Ukraine Adventures – Part 1

By Matt Evans

(Editor’s Note: Local critical care paramedic Matt Evans spent five weeks helping out in Ukraine this summer. In this four-part series, he describes some of his adventures…)

The run down

I went to Ukraine this past summer. I was a volunteer for an NGO (Non-governmental organization) called Frontline Medics. That is a bare-bones operation in which volunteers pay their way to travel to and work in war-torn communities. Frontline provides housing and vehicles to move around the city and get to and from positions. All other expenses are up to the volunteer. They also provide medical supplies, ambulances and establish medical facilities for the Ukrainian military. In the NGO world, the large sources of funding favor “neutral” organizations. They don’t like to pick sides. Frontline Medics refuses to remain neutral. They work with and directly support the Ukrainian military. Because of this, they are primarily funded through small donations. If you want to help them continue their good work, a donations tab can be found at frontlinemedics.org. Twenty bucks goes a long way in Ukraine.

Through Frontline, I was attached to the medical platoon of two different mechanized infantry battalions, although I mostly worked with just one. My role was to run medevac (medical evacuation). Casevac (casualty evacuation) brings the patients from the zero line (the true front) in an armored vehicle, to us. We then provide advanced trauma care during transport to a stab (stabilization point). At any given time, we were between six to 10 kilometers from the zero line, out of range of small arms, but well within range of indirect fire, mostly for artillery and drones. Our projected work schedule was 48 hours on, 48 hours off, though it was often more than that. Home base was in a small city about an hour drive from our front position.

 The city was, at the time, about 20 km from the front. It was often targeted by long range drones, glide bombs and other arial munitions.

When on position, we travelled at night for safety. Our days were spent trying to sleep in the “blindazh” (Bloon-Dosh, the term used for bunker). Picture a WWI-era bunker with certain modern amenities. The quarters were tight, between five and seven people depending on frontline activity, between the casevac crew and us, the medevac crew. It was comfortable, aside from the flies landing on your face while you slept and the mice skittering across the ceiling. 

Wooden stairs shrouded in camouflage netting led into the ground. The tunnel accessing the blindazh was lined with our body armor and helmets. Rough cut lumber formed the walls. The ceiling was made of timber beams covered in a layer of thin silver insulation. Six beds, three on top and three on the bottom lined the back and side walls in a horseshoe. A small table served as our kitchen, the wall behind it decorated with radios and other communication equipment. On the front wall next to the doorway hung the soldiers’ weapons, AK-47s and shotguns. Occasionally an AR platform depending on who was working that day. 

The Ukrainian medic I was partnered with would get the intel on our patients during the day. In the ambulance, they would interview the patient, translate and we would collaborate on our treatment plan. The patients were categorized as Green (walking wounded), Yellow (immobile but stable), Red (severe, in need of stabilization) and Black (aka 200, dead). We would plan our response based on patient severity and arial threats. 

Food came twice a day, generally a grain, a starch and a protein. Buckwheat and mutton, chicken and mashed potatoes, etc. We were well fed, and despite staying up all night, we generally had enough down time to grab three or four hours of sleep here and there.

The transports weren’t far as the crow flies. The roads however, made for a challenge. Six- to 12-inch potholes, one after another the entire way. Some were deeper — deep enough to crack an axel. That coupled with navigating the threat of drones, glide bombs and land mines made for a very challenging and very bumpy ride. Pain management of a soldier with a 3/4 amputated leg was a challenge to say the least. But we did what we could with the tools we had, which was just enough. Sometimes.

Life at base was just normal city life, aside from the strict sun-down curfew, the ban on alcohol and the regular air strikes. We ate at restaurants, visited shops and went to the gym. Our compound was on a decent plot of land on the edge of town lined with a few ambulances hidden in camo netting under trees. A garage served as our medical supply room and we slept in a three-bed, two-bath house. I had a twin-sized mattress on top of a cot, a real luxury compared to some of the other beds. I was on the first floor sharing a room with two others. A bunk room upstairs could hold six. The air raid sirens that seemed almost constant were largely ignored. If we heard drones overhead, we would stay inside. Hiding every time you heard the sirens would mean almost zero time outdoors.

