“It was a special gift that the Russians left for us,” Andrii recalled, describing a live grenade found in the hands of a barely breathing comrade following a Russian ambush.
On a regular patrol, Andrii – whose surname VICE World News is withholding for security purposes – and his squad stumbled upon a car riddled with bullets from a recent firefight. There were four men inside, "three of them dead, one had signs of life,” said Andrii, a combat medic and medical doctor.
“There were signs of battle. Those guys were our guys,” he told VICE World News over the phone, but a cautious commander stopped Andrii before he could treat the man and make a fatal mistake.
Upon closer inspection, Andrii’s commander found a booby-trapped grenade rigged to the hand of the sole surviving Ukrainian. But with no bomb disposal experts and no knowledge of how to disarm the trap, the squad had to flee and leave their barely breathing soldier to his fate.
Booby traps targeting medics and evacuation vehicles are a common occurrence following Russian assaults, Andrii tells VICE World News. After large attacks, Andrii’s squad often finds live grenades planted under the bodies of their fallen comrades, designed to kill those looking for survivors and collecting corpses.
PHOTO: Hospitallers Battalion
As the principal medic for his company of over 100 men operating in the forests near the Russian-controlled southern city of Kherson, he’s lost three medics and had four injured since their operations began in March.
The stresses of battle take a heavy toll on the mind. “I had one [medic] who tried to kill herself, to show the others and get off the frontline,” he explains.
As the war in Ukraine rages on, Russian President Vladimir Putin has ordered a “partial mobilisation” of troops, motivating dissent and protests in Russia. Ukrainian forces have conducted a lightning-fast advance in the northeastern Kharkiv region, taking back over 3,000 square kilometres of occupied territory.
But between the victories, Ukrainian soldiers are suffering casualties, putting increased pressure on battlefield medics. Violent artillery battles in the east and skirmishes in forests in the south are claiming lives and keeping medics incredibly busy.
Andrii quoted a Russian proverb: “to wound is harder than to kill.” Killing a soldier inflicts one life worth of damage to the enemy, while wounding a soldier means more will come to their aid, representing two to three more targets to take out. As a result, painting red crosses on medics and medical vehicles has proven to be fatal.
“Being a medic does not guarantee you any safety. Markings just identify you as a primary target. Kill the medic of a platoon, and the platoon will be bloodless,” he explains.
Following a series of targeted killings in the war’s early days, Andrii’s medics no longer mark themselves with red crosses or special uniforms in an effort to stay inconspicuous. But that’s not enough.
“They study our behaviour. They study the way we collaborate, and they study every action we perform. They know that after every massive artillery shootout, medic cars arrive, and you can hit them [with artillery],” he said.
Drones have changed the game, and Russian forces have adapted tactics to deliberately target medical evacuation vehicles and crews responding to casualties after shelling and firefights.
“Russians can see people running out of the car with medic backpacks and finding out if there are some soldiers still alive there. It’s easy to find out who’s arrived,” Andrii the combat medic said.
And with every vehicle destroyed in these attacks, there isn’t always another to replace it.
His army company’s official cars provided by military funding were all lost to Russian attacks in the first phase of the war. Now, Andrii fully relies on volunteers to supply evacuation facilities.
Dmytro Yurinov runs Dobrovoz, a volunteer organisation tasked with providing aid to the frontline with a focus on vehicles. He was one of the first ambulance drivers to arrive in Irpin, on the outskirts of Kyiv, working with the ragtag territorial defence forces in the early days of the war.
The Russians target ambulances because of their strategic value. “If you shoot one soldier, you kill one soldier. If you shoot the ambulance team, you cut many lives. If the ambulance doesn’t work during the fight, soldiers don’t receive their treatment and they die,” Yurinov said. “They have no rules, they’re just not a civilised army.”
James Spenceley collaborates with Dobrovoz, and can often be found near Ukraine’s frontlines. The Australian telecommunications millionaire travels between Sydney and southern Ukraine’s Mykolaiv, raising money in Australia through a combination of his network of high-net worth individuals and crowdfunding, and driving through Ukraine to deliver evacuation vehicles and ambulances to the country’s civil and military forces.
