. They never went to bed early. She stood close to the garage and he was a little farther away. It is possible that she went to the outhouse–because there has been no running water in Slovyansk since the end of June–and he was standing watch for her. It is also possible that they were simply listening to the sounds of the evening, punctuated by the explosions of artillery shells that fell on their city from time to time. Before the Russian invasion on February 24, 110,000 people lived in Slovyansk, one of the largest cities in the Ukrainian part of Donbas. Now less than a fifth are left here.
Olena’s mother, 68-year-old Oleksandra, with short hair and a cheerful face, was slowly falling asleep. She has been living with her daughter and son-in-law for two months, because the front was rapidly approaching the village where she lived. Although Oleksandra is hard of hearing, the barrage clearly reached her ears. She leaned out the window and looked out.
“Why did you get up?” Olena asked. “If there’s a healthy wallop, I’ll call you.”
Oleksandra went back to bed. At that moment, something hit so hard that she jumped to her feet. It seemed to her that Olena was not responding, but she put it down to her bad hearing. She started calling for her daughter and son-in-law. Silence. She went out in front of the house. The shell landed right in front of the building, the shockwave tore apart the garage, outhouse, and fence. The force of the explosion also severed the power line, so the electricity went out. If it hadn’t been for the garage and the recently purchased car in it, there would have been complete darkness. Ruins lay where Olena had stood before. Oleksandra saw only her son-in-law, who was lying on the ground.
When 65-year-old Serhiy, their neighbor, heard the explosion, he knew that this time it was something serious. It was the third time in the last few days that something had landed near their house. Usually, however, fragments fell that made a few holes. He was at home with his wife, who was more than two decades his junior, and their 12-year-old son. He went outside to see what happened. He heard his neighbor’s calls. He immediately headed towards the house where Oleksandra lived.
Meanwhile, fire was approaching a prone Artur. He felt heat, and was afraid that he would burn alive. Serhiy pulled him away from the fire. Artur hissed in pain because he was injured; mainly his hand, although the leg, from which a piece of flesh had been torn out, looked the worst.
“Hang in there,” Serhiy told his neighbor as he dragged him to safety.
Then he asked, “Where is Lena?”
The mother did not know what happened to her daughter either. Serhiy thought that she had been torn apart. Finally, Oleksandra spotted a piece of her daughter’s dressing gown. She started screaming that Olena was under the rubble.
A typical rescue operation
At that time, the rescue team of the Pirogov First Volunteer Mobile Hospital (PFVMH) was a few kilometers away. Paramedics, doctors, a nurse, drivers and security were hiding in a building with thick walls. They had bulletproof vests on their torsos and helmets on their heads. A shot, a short pause, an explosion–this sequence was repeated many times. Everyone seemed calm. Some were maybe too eager to mask their emotions. Someone cracked a joke, another was trying to dance to music from their phone, while others talked about trivial matters.
Most of them have been in Donbas for a short time—so far they have not had any close contact with the war. Like the 23-year-old doctor Yaroslav, who lives in Kyiv, or the 34-year-old paramedic nicknamed “Kokos,” who comes from the city of Sumy. Their monthly rotation began in late June.
They received a call by walkie-talkie for doctors to come to the hospital immediately. Yaroslav and a security escort left the building in a hurry.
At that time, Olena—found under the rubble and in the most serious condition—was the first to be taken to the hospital by rescuers. She had numerous wounds all over her body, including a skull fracture. Doctors treated her wounds and applied bandages. Olena was having trouble breathing, so they placed an endotracheal tube in her windpipe.
At the time that Yaroslav was taking care of her, rescuers brought Artur to the hospital. He was better. He had lost a lot of blood but was able to breathe on his own. Both were in serious but stable condition.
At the hospital, Yaroslav worked for about an hour and a half. After doing what they could at the hospital, they called Kokos and his ambulance crew. They transported the two wounded from Slovyansk to Kramatorsk, the temporary capital of the Donetsk region, where the hospital is better equipped. There, the couple was to undergo operations.
Scurry like a squirrel
As a paramedic, Kokos previously had a lot of work in his hometown of Sumy—256,000 people lived in this city, located in the north of Ukraine, until February 24. Sumy became one of the first targets of the large-scale Russian invasion; heavy fighting took place in the city and the oblast. Until the Russians withdrew from those territories—unable to achieve decisive successes—health professionals had their hands full.
When his region became relatively safe, Kokos decided to go east. “It’s quiet there, so my hands and head are more useful here,” he says.
He joined the PFVMH. Five days later, he was already in Slovyansk, where he is a rescuer and commander of the current rotation. At first he flinched at every bang. Now he doesn’t stop his work even when there are loud explosions. He claims that in stressful situations his hands listen to him better. While the PFVMH team waited out the shelling, he sorted the medicine as if it were blissfully quiet.
His ambulance team is working in one of the most sensitive sections of the front. The procedure is this: they pick up the wounded just outside the combat zone and from there take them to the hospital. Depending on the patient’s condition, they decide whether to choose a hospital that is nearby, or more distant but better equipped. In the meantime, they try to render as much aid as they can before handing over the injured to doctors.
“Unlike civilian life, you don’t have much time to examine the wounded here. In addition, you do everything in the ambulance, on the road, at full speed, going around corners and with sudden braking,” explains Kokos. “In civil rescue, the principle is to do everything to save both life and limb. In battlefield rescue, the priority is life. You don’t worry about burning the wound because your goal is to stop the bleeding.”