The crew was international with medics and doctors from various Nordic and European countries. Some Americans too. The number of folks in the house fluctuated, but there were generally five or six of us. On the rare occasion we were all at the house at the same time we would grill in the backyard.

My time in Ukraine was something I will never forget. I want to share the whole story, start to finish, but there aren’t enough pages for that here. It is important to understand that nearly everyone I worked with over there has crazier, more impressive and more intense stories than I do. I did not see the enemy face-to-face. I was not constantly fearing for my life. And I did not treat hundreds of critically wounded soldiers. 

There were long stretches of quiet, with a few moments of high intensity. I did get to treat a lot of wounded soldiers, but most were stable and needing very few interventions. Unfortunately, many of our would-be patients died before they could be evacuated. The stories I’m going to share are the most memorable, and the most important to me. But in all, even though these may seem scary or gruesome, they pale in comparison to the stories of the soldiers and volunteers I had the privilege of sharing a blindazh with. I left out names of people and locations for operational security as it is an ongoing conflict.

The people

I did not go to Ukraine because of some profound idealism. I went because I wanted to experience war. I certainly wanted to help and be a part of a just mission against tyranny. But going over there felt selfish to be honest. I have the training to be an asset in that environment and I wanted to know what life in a war zone was like. I wanted to use my skills in a conflict zone and this is a war I can get behind. My experience was extremely short and my time there by no means compares to anyone who has served a proper military role in any armed conflict. I do not have shell shock. I am not a combat veteran. I am just a medic who got a very brief experience in a conflict zone. I feared for my safety with comrades. I mourned with the soldiers over those who had fallen. I saw a some really terrible things. But I also saw a compassion and a strength amongst the Ukrainians that is profound. It’s hard to put words to it.

Plenty of fighting-age Ukrainians fled when the conflict broke out. Those who stayed, who I spent time with, were strong. A female medic I worked with left a comfortable life as a customer support representative for an IT company. She had a great depth of knowledge far beyond her training. She’d learned it all on her own. I was awestruck. And though her eyes were weary from three-and-a-half long years at war, she still treated every patient with genuine compassion. A rarity when dealing with that amount of trauma.

Another medic I worked with had graduated medical school before the war. He realized medicine wasn’t his thing and pursued other careers but when the full-scale invasion began, he answered the call. Setting aside his own desires, he used skills from medical school in the trenches, saving countless lives while fighting the enemy. 

The medic I spent the most time with had done a stint at the front lines CCP (casualty collection point) where he triaged, treated and stabilized patients under direct enemy fire. He would have to take a break from treating patients to man the mounted machine gun until the threat was neutralized and he could return to his medic duties.

They all have stories far more interesting, far more intense, and far more selfless than my own. I feel fortunate to have worked side by side with these men and women. They inspire me to be a more compassionate and dedicated medic. All of them sacrificed comfort and safety to defend their nation from a brutal enemy.

For some time over there, I felt like an imposter. I was constantly in awe of my comrades and felt inadequate. And guilty. They couldn’t just go home to their peaceful lives after five weeks. They were in it from the start and would be in it until the end. Be it death or the war’s end. One day I expressed my admiration and the imposter syndrome to a medic I would come to respect most. She said, “Well, you’re here. You came, and that matters. Having you in the back makes me feel better. You have more formal medical training than me and I am glad you’re here.”

That statement meant more to me than she will ever know. I haven’t experienced something that brought together as many strong, genuine and impressive people as I found in the medical platoon of that infantry battalion. I’m honored to have gotten to work alongside each and every one of them.

(Next week, Matt talks of the close encounters of dealing with war victims.)