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Ulana Suprun about modernization of the army, the nation and Ukraine 

This year's Ukrainian festival "Bandershtat", which traditionally takes place where the Ukrainian Insurgent Army originated, gathered together thousands of young people from Ukraine and surrounding areas. Here, people shared their experiences in regards to their efforts in social work and attempts to make changes to the system. This year, the organizers invited Ulana Suprun, the director of humanitarian initiatives for the Ukrainian World Congress and founder of the organization "Patriot Defence".

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I was born in the US, but three weeks ago I was granted my Ukrainian citizenship. I grew up in a Ukrainian family, went to the Ukrainian church, and my first language was Ukrainian. I met my husband at a winter camp for Ukrainian youth; I was in Plast, while Marko was in CYM. In university, we were both apart of the Nicholas Mikhnovsky Ukrainian Student Association.

We got married in 1991 - the same year when Ukraine gained independence. We always joke that since Ukraine is very close to our hearts, if something were to happen to her independence it would also affect our marriage.

We first lived in Detroit and then moved to New York, but we always wanted to move to Ukraine. Finally, three years ago, we sold our house and began to travel the world. In the fall of 2013, we were in London on our way to Ukraine when the Maidan started. On November 29th we arrived in Kyiv; my husband began translating for Western journalists, while I worked at the medical unit on the Maidan.

On February 20th, during the darkest hours of the Maidan, Marko was pulling people from Institutska while I tried to save their lives. We were brought a man from Kharkiv - Vlad. He had suffered a wound to his right side, and we attempted to stabilize his condition although we lacked any equipment. After he had been transferred to hospital No 17, we thought that we had managed to save his life. Eight days later, Vlad died. He was the last of the Heavenly Hundred. I kept thinking, what more could I have done as a doctor? What could I have done differently that would have saved Vlad’s life? Maybe then he would still be alive. When the war started, I kept wondering the same thing about our men in the ATO. If they had the proper equipment and training, perhaps more of them would return home alive.

In the beginning we went to Western military experts and asked them which first aid kit was the best. We were shown the NATO standard IFAK, and brought 250 of them back to the ATO. But when the soldiers received them they said, "This is cool, but how to use them?"  We then realized that our problem didn’t lie in the equipment, but lay in training.

Modernizing of the army, the nation and Ukraine – this is not a mythical idea. This knowledge, training, information and education are based on international best practices. We invited professional instructors from the American army who not only instructed soldiers, but most importantly, taught Ukrainian instructors. Currently, we have 20 instructors who train the Ukrainian military.

Education is the way to change a country. Similarly, it is education and training that is modernizing the Ukrainian army, not some technology, aircraft or armoured personnel carriers. If you do not know how to use something or how it works, it will not help you.

To date, we have taught over 22 thousand soldiers and have given out more than18 thousand IFAKs. We conduct a two-day course, where the maximum ratio of participants to one instructor does not exceed 20. To begin, instructors explain the theory of tactical medicine. Next, the participants are divided into smaller groups and gain practical skills; this includes how to apply a tourniquet and dressing, how to place a nasopharyngeal tube, how to decompress a pneumothorax, and how to evacuate people under fire. Throughout the first day they apply a tourniquet more than 20 times and acquire many other skills. On the second day, they go over what they have learned, and then during combat simulation they attempt to provide assistance under stressful situations.

Throughout their long years of combat experience, the US military realized that owing to this knowledge, they can save the lives of 15% of the soldiers.

It is not only the soldiers that require training; the combat medics and doctors need it too. We started to train special forces how to give assistance at a higher level as well as develop programs for doctors.

Our students later told us that when they found themselves in real combat, they were able to provide help. They said that had they been able to stand to the side and watch themselves, they wouldn’t have believed that it was their hands doing the work; they were able to cope without panic. The medics that went through our Long Range Patrol Medic course also told us that it was as if they could hear the voices of our instructors, telling them how to give assistance.

The instructors who come to us from abroad are also combat medics, who have extensive combat experience rescuing the wounded.

Currently in Ukraine, there are many veterans that possess invaluable military experience. Among our instructors there are 4 veterans, but we are looking for more soldiers who would like to join us and share their experience. We know that many veterans wish to continue to help in the war effort to help their comrades, their nation, and by sharing their knowledge they are not to leaving their friends in the East.

Recently, we started a training program together with veterans of the ATO who have lost their limbs. We have already conducted three Long Range Patrol Medic courses in which they play injured persons during simulations. Veterans want to, and are able to help the soldiers learn how to give assistance.

Even though soldiers can provide quality care on the battlefield, due to poor evacuation, soldiers don’t make it to the hospital alive. Last week, our friend from the battalion, "Harpoon", was wounded from a mine blast. He sustained injuries to the lower extremities and his upper left limb. The medic, whom we had taught, applied three tourniquets to keep him alive. Another fighter had penetrating chest wounds and a pneumothorax. They applied a chest seal and performed a needle decompression. The second soldier survived, however, due to poor evacuation, the first soldier didn’t make it. This is a big problem. It is important to have the right vehicle, the proper coordination of evacuation, and to also continue to provide assistance during this time.

Unlike in the American army where soldiers give assistance for 10-15 minutes before being seen within the golden hour, due to problems with evacuation, soldiers must sometimes provide assistance for up to 8-10 hours. This is why after the completion of the Long Range Patrol Medic course, we provide a tactical backpack that contains necessities for prolonged field care.

10% of battlefield deaths are cause by blocked airways. To avoid this, you must simply insert a nasopharyngeal tube through the nose. In the new IFAKs, the Ministry of Defence have decided to exclude these tubes because they do not think the soldiers are capable of learning how to insert them.

One-third of Ukrainian soldiers lost limbs as a result of the tourniquet not being loosened in time, halting blood flow to the extremity. According to the United States European Command, the others lose their limbs due to trauma or to infection.

The concept of tactical medicine is relatively new. In the United States it has only existed for 16 years, 10 of which it has been recognized on a world wide scale. Americans document their military very well. After World War II, they analyzed the causes of mortality and found that the majority of soldiers die from critical bleeding. As a result, they changed their protocols and reduced their mortality rate to zero.