АвторAuthor: Olha Verkalets | Translation: Yuliia Demchuk
20 September 2022
Dmytro Androshchuk — military surgeon, chief medical officer of volunteer medical battalion “Hospitallers”, and also tactical medicine instructor. In 2013, Dmytro, a sixth year student of Ternopil National Medical University, went to the Maidan and was saving people’s lives. After the Revolution of Dignity he continued his active social activity: he trained military medics and went to the front line as a volunteer doctor. About changes in tactical medicine, creation of stabilization units and sorting of the wounded – read in “Monologues of the War”.
Before the war I lived in Rivne. I was planning to become a surgeon and work there or in Ternopil. Better to say not before the war but before the Maidan because changes in our society started right then.
I was active in university, supported and founded many initiatives. When the Maidan started we removed our university management. In fact, the students were managing university affairs and sent other students to Kyiv in the format of production practice. We wanted to achieve our rights, we didn’t want to close the road to Europe, to be slaves. At first, there were no patriotic slogans on the Maidan. There was a desire to be a resident of the world, not one country. When students were beaten, the attitude changed.
First, we organized everything in Ternopil, then went to Kyiv. I supervised students who came from our university. I myself usually went there in hot periods: at the beginning of December, on Vodokhreshcha, when Mykhailo Zhyznevskyi and Serhiy Nigoyan were killed. Zhyznevskyi was brought to my operating table when I had just arrived. I have my own collection “Notes of a Revolutionary” about the events on the Maidan.
Then, I came during the events in Mariinskyi Park. We were covering the departure of the main groups of protesters, and we got caught in the crossfire. And the final events — St. Michael’s Golden-Domed Monastery. I was helping as a surgeon. At that time, there was no sterility, “semi-operating” rooms were established in the refectory and in “Pyrizhkova”.
After the events in January on Hrushevsky Street, I had a severe contusion. Many things from those days went out of my mind. On the day I got contusion, I remember about 48 wounded passing through my hands. We kept reports, but we gave them away and it is difficult to remember some numbers now.
When the war started, I decided to become a military medic. It was the middle of 2014. I was doing an internship at that time. But this was an educational process, it could be interrupted. And since the end of 2014, I have been actively involved in working with the military. At first, I engaged in self-taught training activities. I created the organization “White Berets – Rivne”, where soldiers were trained. Later, I joined the Ukrainian-American project “Medsanbat”, where I also trained doctors. Then I went all over Ukraine, visited Kyiv more often and began going to the East. First as an instructor, and then as a medic on periodic rotations.
I was a member of many committees under commanders-in-chief, ministries. I was doing my job effectively. I could help reform the Armed Forces of Ukraine only from the public sector. As soon as I mobilized, my hands would be tied. A soldier cannot say anything against the leadership. And I was at the stage of postgraduate education. Interrupting studies would not be right. That is why I was finishing my internship and at the same time engaged in military affairs.
Since 2014, there have been a lot of educational trips to the frontline areas, especially in 2015. There were also foreign internships. Then my studies became more face-to-face, I was engaged in surgery and allocated only a month of time to go to the East.
“There is always burnout. But it is absent when you see the result of your work. It was an experience for me and I saw the result of my work.”
Now tactical medicine is completely different. If in 2014 people were coming to teach us, now Ukrainian tactical medicine is one of the most powerful in the world. We were taught by the best, we assimilated it and multiplied it by our combat experience, which many foreign colleagues do not have. Only South America, where there are constant clashes between drug cartels and the police, can reach the level of Ukrainians.
February 24 passed in a semi-fog. Despite the fact that the “Hospitallers” battalion had been preparing for this in advance (buying equipment and medicines since autumn), I did not fully believe that this date had come. The brain refused to accept. The work was done, but my mind did not perceive the reality. At that time, we were engaged in the completion of our logistics center: we were looking for vehicles for transporting the wounded and were gathering equipment for the battalion.
A month after the full-scale invasion, we worked as medics in the Kyiv direction. The first departure for the wounded was on February 26 or 27. I faced the chaos of both the military and medical services. There was a lot of misinformation, no communications, radio and telephone communications were jammed. It was difficult to gather everyone together and coordinate.
From the first days, we tried to make a coordinating logistics center for medical evacuations. We contacted emergency medical service and arranged that they would give us cases that they couldn’t go to because of hostilities. “Hospitallers” got the north-western direction: from Obolon to Hostomel, Bucha, Irpin.
I decided to organize stabilization units. The distance from the front line to the hospital was five kilometers, but since the roads were broken, we could drive even 40 kilometers through fields, forests, and villages. A seriously wounded person would not be able to stand a long distance. Therefore, we needed stabilization units with a surgeon, an anesthesiologist, who would perform minimal actions on the wounded so that they could get to the hospital.
We organized units along the entire battle line: in Pushcha-Vodytsia, near the Lavina Mall shopping center, in Irpin and Kanadske Selo. In this way, we helped the military in transporting and rescuing the wounded.
A week after the deoccupation of the territories, we were engaged in humanitarian activities. We helped start hospitals and outpatient clinics. “Hospitallers” were helping victims until local doctors returned to their workplaces. The organization of stabilization units was a non-standard solution for our battalion, but an effective one. We continued our work in the East in the same direction.
