Our Community

SOFREP readers are some of the finest people I’ve ever met. And  I’ve had the pleasure of meeting quite a few in my time here, especially at places like SHOT show, the NRA convention, and SOF Week. We’re a community. I say “we” because I was a longtime reader way before I ever submitted my first piece to the site.

Our community is the type of people who would give you the shirt off their backs.  One valued member of our community, who I have the pleasure of calling my friend, is over in Ukraine right now. He’s been there for a couple of weeks now. And oh, the stuff he’s seen. Just the other week, as he was taking a walk with his significant other and checking out the damage to a civilian facility, he witnessed no other than the leader of the nation, Vlodymyr Zelensky, silently praying for the dead amongst the rubble.  It must have been a surreal moment.

Men holding supplies
A box full of medical supplies (tourniquets and Israeli bandages) that went on to save numerous lives. These TCCC tourniquets were shipped to Estonia from Canada by a UK connection/vendor. They were then driven in a van from Estonia to Ukraine a month after the full invasion.  Photo courtesy of Lifeline

A Lifeline to Those in Need

Since we can’t use his name, I’ve given him the codename “Lifeline.” This is appropriate because he has been helping to get Ukrainian medical units badly needed supplies since the beginning of the war. With hundreds of thousands of Ukrainian casualties, both military and civilian, you could say treating the injured is rather resource intensive.

I happen to know a thing or two about Medical Operations in a theater of war, as my last military position was as an Army Medical Operations Officer with various units way back in ’03 and ’04. Suffice it to say it can be a bloody and surprisingly dangerous business. “Born to kill, trained to save” is one rather dark motto that comes to mind.

Lifeline and his comrades are definitely in the business of saving lives.  I came up with a list of a few questions I wanted Lifeline to ask Ukrainian combat medics to gauge the level of medical treatment the wounded might be receiving in the field.  Lifeline passed these on to a senior medic who, for the purposes of these articles, I’ll call “Papa.”

Through Lifeline and an interpreter, SOFREP interviewed this man who has endured the invasion of his homeland and 16 straight months of bloody war. What follows are his responses.

destroyed building
A Ukrainian medical facility destroyed by the Russians and then abandoned. Photo by Lifeline.

Papa Speaks

SOFREP: What are the most common injuries that you are seeing in the field? 

Papa: The most common injuries are baro trauma from artillery fire, concussions, and shrapnel injuries of the limbs (Papa specified limbs so I assume the plate armor or flak vests provide adequate torso protection).

SOFREP: Do you feel like you have enough medical supplies to do your job? 

Papa: So I have enough equipment at this stage. (I will explain: assistance to a wounded person consists of two parts, pre-medical (case evac) and medical; assistance in space and time from the impression zone to medical evacuation is pre-medical through case evacuation; the evacuation case ends with the transfer of the injured to medical evacuation. In this case, medical evacuation takes the injured to a stationary aid point. Each stage provides a larger volume and more qualified assistance). Personally, I and my team closes the first two laps of the stage, case evacuation, and medevac; it takes up to 1 hour for 20-30 km driving to STAB point. [Assmuing STAB is short for “stabilization” meaning an area where a casualty is prepped for further evacuation. –GDM]   **Case evacuation is TQ/Bandage and remove from the hot zone, then medevac begins. Casevac is an APC or pickup truck; then they switch to their ambulance, ideally an armored ambulance with medical equipment.

destroyed ambulance
The ambulance that went along with the forward hospital, destroyed as well. Photo courtesy of Lifeline.

SOFREP: Do you have doctors in the field with you? 

Papa: There are no doctors with us for casevac or medivac. (Some doctors are at Stab points).

SOFREP: Do you have any means of aeromedical evacuation?

Papa: We do not have Aero Med evacuation. ***A friend of mine who is a UKR military trainer confirmed that his friend and ranking officer has been successful on a limited basis with performing aeromedical evacuation. Its logistically difficult, lack enough helicopters to spare for this, AA placements make it dangerous. Also notes that O2 concentrators are preferred over O2 bottles due to flammability if shot.

SOFREP: What resources or support do you need the most as a medic in a combat zone? 

Papa: Are there enough supplies? It is never enough! I want many new devices; they expand the quality and speed of assistance. At the same time, thanks to the volunteers (Ukrainian and foreign volunteers), I am provided with everything necessary and to the full extent. Personally, I have everything that should be in the state and even more.

Medical transport
This is what happens when a medical transport vehicle hits a mine intended for a tank. Photo courtesy of Lifeline.

SOFREP: Can you provide a list of additional equipment you’d like to have or that you see your fellow medics need? 

