Rescue teams in Donbass: “I don’t think beyond a day”

Traumatic brain injury, torn organs, broken bones: This is everyday life for Ukrainian doctors on the front in Donbass when they save injured soldiers. Russian gas warfare agents pose an increasing danger.

It was already dark when the evacuation team brought the three soldiers. They have just been injured on the nearby front in the Donetsk region. They sit there pale, cold and exhausted. They have red and watery eyes, dry throats and shortness of breath. One coughs particularly badly.

For chief surgeon Viktor Rodin, the initial diagnosis is quickly made: “This is poisoning with an unknown gas weapon.” The Russian side dropped it and the men inhaled it. “Now it smells like chlorine, but we still have to analyze what it is.”

New clothes for the soldiers

The team at the stabilization point includes surgeons, anesthesiologists and paramedics who are caring for the three injured people. How many there are and where the stabilization point is cannot be said publicly.

They measure blood pressure, shine a light in their eyes, give oxygen and painkillers and make sure the men are warm. The five beds in the stabilization point are also always heated. The soldiers undress and are given sweatpants, T-shirts, jackets, socks and shoes.

Uniforms are examined

Their uniforms are put into black plastic bags and sent to the laboratory for detailed analysis, says surgeon Rodin. We will find out what type of toxic substance it is and then document it.

The United Nations Chemical Weapons Convention prohibits the use of chemical weapons. Ukraine has long accused Russia of using grenades containing CS gas. According to the Ukrainian army, gas was used more than 800 times from the beginning of the major Russian invasion until the beginning of February 2024. Dropped by Russian drones or by shelling.

Amputations in the wrong place

Until the major Russian invasion on February 24, 2022, Viktor Rodin was a civilian and operated in his own clinic in Zaporizhia. This now has to do without him because the experienced emergency doctor has been mobilized. Medicine is medicine, says the 57-year-old laconically.

But he admits that he still had to get used to severe war injuries. For example, when front-line evacuation teams amputate injured people in the wrong place, for example too high up the leg. However, he now knows that something like this can happen and what to do if it does, explains the calm-looking doctor. “We have to work very quickly here,” he adds.

Many wounded with polytrauma

On average, injured people are transported to a nearby hospital after 20 to 30 minutes. There is a rest room for those with minor injuries where they can wait. Operations are not performed in the stabilization point. Most of the wounded had what is known as polytrauma, i.e. one or more life-threatening injuries.

For example, open traumatic brain injury, lung injuries, injuries to the chest, abdomen or bones. “It may be that a soldier has all of this,” states Viktor Rodin. Injured people have to breathe, not bleed and need painkillers, he summarizes what stabilization basically means.

Tinnitus, dizziness, nausea

Many injured soldiers have a so-called contusion. Roughly speaking, this is a shock to the organism caused by the force of explosions. The consequences are varied: bruises to the lungs, internal organs, spinal cord or a traumatic brain injury. Triggered by enormous pressure, such as a mine grenade in a trench or a grenade that penetrates a vehicle.

Many soldiers suffer several such contusions at once, says the doctor, the consequences of which can overlap and lead to permanent damage. These include headaches, tinnitus, dizziness, nausea, vomiting or tremors. Contusion is not a new phenomenon. During the First World War, soldiers with this diagnosis were called “war tremors”.

Emergency surgery in the Fast forward

There are enough anesthetics, medications and blood substitutes, say the surgeons. But there is a lack of sleep and rest because people work around the clock at the stabilization point. “A good day is a quiet day where I can sleep and drink coffee,” says Volodymyr self-deprecatingly.

The 39-year-old from Dnipro explains that he was not familiar with 90 percent of the injuries in his civilian life as a neurosurgeon, such as severed arms or legs. But he mastered his craft and the bloody reality of war quickly taught him the rest. Colleagues, the Internet or a thick US textbook on military emergency surgery were helpful.

“Not everyone can handle it”

“I’ve already spent two birthdays here,” jokes Denis from the front-line town of Nikopol. The 37-year-old with the brown beard swapped his job in an industrial company with the stabilization point near the front in Donbass.

He took in the three injured soldiers and questioned them because he makes the statistics. In the past few months, around 30 injured people have been brought in every day. He suspects that this is due to the winter weather. In the summer there were significantly more at 150 to 200.

Denis was not mobilized but volunteered from his non-medical profession. At the beginning it was difficult. “We’ve had people come from here to the psychiatric ward. We try to make jokes and lighten the mood. But mentally it’s difficult and not everyone can handle it.”

24 hours waiting for the rescue team

On the walls hang colorful, self-painted pictures of children whose soldier parents survived with the help of the team. But not all of the injured make it. They die on the way, in the stabilization point or are rescued from the front already dead.

Ongoing fighting makes evacuations from the front lines difficult. It’s a little easier in the evening or at night. Even those who are seriously wounded must be able to endure. Like Bogdan, who has been fighting for a year and a half and has already been wounded five times.

The last time was mid-February. At that time, shrapnel from mortar shells hit his leg. His evacuation was difficult and the blood was already frozen, he says. “The enemy shelled us too intensely and it was not possible to evacuate. I waited for 24 hours to evacuate,” Bogdan says.

Soldiers remained behind at Avdiivka withdrawal

There are cases in which evacuation teams are unable to recover or rescue the dead and wounded – such as after the Ukrainian defeat in Avdiivka, when injured soldiers were or had to be left behind.

Death, shelling, injury, disability: this is also everyday life for the surgeon Olexandr Kosse. “We’ll do this for as long as necessary. We can’t say: Guys, we’re tired of it. We’ll carry on until the end, as a whole country.” Two of the three injured soldiers at the stabilization point have recovered somewhat. They say they were attacked by a Russian drone and bombarded with gas.

“You don’t think far into the future here”

“We’ve had several cases of gas poisoning more often recently,” says surgeon Kosse in the stabilization point after examining the injured. He believes some chemical substance was dropped on the three soldiers. Maybe something with chlorine. “Chemical weapons have been used particularly frequently in recent months.”

Oleksandr Tarnavskyi, the commander of the Ukrainian Tavria group that fought in Avdiivka, said on Telegram this week that the Russian side was using gas grenades in the Donetsk region.

Surgeon Kosse comes from Russian-occupied Mariupol. His parents remained under the occupation. The 27-year-old father dreams of a civilian life – after the war. He would like to wish his child a happy birthday in April, but he has no other plans for the future. “I’m not thinking beyond one day. You’re not thinking far into the future here.”