If “Hospitallers” was a legal structure and separate from the Armed Forces of Ukraine, we could work more effectively. But the Armed Forces of Ukraine still have a post-soviet approach. Many leaders work according to old textbooks. In their opinion, a paramedic on the battlefield has to carry the wounded on his shoulders almost to the hospital. They still do not have an understanding of the medical evacuation service and the work of stabilization units.
All the projects we launched fell apart due to resistance in the leadership of the medical services of the Armed Forces of Ukraine. I remember that there was an educational center for the training of military medics. It would seem logical to send paramedics and nurses for training there to improve their knowledge and become qualified medics on the battlefield. But they were not released, instead a person who had nothing to do with medicine and could not master the program was sent there. As a result, they somehow completed the course and became not a very good medic on the battlefield.
Voluntary work is organized in rotations. We go to positions for a month and work as medics. For the past month I have been working in a large stabilization unit as a vascular surgeon and was helping to save the lives of the wounded.
Since February 24, I have been working in the Kyiv, Vuhledar, and Bakhmut directions. Conditions for work are different. But it is more comfortable to work when there is oxygen and an adapted resuscitation room. It’s possible not everywhere along the front line.
Thanks to donors, we are much better equipped than other medical units. Each of our crews involved in evacuation from the front line must have a night vision device. This issue is not yet closed for us. But we try to solve it as soon as possible.
Most of all, there is a shortage of medicines that you cannot find in Ukraine and powerful drugs. There are problems with the import of over-the-counter medicine that is not produced in our country.
The chief medical officer’s job is to check reports on the quality of care. If something went wrong during the rescue of the wounded, we immediately analyze the situation. And in general, I perform a recommendation function in the battalion when advice is needed on the use of modern medical devices. I am also an international tactical medicine instructor. And I have more experience in using new technologies to rescue the wounded.
In Kyiv, I work as a surgeon in a clinic, and in the East, as a surgeon at a stabilization unit, and at the same time I help to improve the quality of care provided by our “Hospitallers”. This is the moment that gives an opportunity to get distracted. It is necessary to change the types of activities, not to focus on one.
The main injuries of soldiers are mine-explosive or shrapnel injuries. This is probably 70% of all statistics. But it depends on the nature of the work. Intelligence officers, for example, have more bullet wounds.
The first difficult case in providing help to the military was back in 2015. He was wounded in the back and buttocks. It was stressful for me, because the guy pushed me away and covered me with himself. The injury was not terrible, but the incident itself was memorable. I could be in his place. And he was lying there and laughing: “How good, doc, that I was wounded, and not you. Because I wouldn’t know what to do with you.”
There are many difficult cases. During the last rotation, we rescued victims who could not stay alive. According to international protocols, there was no point in resuscitating them. But then I used the skills of a vascular surgeon. In one month, we saved six people who might not have survived if specialized surgical care had not been provided. Not everyone was successfully rehabilitated. But four of them stayed alive.
Patients have to be “sorted” every day. When the wounded are brought to the stabilization unit, we first assess the severity. We immediately divide: into a surgical unit or into an anti-shock unit. And after providing help, it is necessary to decide who will go in a sitting position and who will go in a lying position.
The largest number of patients I received within an hour was 40-50. Those were unsuccessful maneuvers in the Kyiv direction. There were two medics. I was the only doctor, all the others were paramedics, drivers. But there were a maximum of four difficult cases then. Mostly medium injuries.
There are still many supporters of the “russian peace” in hotspots who are waiting for russia to save them. They understand that it is russia that is shelling houses, but they reveal the positions of our military. There are also people supporting Ukraine, but they have nowhere to go.
We save everyone. When the russians approach big cities like Lysychansk or Sievierodonetsk, there are more casualties among the civilians. They scatter cluster bombs, “petal” mines in the neighborhoods of civilians, from which a leg is torn off, but a person remains alive.
Recently, “Hospitallers” have been recruiting fewer new people. Everyone has to go through an educational training center. But recruitment is always active for doctors and medical personnel. We are short of good doctors. There is always place for them in our crew. You can contact anyone from the battalion and you will be forwarded to me or the recruiting center.
Over the past six months, my understanding of what is necessary in my life has changed. You can survive with one backpack on your shoulders and reliable friends by your side. This will give you much more in life than castles, luxurious houses, cars that can be destroyed by a missile tomorrow.
Knowing that I’m doing the right thing helps me hold up. I will not be ashamed to look my children in the eyes. I’m in the right place.
To help medical battalion “Hospitallers” follow this link: https://www.hospitallers.life/needs-hospitallers
Чому важливо поширити цю історію?
Якщо українці не розповідатимуть свій погляд на війну в Україні, світ поступово забуватиме про нас. Натомість цим обов’язково скористаються росіяни. Тому не даймо їм жодного шансу.
Why is it important to share this story?
If Ukrainians do not share their views on the war in Ukraine, the world will gradually forget about us. Instead, the Russians will definitely take advantage of this. So let's not give them a chance.
АвторAuthor: Olha Verkalets | Translation: Yuliia Demchuk
“I was the most afraid for our tiny daughter who hasn’t seen the world yet, and we desperately wanted to show it to her”. This is the story of a woman from Kyiv who was evacuated together with her daughter to Montenegro