The nightingales singing to the wounded. How Ukrainian medical staff save lives under fire

Medical staff tend to the ones of one of the injured soldiers brought to the stabilisation point from the front lines near Bakhmut. Photo: Kateryna Pryshchepa

By the beginning of June, Ukrainian army units began a pushback, trying to encircle and lock Russian forces inside the city. The night when I visited the stabilisation point near Bakhmut was one of the calmer ones, I am told, which saw the treatment of a several dozen soldiers mostly with shrapnel wounds and concussions.

Evacuating the wounded

Given the concentration of the army units in the area and the high number of casualties, there are several stabilisation points operating in the proximity of Bakhmut. Each one is managed by a larger army unit. In the majority of cases, the staff is reinforced by medics from several different units, who also perform tasks in the area but currently do not have resources to operate their own stab.

The evacuation of a wounded soldier begins on the battlefield, where personnel first provide pre-medical aid by applying tourniquets and bandages. Afterwards, the wounded soldier is carried to an area where he or she can be put in a military vehicle. Several kilometres from the combat line, the wounded soldier is picked up by the medical staff of his unit who then transport the wounded to a military stabilisation point. The main purpose of the point is to give a chance of survival for the soldiers with grave injuries. To raise the chances of survival for soldiers with severe injuries, it is necessary that a soldier gets to a point where they can get the required medical treatment within an hour and the trip from the battlefield to a proper hospital can take hours. Even with the stabs located midway between the battle line and the hospital, getting the soldier to the doctors within an hour is not always possible. Russian forces often shell the evacuation teams, which make it difficult to reach the wounded or get them out of the combat zone.

On May 22nd 2023, Oleksandr Yabchanka, the former speaker of the Ukrainian health ministry who joined the army in February 2022, posted on his Facebook profile about his unit’s experience. From Yabchanka’s account, an attempt to evacuate one wounded soldier in the Bakhmut area led to 11 more casualties among the evacuation teams, including himself.

With the medics being targeted by the Russians, the army units take precautions not to disclose the exact locations of the medical aid points, as they are often shelled. The windows in the point I visited are covered with plywood to keep the staff safe from broken glass, and to avoid revealing their location at night by blocking out the light. There is also a big shed at the entrance to hide the cars that transport injured soldiers. The shed is also a place where the staff can take a break, get some air and have a cigarette while taking care of the wounded.

I arrived at the stab with two colleagues after 10:00pm and walk to its doors in complete darkness. Some of the medics smoking inside the shed ask if we were not injured. The brigade’s press officer says we are press and we are allowed inside. The first thing I notice inside is that like most Ukrainian army locations, the stab interior is decorated with children’s drawings. These range from simple blue and yellow-coloured hearts to detailed drawings of the city battle, suggesting that the child witnessed military action him or herself.

The stab I visit is run by the 93rd Mechanized Brigade “Kholodnyi Yar”, but medics from three different brigades are working here. They are assisted by the staff of the First Volunteer Mobile Hospital (FVMH) – a volunteer organisation that has been active in Donbas since 2014, helping with medical evacuations of army personnel and civilians. Most casualties from the Battle of Bakhmut are the result of shrapnel wounds or concussions of various severity.

The access roads to Bakhmut are shelled constantly, so the wounded soldiers come in groups as soon as the evacuation cars manage to slip through the heavily shelled areas. A soldier with the call sign “Jesus” assisting at the stab tells me that usually more soldiers are brought to the stabilisation points at night, as there is a higher chance to avoid shelling. This is why some soldiers get to a stabilisation point only hours after being injured. During my time there, one of the wounded soldiers with shrapnel wounds was brought to the point almost two days after being injured in combat. Heavy shelling made it impossible for the evacuation group to reach him earlier.

Treating the wounded

The staff in the stab work in 24-hour shifts. There are surgeons, anaesthesiologists, nurses and some soldiers serving as assistants, cleaners and drivers. The army personnel are assisted by FVMH volunteers. Most of the doctors working at the stab have not been in the army prior to February 2022. One exception is an anaesthesiologist named Luba, a local from Donbas who joined the army before the full-scale invasion. Some of the soldiers helping at the point are also Donbas locals, who joined the army after the first Russian attempt to take over the region in 2014. During a short pause Luba points to one of the surgeons, a white headed and bearded man who looks like a Santa dressed in an army uniform, and says: “You know he lost his son just few weeks ago. Killed in action here in Bakhmut”.

