Vascular surgeon Dr. Dmytro, left, works with surgeon Dr. Vitaliy and Dr. Mykola on a patient with abdominal injuries in a hospital where military are treated on October 7, 2022, in Donetsk District, Ukraine.

Vascular surgeon Dr. Dmytro, left, works with surgeon Dr. Vitaliy and Dr. Mykola on a patient with abdominal injuries in a hospital where military are treated on October 7, 2022, in Donetsk District, Ukraine. Paula Bronstein/Getty Images

US Medics Must Learn from Ukraine’s Harsher War, Report Says

Russia’s artillery and jammers make battlefield medicine harder and more dangerous than in Afghanistan and Iraq.

Dima, a Ukrainian mortician-turned-medic, knows all too well how dangerous medical evacuations can be. Speaking to Defense One near Kherson last November, he described how Russian tanks once fired on his ambulance, sending shrapnel through its thin sides.

Dima’s experience is far from unusual, according to a new report that describes the experience of frontline Ukrainian special forces surgeons. Published in the Journal of the American College of Surgeons, it says the U.S. should get ready for wars defined by artillery, not the homemade bombs seen in Afghanistan.

“If you look at what the next war is gonna be, every incident is going to be a mass-casualty incident,” Aaron Epstein, a doctor and president of the group that produced the report, said in an interview. 

The U.S. military’s medical community needs to figure out, among other things, how to treat casualties amid ever-more-accurate artillery strikes, how to deal with electronic jamming, and how to ward off attacks on medical vehicles, the report said.

The organization behind the report, Global Surgical and Medical Support Group, has worked in Ukraine since the beginning of the war, training Ukrainian soldiers and providing medical support. It is primarily staffed by former U.S. military medical personnel, including many former U.S. special operations forces combat medics. 

The organization coordinates with both Ukrainian special forces and U.S. Special Operations Command in Europe, Epstein said, although they do not carry out Defense Department tasks. The report’s authors interviewed Ukrainian special forces surgeons and those working for Ukrainian military intelligence, who, despite their specialty, treat all branches of the Ukrainian land forces. 

Ukrainian surgeons who contributed to the report said artillery and rockets caused 70 percent of wounds and deaths. Anti-tank guided missiles are also a major threat; the report cites a Ukrainian source as saying that strikes on unarmored or lightly armored vehicles typically killed 70 percent of those inside. 

Compared to the improvised explosive devices the U.S. faced in Afghanistan and Iraq, these weapons can also be radically more deadly. One Russian thermobaric weapon killed 12 people immediately within 65 feet of the impact point, while another person 200 feet away suffered burns over 80 percent of their body and subsequently died. 

The high numbers of wounded means that Ukrainian surgeons must work round the clock to help them, the report said. One surgeon interviewed said they treated 200 patients in a week while under bombardment, or around 28 patients a day.  

Ukrainian body armor and helmets appeared helpful in preventing injuries, but the lack of full-torso protection was a problem. Around 60 percent of wounds occurred in soldiers’ sides, between their front and rear body armor plates; and 30 percent occurred below them, the report said. Ten percent of those injured either had projectiles pierce their armor or were not wearing armor. 

Surgeons found it challenging to treat soldiers hit by artillery fire because they often suffer multiple types of injuries, such as life-threatening wounds, blunt-force trauma from being thrown, and traumatic brain injuries. 

Russia’s targeting of medical personnel and facilities further complicates the task. Surgeons typically have no warning about incoming patients, as neither frontline units nor the surgeons have encrypted communications that can withstand jamming or elude surveillance. 

For months, Epstein said, his organization had been telling the U.S. military about Ukrainian surgeons’ requests for more communications equipment. He was told that the communications equipment recently sent in U.S. military aid packages in April may go to the surgeons his organization supports. 

Medical centers are so fearful of being targeted by Russia that they may not use electrical generators, whose warmth Russia can see through the use of thermal vision. That means that, despite the high need for blood transfusions, Ukrainian surgeons cannot store supplies of blood in refrigerators or warm up freeze-dried blood. 

Another alternative, the “walking blood bank,” in which soldiers with universally-usable blood provide their own blood, isn’t feasible in Ukraine, the surgeons added, due to the high rate of casualties. 

Russian targeting of medical staff on the road, meanwhile, means that surgeons can’t immediately evacuate wounded patients. Medical evacuation by air is too risky, and roads out of combat may be under fire for days at time. 

These conditions, the report argues, suggest that U.S. medical personnel must prepare to treat more casualties closer to the frontline and protect them for longer periods of time, potentially even buying rapid tunneling machines that could help protect medical points. 

Epstein said the U.S. government had yet to formally reach out to his organization about the report, although he has heard from U.S. special operations forces surgeons that they are widely sharing it. 

“We need to learn the lessons now, because this is a new form of warfare,” Epstein said. “There’s no time for that learning curve in the next war.”

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.