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Two “Patriot Defence” instructors spent the month of August with the Pirogov First Volunteer Mobile Hospital.

Kostya Korolyov (Kit) and Ihor Simutin (Sima) used to hold regular civilian jobs before the Maidan Revoultion of Dignity, the war in the East, and joining “Patriot Defence.”  Kit used to be a business trainer and Sima was the head of an automobile company.  During the Maidan, both worked for the “Red Cross” and later joined “Patriot Defence” to train soldiers in combat first aid.

 At the end of July 2015, Kit and Sima started a month-long service at the Pirogov First Volunteer Mobile hospital.  During their time there, they evacuated wounded soldiers, trained individuals in tactical medicine, repaired vehicles, and communicated with the military.  There were moments when they felt betrayed, frustrated, and ignored.  At times they felt like aliens, because they were used to living and working by different standards.

Kit and Sima shared their impressions and experiences from the Ukrainian frontline.

Attitude towards life in the war

Sima:  We were a self-sufficient group, with our own car.  We held many trainings and were often invited to teach, but when there was time, we went out to evacuate casualties.  If the word ‘evacuation’ was mentioned, we were ready to go, one step ahead of the rest.

Kit:  We held an adapted Combat Lifesaver (CLS) course on the front line: not many people showed up, some of them were drunk, most of them careless.  But as soon as they learned that they would receive a first aid kit after the course, the need for training grew exponentially.

Contract soldiers, on the other hand, value both the training and the first aid kit. The kit is cool, but the knowledge gained from training is more important to them. They understand that it will affect their life because they will be serving for the next three or five years, some have been serving for seven. But if I am an alcoholic, coming to serve for only a year, what do I care about training or standards. When we were choosing where to carry out training, I always asked about the number of contract soldiers -- those men have a completely different attitude.

Some of the servicemen had already been trained.  Some knew us and invited us back because new people had joined their unit.  About four months ago, we were working with an artillery group.  When they learned that we were at the Mobile hospital, they invited us to come to them: “Guys, they added a third battery.  There are so many people.  Everyone else has first aid kits, except for these guys and they’re at the firing position.”  These are the types of units who value training.

Sima:  Our collaboration with the Mobile Hospital gave us the opportunity to go to places where it had been difficult to go to with “Patriot Defence”. If you talked to these servicemen, most of them said they didn’t think they would end up where they were. Some had rubber tourniquets and old bandages. Others had first aid kits from the previous rotations or from their godfathers and brothers – and even that was rare.

The boys who don’t receive first aid kits don’t know that sometimes you just have to ask – but they’re afraid of being punished. And some don’t understand their own needs. But there are boys who were shot at and understand just how important the training is.

Kit:  There is a reluctance and fear left over from the Soviet Union. “I will not ask my commander because my commander is afraid to ask his commander,” so the thinking goes.  And as a result, when the General Commander asks "Does everyone have everything?" and they reply: "Yes", then how is he supposed to know that people are missing things? Everyone seems content.

In the Army they always ask, “Any questions, comments?”  When I served for a year and a half, no one ever had any remarks. They answered that everything was good. If everything is good, then why are people complaining?

On “betrayal”

Kit: People don’t want to work on developing their skills. For them, it’s simple: “I came here, a year will go by, and then I’ll go home.” But you are going to war! Everyone around is talking about tactical medicine, there are instructors who are teaching, you know what you need, and these things don’t take much.  If a person doesn’t want to do something for their own sake, then nothing will help them -- neither the president, nor medicine, nor anything else.

The problem is in the “I don’t want to do it” attitude.  Everyone feels betrayed and abandoned.  But at one checkpoint, near Horlivka, there is everything including a television, and there is no “betrayal.”  But there are other checkpoints, empty, and they are suffering.  The Commanders and Generals have little to do with this. It’s just plain reluctance.

There are units who have had our first aid kits for over a year now. At the end of a rotation, the kits are replenished and ready to be used by the soldiers to come. And then there are units that you know received 200 kits, and they claim they have nothing left from the previous rotation. So they go home and don’t leave their kits behind? Maybe nobody asks them back?

Sima: Three months ago, when the instructors and I were in Artemivsk, we saw a nice ambulance, I said, “Guys, we made that. It was hard to repair it, working at night, because the engine had gone kaput.”  When I approached the head of medical services of the sector, he informed me that there were many ambulances like that, but there weren’t any drivers. I never told my mechanics about that.

Kit: Some soldiers throw away the old bandages they are given because volunteers bring them modern, non-Soviet ones. Others don’t even bother picking up a bandage. Sometimes, people make such a big deal out of things, just to attract attention. People write on social media that their loving husbands are being sent from Yavoriv into the Zone. So everyone has to stop what they’re doing to buy things for this loving husband, who has been resting and drinking in Yavoriv for the past four months?

Sima: I still haven’t lost my desire to help, despite some people spoiling this job for me. But I understand that we need to give people the bait, not the fish. If my car breaks down, and I really need some car part to fix it, I'll call first and find out whether this part is available in the warehouse before rushing to buy it.

If you look globally, everything depends on the leadership and the guys themselves. These people, when they were recruited into the army, didn’t feel needed by their country. They were given pathetic boots and uniforms. Some were offended and expected more from their leaders.  Some just didn’t want to do anything at all.

Kit: I understand when people say they were just thrown in this mess by the state and forgotten. But we aren’t just talking about the war now, but about an individual’s overall health and wellbeing. Who can make you wash your feet, besides yourself? It isn’t rocket science. You want to live? Yes! Then do something about it.