Papa:  I would like good atraumatic scissors, a pelvic tourniquet, an intraosseous access system, good helmet-type headlamp (MPLS Charge 4LED Night Evolution).  [Here are the] 5 most necessary items. The fact is that the items that the soldier has and are necessary for him are complemented by the fittings that are in the backpack of the paramedic.  The backpack itself must be strong and functional. I don’t care what brand of medical bag as long as it is organized, provides good support, and is filled with the equipment I need.

Tourniquet (I personally and our unit are fully provided). We have different manufacturers for our tourniquet. It’s hard to say, as we have CAT, SWAT, and different Chinese ones. Israeli bandage: I personally and our unit are fully provided.    Occlusal sticker, bandages, adhesive dressings. I personally and our unit are fully provided  Tactical scissors of the Leatherman Raptor type (for a paramedic) are quite familiar to the medic. Normal infantrymen use regular shears.

 Other tools used: The combat medic in his work uses a rather narrow list of tools and tools. But it all depends on qualifications and experience. Tourniquet Combat-Application-Tourniquet), bandage (Anping Guardian Medical Equipment), nasopharyngeal tube, occlusive bandage, pear-bag Ambu, Decompression needle ARS Needle Kit, Hydrogel (anti-burn dressings). iTClamp clamp-pinch (clamp wound for hemorrhage control) Many more, our work is similar to the 911 only in combat conditions under fire, without roads….

Good high-quality lights/headlamps are really needed, because there is no light and cannot be turned on….Dudes need night vision devices (goggles), not for hunting or killing, but for driving without headlights on a casevac, searching for wounded, moving under fire at night….to evade artillery barrage.

You need a body camera to capture work, and reports and to figure out mistakes during the work for after-action training (medical or tactical mistakes) in the following…

a van converted to an ambulance
A civilian van converted to use as an ambulance. Photo courtesy of Lifeline.

SOFREP: How are you coping with the emotional/psychological stress of what you see every day?

Papa: Stress and emotional burnout are really a problem; I pray and meditate. I communicate with soldiers; sometimes, they let me go home for a short time….

SOFREP:  Can you confirm reports of Wagner or Russians targeting medics?

Papa: I cannot personally say about the Wagnerians and their hunt for doctors; we knocked them out of our positions in the winter, and they never returned. As for the army of the Russian Federation, yes, it’s true, they are hunting for doctors, we don’t even wear insignia so as not to cause attention, but unfortunately, they see our cars and hunt for them too. As for the death of paramedics, unfortunately, the statistics are very bad. Every 2-3 days, they report the death of a medic, and their combat unit/company is 2 person/medics no more. Normally there should be a maximum of 2 reported medic deaths/causalities per 100 days, not every 2 or 3 days…….[Being] a medic is a very dangerous job as a sniper or machine gunner, and maybe worse….

SOFREP: Do you have any mobile surgical hospitals in the field, or does everyone who requires surgery have to go to a fixed facility?

Papa: The very scheme of mobile surgical hospitals in our country does not work to the extent that people in the civilized world are used to. Russians, first of all fire missiles and bomb these mobile hospitals with airplanes; for them, this is the number one target. We make mobile points in abandoned houses, sheds, just premises that have been standing for a long time and do not arouse suspicion. We work with flashlights and lamps. According to the stages of evacuation, the injured person gets to the surgical table in 1-2 hours from the moment of impact. There are many medical institutions used for treatment… within a reach of 50 km… None of the wounded goes anywhere by himself; he is accompanied by medical personnel from the point of medical evacuation to discharge from the hospital….

 I don’t have enough armored vehicles for evacuation, I don’t have enough qualified colleagues……. 

Ideally, an APC would perform the Case-Evac, but Papa uses a pickup truck or armored bank van. I have another contact who uses an MT-LB for Case-Evac.

Papa’s Ambulance Van: His was originally an armored bank van.

SOFREP: Do you have night vision

Papa:  I don’t have any night vision; friends sent me some household device, but you can’t drive in it; I can’t see through the car glass.

SOFREP: Are any of your wounded being transported out of Ukraine for treatment outside the country? 

Papa: Yes. So my one wounded person is being treated now, and Denmark. And for three more, documents for treatment in Germany are being prepared.

Editors Note: The European Commission put out this report quite some time ago stating that over 1,000 Ukrainian patients had been transferred to European hospitals. That was almost a year ago. –GDM

This is a young Russian female who joined the 24th Mechanized Brigade. She was killed in action, and her story was all over the news in Ukraine. Many Russians have joined the 24th. I found that to be interesting.

War is an ugly, ugly business. There is nothing good about it. No upside.

Men like Lifeline could have chosen to stay home, back in the States in their not-so-dangerous civilian job, and let events play out in Ukraine.

Lifeline, however, has family in the warring nation. He has strong ties.

He could not let himself be a bystander while those he loves face danger.

More to follow.