The Ukrainian Armed Forces will transform their medical department into a stand-alone service branch, a move aimed at bringing military medicine into line with NATO benchmarks.
Under this new model, all of the military’s medical services will be subordinated to a unified control center with a single universal chain of command. The reform will also grant military medics relief from bureaucratic duties that distract them from saving soldiers’ lives, Ukraine’s top military doctor, Col. Ihor Khomenko, said during an April 6 briefing at the Defense Ministry.
In creating the plan to restructure military medicine, Ukraine took particular inspiration from Germany’s Bundeswehr.
“After studying the medical services of many of our allies, and by consulting our U.S., Canadian, and German advisors, we decided to adopt the Bundeswehr model in all of its basic principles,” Khomenko said. “We must complete the NATO reform by late 2020, so we opted to choose the German recipe while time is very short for us.”
However, the reform has required breaking free of the old practices. The first important step was to eliminate webs of Soviet-style command and control echelons with complicated and often conflicting authorities over the army’s medical service.
Before 2018, Ukraine had two separate top-level medical service departments, one under the Defense Ministry and one under the Armed Forces. In early January, both agencies were disbanded and a new unified Chief Military Medicine Department was formed to ensure a universal chain of command.
In the future, following the Bundeswehr model, the military medical services will cease to be loosely scattered between different military formations and will instead assume the authorities and functions of a separate branch of the service, Khomenko said.
Another important challenge was sorting through the complicated process of appointing military doctors to army units — and particularly to combat forces deployed to the war zone in the Donbas.
In the current system, it can take as long as nine years to train a military surgeon, therapist, or anesthesiologist before he or she can receive an appointment to a medical company within a military unit, Khomenko explained.
However, in most cases, medical companies attached to combat units simply don’t have any surgical wards or shock rooms. In fact, they are not even supposed to have such complex equipment immediately in combat zones.
“As a result, high-profile medical specialists have to serve as general practice doctors in combat units,” the colonel explained. “There were many occasions when, for instance, extensively-trained military surgeons were rendering first aid to the wounded as battlefield medics.”
“Without the opportunity to work in their specialties, military doctors simply lose their skills.”
To resolve these problems, the top medical command called for the abolition of the post of medical company surgeon in army brigades’ staff structures.
“Military doctors will work in mobile hospitals, medical reinforcement groups, and forward surgical teams,” Khomenko said. “We will have a system that is common for the United States or Germany, when a combat brigade that enters the war zone is attached to a medical team with an appropriate set of equipment and specialists.”
Now, combat formations will include appropriately trained general practice doctors and battlefield medics to take care of soldiers and officers on a regular basis, and to deliver first aid, evacuate, and stabilize those who are wounded in action before sending them on to hospitals outside combat zones.
Since 2014, the Defense Ministry has introduced new medical positions for the army’s combat formations, such as squad combat medic and senior company combat medic. The military command also lifted a formal ban on female medical instructors at training camps.
“Everyone will do what they were trained to do,” Khomenko said.
Currently, Ukraine’s Armed Forces deploy a tight network of medical units to the Donbas war zone, including four large mobile military hospitals, along with more than 10 forward surgical teams in the region’s largest cities.
According to the military, the death toll among wounded soldiers has fallen considerably in the past few years thanks to this.
Immediately after the start of Russia’s war in the Donbas, only two out of four heavily injured soldiers would make it to hospitals in the city of Kharkiv alive after a six- to eight-hour medical evacuation, Khomenko said.
Today, however, up to 80 percent of the wounded soldiers are successfully taken to military hospitals in what is termed the “first golden hour,” when the chances of saving a soldier’s life are highest. Thanks to the gradual adoption of NATO best practices, the military managed to decrease the mortality rate of soldiers during medical evacuation to 1.35 percent.
Moreover, up to 93 percent of the wounded or sick eventually return to the ranks of their combat units after successful treatment, Khomenko said.
As of late March 2018, as many as 2,700 Ukrainian servicemen were killed, according to official figures. More 13,000 were wounded in action.