“Why bring him to a hospital?  He’s alive!”

Kit: Someone noticed a boy with a purple finger so we offered to take him for X-ray. The Commander didn’t see the need: "Why would you want to do what? The seniors wouldn’t understand He’s alive. He isn’t injured." A broken finger - who cares about that? We put a splint on it and were promised that the doctor would take him for an X-ray.  We came upon another man with an ulcer who hadn’t eaten anything for days. He had two months left before demobilization and the command team didn’t have time to deal with that. I understand that there’s “no time” for such things when there is active fighting going on. But when soldiers are allowed to walk around wearing sandals and no bulletproof vest at the very front, I’m sure “there’s time” for this, too!

I'm sure if they locked one of these commanders up for a year for murder or mistreatment, there would be fewer mistakes. The next time someone had a sore throat, they would immediately be sent to a doctor.

Sima:  Another example. The Mobile Hospital drove to the front with an X-Ray machine. In 4 months, they discovered eight cases of tuberculosis. One sneezes - and then everyone’s sick because they had kept quiet about his condition at the enlistment office. There are also other serious cases when a person with Hepatitis C is sent to serve alongside others.

About the medical taxi

Команда ПДМШ імені Миколи Пирогова

Sima: Once we went to Luhansk for an evacuation. Artillery fire was still on whan we arrived, so were the only ones there. Then some people arrived. They brought two casualties. I tried to examine one of them: he had a head trauma and an injured left shoulder. His Israeli bandage was applied somewhat clumsily. We still had some time to re-wrap the bandage. When I started to tend to his injuries, others came and told me he was “their” casualty, so they took over. We hadn’t been there for long, so I didn’t know you had to wait in line to treat a casualty!

It would have been different if I saw a qualified team evacuating the casualty. They had a white Mercedes van, the driver and the medical assistant took the front seats. They put the wounded on the floor in the back. No access to the casualties. I said, "Guys, this is no good" They said: "No problem. They’ll take care of each other. How long can the drive take?” One of the casualties was sitting and the other was lying down. The one lying had the injured shoulder and head. The one sitting was pale and looked like he had a severe concussion. The road was awful.

This medical taxi is a problem. They look like some volunteer groups trying to maintain their image, so they just come and grab wounded soldiers.

Kit: The Pirogov Hospital has marked territories. To change these locations, you have to receive permission from the head of the medical services. The medical taxi will simply go if firing begins. They aren’t subordinated to anyone. There is no responsibility, no accountability.

Sima: The thing is that before each departure, we knew that we were going to the front line. We had a training backpack and a separate one for providing medical assistance with our skills. And each time before leaving, we tested our gear, because we learned to do so at "Patriot Defence”.  And so we started doing the same with the cars. Before leaving, we inspected them. I would never leave with an empty backpack or with a flashlight without batteries. Kit and I repaired our armored vehicle and added a light. We are used to doing things this way, it’s a lifestule now. If our job is to evacuate, we need to understand that we can be called for at any moment, so we have to be ready, and so we think ahead.

When you are driving a person with a gunshot wound through the knee, then every pothole is painful for him. When were trying to get to Kharkiv, I was driving in first or second gear, because I heard him crying through the window and he was in excruciating pain. We had been driving for 6 hours, and we covered a distance of only 200km, because we blew a tire on the road; it just got ripped to shreds, because of the horrible roads and potholes. He couldn’t take any more painkillers. He needed tthe bullet to be taken out urgently but they didn’t do this in Artemivsk. And the donated British ambulance broke down before departure.

“Defend yourself from yourself”

Kit: There are lots of domestic problems. People end up in the hospital not only because of war wounds.  One guy walks around in flip-flops and breaks a toe, another one walks into a branch, piercing an eye. A drunken guy shoots himself in the leg. I guess we need a “Defend yourself from yourself” first aid kit.

Everything that happens at the front line checkpoints is blamed on a separatist reconnaissance groups; a car hits an electric pole - the seps are to blame, our soldiers hit a mine on the same road twice - it’s the seps! And then it turns out that the Ukrainian army had laid eight landmines in a row, but forgot to warn everyone.

Sima:  Shrapnel was and is the biggest cause of injury, from artillery. Most gunshot wounds occur either by accident or friendly fire. That’s what happened to us. The guards are always waiting for something big, like a tank, to come from home front. And here we are driving, and they begin shooting at us. The finding out came later.  Well, the boys were a little drunk.

Kit: We understand that there is always a threat of bandits and separatists...But when you are standing 15 km from the front line checkpoint and you know where your unit is, and one car with a red cross is coming towards you through the cornfield and you think its a group of separatists, well that’s just ridiculous. When you start shooting into the air and nobody fires back, when people come out of the car and you don’t see any weapons on them, then a light should go off in your head. But when you're drunk - there’s an enemy in every bush.

The first step to solving any problem is acknowledging that there is a problem

Kit: In Iraq, the Polish military made bets and fired at homes. Before that incident, they had had many achievements: they occupied a mountain, killed a bunch of terrorists -- but one YouTube video with two houses thay shot at ruined their entire reputation. No one ever tried to find out whether there were people in those houses. One act negated all their previous achievements. We’ve got plenty of that going on. Wy\hy hide the truth and act like everyone’s a saint? The problem is that everyone keeps quiet, and everyone keeps pitying everyone.