The staff finish bandaging one wounded soldier and turns off the light to get some rest. Soon a new group arrives, mostly with shrapnel wounds. Their faces are black with dirt the soldiers look like the miners on the old photos. They receive anaesthesia and fresh bandages. Broken limbs are treated with casts and the soldiers are changed into clean clothes and prepared for further transportation to hospital. There are four tables for such activities in the stabilisation point, so four soldiers are treated simultaneously.

When the next evacuation car brings a larger group, the less seriously injured soldiers wait their turn. While waiting to be treated, the soldiers with concussions provide an account of the combat they just experienced. Some try to focus and come back to their senses. The assistants check the soldiers’ blood pressure and heart rates, writing the numbers on their arms with markers.

While disposing the clothes belonging to one injured soldier who sustained a shrapnel wound, the cleaner finds a fragment of shrapnel roughly the size of half a carrot. This had miraculously become stuck in the soldier’s equipment, saving his body from more harm. Someone suggests the soldier should keep it as a souvenir, while one of the doctors argues to throw it away, superstitious it could bring more injuries. Having received his treatment, the soldier who luckily escaped the carrot-shaped shrapnel falls asleep while lying on the stretcher. One of FVMH nurses starts chatting with him to keep him awake, before he is sent to hospital.

Between the arrivals of injured soldiers, the staff at the stab try to get some sleep, lying down on the same stretchers the soldiers are treated on. I come outside to have a breath of air in the shed and ask one of the soldiers who is having his cigarette there if he has seen the television series MASH. The stab interior and communication between the staff sometimes feels like the its re-enactment.

Despite it being a relatively calm night for the stab, the shelling of the area where the aid station is located does not stop. At some point between two and three in the morning, the shelling becomes so intense that the staff retreat from the treatment room into the corridor inside the building. The corridor has no windows and provides “two walls”, better shelter from the shelling. It has two walls for cover – the outer wall of the building and the inner wall of the corridor.

The staff spend at least 40 minutes in the corridor until the shelling becomes less intense. No wounded soldiers are brought to the stab during that time. I ask what would happen if an evacuation car managed to get to the aid station during the shelling. Luba, the anaesthesiologist, tells me that in such cases the wounded are treated in the corridor.

The work goes on

Not all the staff are happy about journalists visiting the stab. Luba complains that the journalists are careless. Several months ago following the visit of a journalist, a stabilisation point which was then located even closer to Bakhmut was targeted during shelling. Luba suspects it was because of an article published by the journalist which inadvertently revealed the stab’s location.

The shelling from the enemy was met with a response from Ukrainian units. As one of the soldiers explains, a high-pitched rattling noise we hear while taking a breath of air in the shed outside the stab is most likely made by a HIMARS rocket launcher system from a place nearby. When the shelling calms down, I go outside the shed to take a look at the marvellous night sky. There has been no rain for days and the sky is clear. The absolute absence of light in the village makes it a perfect observation point for the stars, it seems I can touch one just by stretching out my hand. Between the sounds of distant explosions, the crickets chirp in the grass outside the building, a nightingale sings somewhere close by and only artificial lights come from the cars arriving from Bakhmut.

Several more groups of wounded soldiers come to the stab from Bakhmut between three and eight o’clock that morning. Many have concussions caused by grenade explosions. One of the wounded soldiers has a piece of shrapnel in his abdomen and the surgeons are worried whether his spine is injured as well. His treatment requires almost all the available staff and demonstrates their impressive level of coordination. When the soldier is placed on a stretcher and taken outside to be transported to hospital by the FVMH car, it is already light outside, something that is difficult to notice while being inside the stab, with its closed windows and artificial light. The FVMH volunteers get ready for the road by putting on helmets and protective vests. The patch on one of the nurse’s vests says “The Lord protects me and gives victory”.

By eight in the morning soldiers with concussions make up the largest portion of the new arrivals at the stab. As the current group of soldiers receives the necessary assistance, the FVMH group who have returned from their trip to the hospital some time ago complete their shift. They bid farewell and head towards a town nearby for their two days of rest. Having treated the latest group of wounded soldiers, the personnel remaining at the point go to get a morning coffee and a cigarette. Some are hoping for a bit of sleep before a new group of wounded arrives. The work goes on.

Kateryna Pryshchepa is a Ukrainian journalist and a frequent contributor to New Eastern Europe.

Bakhmut, Frontline, Russian war against Ukraine, Ukraine