For medics on the front line in Ukraine, the biggest shortfall is people

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STABILIZATION POINT AZOV, NEAR LYMAN, Ukraine — Near noon on an early March day, a scuffed SUV winds down a narrow dirt road through a dense pine forest on the outskirts of Lyman, a small city in Ukraine’s eastern Donetsk region.

Seized by Russian forces in late May 2022, the city and its 20,000 inhabitants were liberated by Ukraine on Oct. 1, mere hours after President Vladimir Putin formally annexed the land as sovereign Russian territory. Yet the liberation has come at a hefty cost, with much of the city destroyed by constant shelling.

Months after the Ukrainian army reclaimed the city, most of Lyman’s residential buildings bear the scars of the fighting and artillery fire echoes regularly through its near-empty streets.

“This road was built specifically to evacuate casualties away from the front line,” says 51-year-old Serhii, a press officer with the Azov Battalion of the Ukrainian National Guard.

As the car bounces up and down the road and swerves wildly around the bends, he explains that the area has been the site of fierce fighting for months. The forest floor is littered with spent shell casings and burned-out carcasses of armored vehicles. The road appears too narrow to accommodate two vehicles, and it’s hard not to think what would happen should one of the ambulances suddenly appear at a curve in front of the SUV.

There is no going off-road here. The pine trees on each side bear the scars of the constant shelling, their trunks blackened with soot or splintered by shrapnel. Occasionally, the remnants of a Russian GRAD rocket can be spotted jutting out of the pockmarked ground.

After an uneventful ride, the car comes to a halt in a sunlit clearing. At the entrance is a hanging makeshift sign: “Stabilization Point – Azov.”

Two soldiers in casual attire are enjoying a cigarette break outside a dugout. They wave at Serhii as he walks past.

“The front line is located about 6 kilometers away, in that direction,” he says, gesturing toward the horizon.

As if to emphasize his words, the distinctive sound of an outgoing volley of GRAD rockets echoes in the distance.

Understaffed and overworked

Making his way down a narrow flight of stairs, Serhii is greeted by 34-year-old “Johnson,” an anesthesiologist within the Azov battalion. Handsome, with high cheekbones, slicked-back hair and piercing blue eyes, Johnson has been serving since the very first days of Russia’s invasion of its neighbor, first in the Ukrainian Armed Forces and then as part of the Azov Battalion of the National Guard.

“I initially served as a combat medic and took part in medevacs, but when I joined Azov, I went back to working in my field as an anesthesiologist,” he says.

The dugout where he spends most of his time has been converted into a makeshift operating room, with a medical bed in the center outfitted with various monitors and a nebulizer and wooden shelves stocked full with various medications, bandages and bottles of antiseptic. In the corner, a dozen CAT tourniquets hang on the wall.

The grinding trench warfare of the Russia-Ukraine fighting has sparked widespread comparisons to World War I, but this little corner of the battlefield resembles nothing so much as a Korean War-style MASH unit, like the television show, located frighteningly close to the front lines and run by an understaffed, overworked group of medical professionals.

“I work here with a surgeon, doctors and nurses to provide first aid to wounded soldiers coming straight from the battlefield,” Johnson says while two women in combat fatigues enjoy a brief respite from their work on field beds. “Now, the situation is rather calm, I’d say, much quieter than it was two or three weeks ago.”

Like Ukraine’s combat units, the medics deal with equipment and supply shortages in the face of a larger, better-equipped enemy. Johnson says the most glaring shortfall isn’t material.

Daily Russian shelling is far from the most pressing concern for the team, he says. When asked what he and his team need the most, be it medicine, vehicles for evacuation or medical equipment, the anesthesiologist doesn’t skip a beat: “People.”

“We don’t have enough trained professionals, surgeons, doctors or nurses,” he says. “A medical professional can do more with less resources, and that’s precisely what we lack at the moment.”

Heavy workload

At the height of the fighting in the area, the stabilization point would treat more than 70 soldiers a day, many having sustained grievous bodily harm.

On his phone, Johnson plays a video recording of one of the recent surgeries in which he took part. The gruesome footage shows an unconscious soldier having his mangled foot amputated after stepping onto an antipersonnel mine.

“Here, we can treat basically any injury, even amputation, before sending the soldiers to the next level of care,” he says.

Drones are slowly becoming one of the main sources of casualties on the front lines.

“Artillery is still responsible for the majority of wounds, but the number of those caused by drones has increased,” he says. “When a shell falls, you can throw yourself on the ground. A drone, on the other hand, is remote-controlled and can hit you even if you’re taking cover.”
Outside the dugout, the muffled sound of an explosion echoes in the distance.

“Yesterday, a shell landed just on the other side of the road,” says one of the soldiers helping evacuate the wounded. “It was close enough to feel the shock wave.”

“Rina,” the 24-year-old manager of Azov’s medical company, echoes the complaint about a staff shortage. “We don’t have enough educated and trained health professionals, not just in the army but in Ukraine in general,” she says.

She has been serving since the very first days of the war, initially as a combat medic and then as a medical manager within the Azov Battalion.

“I have no medical training, but I studied biology, and I felt I could make myself useful,” she explains. “That’s why I resent the doctors and nurses who fled abroad. We need them here, on the front line and in the hospitals.”

Yet the medics’ predicament is far from an exception in Ukraine. In recent weeks, Ukrainian lawmakers have been debating a bill that would allow for the mobilization of up to a half-million soldiers, most notably by lowering the age of conscription from 27 to 25.

As a major U.S. military aid package remains stalled in Congress, the besieged country has been left with little choice but to draft more people to replenish the ranks of its depleted and exhausted brigades.

“We’ll keep on doing our work until victory,” Johnson says with a weary smile. “We just wish it was a bit easier.”