Medicine at the Front Line: Inside Warzone Medical Center

Medical care at the front is a key component of combat operations. Assistance, rapid evacuation, stabilization and treatment can all be lifesaving for wounded soldiers, increasing their chances of returning to duty and enhancing the unit’s combat capability.

The Armed Forces of Ukraine (AFU) has been operating advanced military medical systems for almost a decade. Unlike the Russian army, which often abandons its wounded or executes them on the battlefield, Ukrainian combat medics fight for every life. Their incredible success frequently surpasses that of rear hospitals located far from the front line.

Stabilization points play a critical role in frontline medicine. These are the facilities to which wounded soldiers are first brought from the battlefield. Situated just a few kilometers from active fighting, they operate like an emergency department. Here, a wounded person’s condition is stabilized, first aid is administered, and critical decisions are made about their next destination.

Kyiv Post visited one of the most dangerous areas – Toretsk in the Donbas – to observe the work of the Azov Brigade’s stabilization point.

“You say to the wounded soldier, ‘Sunny, everything is fine. We’ll remove the tourniquet, insert the catheter, measure your blood pressure – you just need to lie on your side.’ You talk to him because, until you do that, he won’t calm down,” says Olha, an anesthesiologist at the facility. Olha receives the wounded and initiates necessary procedures.

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Modern and equipped

The Azov stabilization point is essentially a fully equipped hospital. Established from scratch, it includes a large hall capable of handling three critically injured soldiers simultaneously. In addition to a full range of medication, the facility has blood supplies of all types, plasma, ultrasound equipment to assess internal organs, and X-ray machines.

“If the injuries are less severe, we handle them quickly. We prioritize the patients – first the critically injured, [then] the less severe cases.

“We perform vascular ligation, catheter placement, blood transfusions if necessary, and treat hemorrhagic shock. We are fully equipped to handle such cases,” Olha explains.

She demonstrates not only the available equipment but also explains the specifics of the team’s activities. There are times when multiple wounded soldiers arrive simultaneously, making it crucial to identify the most critical cases quickly. Then begins what they call “work.”

“On one day, I treated a maximum of 36 soldiers. Most often, injuries come from drone attacks. These are not metallic fragments but aluminum, causing minor to severe limb injuries. The mild cases involve superficial skin wounds, while the severe cases involve significant damage, such as grenade injuries that tear through bones and muscles. We also deal with remote mining incidents where soldiers step on anti-personnel mines. Unfortunately, these often lead to loss of limbs. And there’s an increase in injuries caused by chemical weapons. These don’t cause visible injuries but result in respiratory tract damage. When combined with other wounds, they complicate the assessment and delay evacuation,” Olha says.

Before the full-scale invasion, Olha was a highly qualified medic working at one of Kyiv’s largest private clinics. To her surprise, some of her colleagues did not support her decision to mobilize and serve as a combat medic. Despite the moral and emotional challenges, she says she couldn’t have chosen differently.

“I couldn’t stand by and do nothing. It’s a completely different life with different values. It’s tough when you treat a soldier and then see a photo of him online – a young, handsome man with a wife and family announcing his death. Or when a medic you recently spoke to is killed in action, their body unrecoverable due to a direct hit.

“You talk to a wounded soldier, knowing his leg will soon be amputated. He might be conscious, drinking water, or showing memes on his phone, but his leg can’t be saved. If the tourniquet stays on too long, it could lead to kidney failure and death. The only option is to amputate,” Olha explains.

Fast thinking and innovative solutions

During our visit to the stabilization point, a soldier arrives with a shrapnel wound to his leg. Despite the pain and shock, he remains composed and lies down on the table.

The doctors quickly assess the injury, apply local anesthetic, and locate the shrapnel first manually and then with an X-ray. They debate whether it’s aluminum from a drone or steel from a mine. Once identified, the operation begins, proceeding swiftly.

“We found the shrapnel on the X-ray. It’s relatively large but not very deep, so we could remove it quickly. Using the X-ray, we pinpointed its location and extracted it with a magnet,” explains surgeon Volodymyr, showing the X-ray image.

Volodymyr is a civilian doctor, mobilized six months ago. He says his time at the front has greatly enhanced his skills as a surgeon.

“Military surgery doesn’t change the fundamentals, but the organization is completely different. Comprehensive care isn’t provided here – combat injuries are treated in stages. Improving your knowledge in military surgery requires a shift in perspective from civilian practice. Thankfully, our brigade understands the value of trained specialists,” he says.

To streamline their work, the medics have devised innovative solutions, such as a rope with tools hanging above the operating table.

“It’s practical. You need to cut off a wounded soldier’s clothing quickly, then toss the scissors aside,” Olha demonstrates.

“The most difficult moments are when you can’t save a life. Every operation aims to preserve life and health, but when it’s impossible, that’s the hardest part,” Volodymyr explains.

However, today is a good day. The soldiers treated here survived. Perhaps it’s because today is Christmas.

In the next room, the stabilization station’s chef, who goes by the call sign “Owl,” is preparing Christmas dinner.

Owl takes pride in feeding recovering soldiers. “There’s no set menu. We have breakfast, lunch, and dinner. Today, it’s homemade dumplings and borscht,” Owl says, rolling out dough.

For Christmas, Owl sets a proper festive table. It features traditional Ukrainian kutya, dumplings with mushroom gravy, salads, potatoes, meat with cheese, and uzvar made from dried pears and apples.

The recently treated soldier is the first to sit down and taste the dishes. Soon, he will be transferred to a rear hospital.

“They usually ask for sweets, so I always try to bake something for them,” Owl smiles.

When no new patients arrive, the team gathers for dinner. Sharing food, jokes, and smiles, they resemble a close-knit family. During their six-day shifts, they also train in a mini-gym to stay in shape.

“The war has been going on for 10 years. What’s there to fear? I’m not afraid. I have my boys and girls – my team. What’s there to be afraid of?” says Olha.

You can find the video version here.