MARIUPOL, Ukraine -- As Russian-launched rockets hit a market in Mariupol on Jan. 24. killing 30 civilians and wounding more than 100 others, Viktoria Kovach rushed to tend to the injured, risking her own life. Kovach, a volunteer combat medic, left medical school to embed with Ukraine's Azov Battalion as their chief combat medic.
For the last six months, she has tended to their bullet and shrapnel wounds, going wherever they went. “Combat medics are not immune to the brutality of war, but I will do whatever it takes to take care of the boys who are fighting for a free Ukraine,” she says.
Kovach, who was trained as a combat medic by Patriot Defence, an initiative that has introduced tactical medicine education to service personnel and combat medics, threw herself into action and treated the injured amid the rubble where the marketplace once stood.
“People were scattered throughout the area, covered in blood and in shock from the trauma of the artillery shelling, disoriented and panic stricken. I didn’t expect to see so many people dead,” said Kovach, who was at the battalion’s base just outside the port city on the Sea of Azov.
Combat medics, who have been formally trained in tactical medicine, or combat medicine, in Ukraine, have played a key role in treating soldiers on the battlefield as well as civilians caught in the cross hairs of the conflict that has claimed more than 5,000 lives, according to the Ukrainian government, which has been accused of under-reporting the casualties.
Tactical medicine includes instruction on how to perform first aid care under fire and how to care and treat battle-specific injuries, such as gunshot and shrapnel wounds from explosive devices. It greatly differs from civilian medicine, requiring knowledge of how to work in extreme weather, in darkness and without supplies.
Medic Viktoria Kovach trains members of Ukraine’s Azov Battalion in emergency medical assistance for those wounded in battle.
Prior to the war with Russia, Ukraine lacked knowledge of potentially life-saving tactical medicine that met NATO standards.
Many soldiers were being deployed without any knowledge of how, and when, to use basic medical items for combat, such as a modern combat application tourniquet used to stop extreme bleeding, or how to use a gauge needle to treat a collapsed lung.
In countries like Canada, Great Britain and the United States, soldiers receive training in combat first aid as part of basic training, but in Ukraine, where resources for such basics as boots and sleeping bags are scarce, first aid training is often an afterthought. But, that is now slowly changing in Ukraine.
To address the gap, Patriot Defense began introducing adapted Combat Lifesaver training, a NATO recognized course that teaches soldiers life-saving skills like how to perform medical care under fire, open and manage an airway, treat an open chest wound, collapsed lung, and tactically move a wounded soldier, or civilian, to safety.
Following the completion of Combat Lifesaver training, an Individual First Aid Kit that contains lifesaving medical supplies, sourced in the United States, including modern tourniquets and combat gauze, are given to participants. “Every day we get reports that CLS training and IFAKs are saving soldiers’ lives,” says Dr. Ulana Suprun, who has headed Patriot Defence since May 2014.
Combat Lifesaver training is currently under way for more than 2,300 new service personnel in Kyiv, Zhytomyr, Lviv, Kharkiv, Odessa and Khmelnytsk who will be deployed to eastern Ukraine in the spring.
Since the start of the program, Patriot Defence has trained more than 12,000 service personnel and handed-out more than 9,500 IFAKs, which cost $100, says Suprun. Patriot Defence has also taught combat medic instructors, like Kovach, how to teach others Combat Lifesaving training.
When the war escalated in the spring of last year, Kovach, 21, who studies medicine at the University of Vinnytsia, left school, volunteered for the front and enrolled in CLS training, and the Long Range Patrol Medic program. “I wanted to use my medical knowledge to help the boys.”
She has taught CLS to approximately 300 volunteer service personnel within the battalion and given them each an IFAK. The CLS training and the IFAKs have saved many lives, she says. “Volunteer service personnel who are fighting in the conflict zone are mechanics, truck drivers, and office workers. Going to the visit the doctor is the only familiarity they have with medicine. They have no knowledge of basic first aid.”
Within her battalion things are slowly beginning to change thanks to Kovach. “The boys are thankful for the training and realize that it could save their life or their friend’s life.”
That’s exactly what happened last month in Debaltseve, a strategic town in eastern Ukraine that has recently been hit hard by rebel shelling, she says. The battalion was caught under heavy shelling, wounding more than 3 members including the combat medic, says Kovach. “The boys tended to the medic first so he could treat the rest of the battalion. The medic got fixed up. He was then able to fix everyone else up and they headed back into action and out on patrol.”
A humanitarian initiative of the Ukrainian World Congress, Patriot Defence has also played an important role in introducing tactical medicine in Ukraine when Ukraine needs it most.
In January, Patriot Defence held an international conference, the first of its kind in Ukraine, on developing a comprehensive tactical medicine implementation strategy in Ukraine.
The conference was attended by more than 450 people, including the heads of the medical departments of the Security Service of Ukraine, Ministry of Defense, Administration of State Guard, Ministry of Internal Affairs, volunteer battalions and representatives of military universities as well as military attaches of NATO member countries and tactical medicine experts from Canada, the European Union and United States. Following the conference, the organization received over $1 million in donations to further train Ukrainian service personnel in tactical medicine.
According to Dr. Oleksandr Linchevsky, a thoracic surgeon at the 17th Hospital of Kyiv, Ukraine suffers from minimal first aid training and real combat experience that has resulted in a large gap in knowledge of combat medicine. “A year ago there wasn’t even a name for tactical medicine in Ukraine. Today, the field of tactical medicine in Ukraine is evolving and standards are being upgraded thanks to volunteers and organizations such as Patriot Defence.”
Linchevsky, who travels to the conflict zone regularly to treat service personnel, says a shift in mindset among doctors and elected officials is critical to further developing tactical medicine in Ukraine. He has been a passionate advocate of Ukraine embracing Trauma Combat Casualty Care , a course that teaches combat medics to save the life of a wounded soldier at the pre-hospital stage, directly on the battlefield, and helped the United States combat forces achieve the highest casualty survival rate in its history.
“We must move towards evidence-based medicine for the well-being of our service personnel and start raising the bar on how we treat and care for the wounded in Ukraine. This includes implementing standards like TCCC that are proven to work.” Although this would require a huge commitment from various ministries in the Ukrainian government, Linchevsky believes this must be done to modernize the Ukrainian military.
For Kovach, her training in combat medicine has changed the course of her career. She now wants to finish her remaining two years of medical school in Vinnytsia and attend the Kyiv Military Academy where she hopes she can help work on developing the area of combat medicine and provide vital trauma care for wounded service personnel.
More information about the Patriot Defence program can be found here at the Ukrainian World Congress website./
Alexandra Stadnyk is a former Kyiv Post editor now living in Toronto, Canada.