Kokos recalls how one evening they were called to the evacuation point by the front line. Six ambulances left, though it turned out that there was not enough space in them anyway. Two military paramedics took turns pulling out eight wounded soldiers and stuffing them into their car. Some of the wounded screamed in pain, some bled silently, while others were unconscious. There was chaos in the darkness, punctuated by the sharp beams of flashlights.
“I asked the paramedics who brought them who we should take first, and they replied that they had to think,” says Kokos. “They did so much work on their way to us at the evacuation point that they no longer remembered what ailed who. They had to scurry like squirrels.”
Support from Namysłów
PFVMH sent out its first rescue team at the end of 2014, a few months after the outbreak of the war in Donbas, which has resulted in the deaths of over 13,000 people over several years. However, the beginnings of PFVMH date back to the anti-government protests in Kyiv’s Maidan—demonstrators formed medical brigades there to save the wounded. Since the beginning of hostilities in 2014, they have sent several dozen rotations to the front and now, since February 24, three more.
PFVMH is a voluntary, unpaid organization. “We work for a ‘thank you’ and nothing else is needed. It’s good to know that you got a boy to the hospital alive. His words, smile and his life are most important. They protect our families and do not let the Russians reach our homes,” says Kokos.
PFVMH does not receive equipment from the state. All equipment comes from donations, thanks to help from home and abroad. In Ukraine, it is difficult to find equipment for tactical rescue, because the needs are huge and all store supplies have been bought out. Therefore, many medicines can be obtained thanks to support from abroad, e.g. from Poland, Germany, Italy and the United States.
Friends of Kokos from Poland also help. He lived in the town of Namysłów for five years, where he first worked in a factory, then became a truck driver and traveled all over the European Union. He is still in touch with his Polish friends and they support him as much as they can: they collect money, buy what is needed, and send it to Ukraine. Kokos would like to send his wife and two children to Namysłów, with which he feels connected, until the situation in Ukraine calms down.
“Without this help, we would have nothing,” he says.
The consumption of medical materials is very high, the PFVMH warehouses are constantly short of the necessities: decent tourniquets that stop bleeding (many of the ones they received—bought in good faith—were useless, falling apart in their hands), homeostatic dressings, Israeli bandages (i.e. tactical bandages), needles for decompression of the pneumothorax, occlusive dressings (they work by closely adhering to the wound, which causes it to close; they often also contain hydrogel). That is, all the resources that are needed to provide first aid to an injured person, especially to stop bleeding.
The need to constantly repair ambulances is also a challenge; due to work in wartime conditions and poor roads, they quickly wear out or even get damaged due to shelling or accidents.
Too quiet to sleep
Yaroslav was 15 years old when Russia unleashed the war in Donbas. He could not have expected then that one day he would end up where it all began.
In the spring of 2014, Slovyansk was the first city that fell into the hands of the separatists and—as we know today—the Russian special forces supporting them. A small city that few people had heard of has attracted the attention of the whole world. Today, eight years later, Russian troops are approaching it and, as analysts predict, Slovyansk may soon become the target of their direct attack (it has been the target of shelling and airstrikes for a long time).
Yaroslav thought for a long time about whether to go to Donbas. When the Russians left Kyiv, he decided that he would be more useful in Slovyansk than at home. He waited until he received his degree, and two weeks later he was in Slovyansk. He performs the functions of an internist, orthopedist and, if necessary, a senior operating nurse.
He had not undergone military service before, so everything was new to him at the front in Donbas. He dug a trench for the first time in his life. But he operates according to the assumption that it’s better to have such experience, even if it will be of no use to him later.
“It’s hard to get used to war, but it’s scary how quickly the sense of fear, the survival instinct, dulls. As a result, you ignore anti-aircraft alarms or explosions,” says Yaroslav, and the background of our conversation confirms his words, because artillery strikes from time to time somewhere in the distance. “We joke that when we get home it will be too quiet to sleep,” he adds.
Yaroslav got engaged prior to February 24. He thought about moving the wedding, but after arriving in Slovyansk, he decided that it’s better not to delay, because anything could happen. He immediately told his partner where he was going. But he lied to his parents, saying that he was going to Pavlohrad in the Dnipropetrovsk Oblast, which is adjacent to Donetsk.
But his parents recently caught him. They asked for a photo from outside the hospital. He sent one to them, and they used the internet to find out that this is not the building that their son told them about. To this day, they are furious with him for going away to a dangerous place and, worse yet, as a volunteer.
A difficult morning
An hour and a half later, Yaroslav returned to the base. The doctors did everything they could for the injured couple: Olena and Artur were in serious but stable condition (she was worse off). PFVMH rescuers transported them to Kramatorsk.
In the morning, Oleksandra waited for information about her daughter and son-in-law, clutching the phone in her hand. She didn’t care about the ruins in front of the house, or the burnt-out car. She didn’t even see the neighbors who were sweeping broken glass from the windows, she didn’t see the pockmarked facades of buildings and broken cables that electricians stubbornly tried to fix as if nothing had happened. She was worried only about the health of the children. At every mention of them, she burst into tears and looked at the bloodstain that remained where Arthur had been laying.
Serhiy and other neighbors came to help make a makeshift fence out of bent and perforated sheet metal in front of the house where Oleksandra found precarious shelter.
When I was finishing this text, Olena was fighting for her life in the hospital. Arthur’s condition was deteriorating rapidly. The doctors at the hospital in Kramatorsk decided to transport him to Dnipro—the main medical base, where there are more specialists. Artur died on the way.