The vehicles’ journeys start in western Europe. Ambulances, used mostly outside of the front lines, and 4x4 trucks, for operation in the toughest of combat zones, are often purchased in the UK.
When necessary, they undergo a conversion process in the UK, in which regular off-road trucks are transformed into de-facto medical evacuation vehicles, with spaces for stretchers and benches for medics installed.
A vehicle being modified. PHOTO: Dobrovoz
Instead of fitting cars to multi-storey tow trucks, Spenceley and his volunteers drive them each across Europe, where any issues found along the often 1,000-plus kilometre journey are repaired in Poland. After crossing the border, they hand over vehicles to frontline soldiers.
But as Dobrovoz found, ambulances are becoming scarce in western Europe because most of them have already been donated, which is forcing volunteers to make the hard choice of who deserves the ambulance more.
Several weeks ago, they dropped an ambulance off to an elite army unit in Ukraine’s eastern region. The week before Spenceley arrived, the unit lost two of their ambulances and multiple medics, when a collaborator gave up their house’s location. “All of a sudden, in the middle of the night, Russian artillery just came in, and with no military stuff around apart from these medics and ambulances, [they] just blow up the house and two of their ambulances,” Spenceley said.
In a fight against an army without rules, medical evacuation is harder than ever. “The first phase [of evacuation] is to get the guy from the frontline to an area with some roads,” Mykyta, a Territorial Defence rifleman, told VICE World News over the phone. We are not disclosing his surname for security reasons. “Not all medical cars we have are able to go in the field.”
The frontlines are often plagued by rough and roadless terrain, where traditional ambulances just aren’t designed to be driven. They’re unstable in rough terrain, and they look like ambulances, which makes them a big moving target for the Russians.
Ukrainian teams on the frontline prefer fast and rugged off-roaders – 4x4 pickups are a favourite.
Mykyta’s battalion is fighting in the shell-littered fields of the Donetsk region, but he’s in Kyiv for three days on official business where he’s picking up a newly delivered Mitsubishi L200 4x4 truck for his battalion.
“We are not saints. We are sinners,” Andrii the medic said. “All your actions should have an objective of winning the war – saving people is not as important as killing the enemy.” As such, the choice to risk troops’ lives by ordering an evacuation is up to the commanders, not the medics.
After an evacuation is made and the team makes it to the road, the second phase commences; casualties need to be stabilised in an ambulance and brought to hospital. “We hide ambulances in ‘evacuation stations’, around abandoned villages and houses, even trees. Anywhere where there’s roads near the frontline,” Mykyta said.
Medics and nurses will be waiting at these covert ambulance stashes to move the casualty into the ambulance. But the danger doesn’t end there.
The aftermath of an antitank mine. PHOTO: Hospitallers Battalion
“We have a really good hospital maybe half an hour away,” Mykyta said. “The journey is a crazy one. We go very fast. Sometimes there’s very urgent injuries. He doesn’t have time to wait, we need to go to the hospital for blood because we don’t have it in the ambulance.”
And during the high-octane race against death, drivers find themselves dodging landmines and artillery strikes attempting to destroy the vehicles and medics who are crucial to the war effort.
Recently, Russian Grad rockets struck a hidden medical evacuation vehicle, damaging the 4x4 and injuring two men on Mykyta’s squad. The two soldiers are now being treated for their wounds and contusions.
“It’s very hard to say who and why they target. I don’t understand the enemy at all. They just shoot at anything – we’re all enemies to them. Doctors, soldiers, civilians, journalists. For Russians, all of us are the same enemy,” Mykyta said.
With winter on its way, life is only going to get harder for both forces, leaving medics to deal with even more problems.
Soon, concealing ambulances, soldiers, and equipment in the trees after they have shed their leaves will be nearly impossible, shifting the playing field and making the battlefield that much more dangerous for Ukraine’s indispensable medics.
Additional reporting by Vlad Fisun & Jeremy Chan
Follow Mihir Melwani on Twitter @mnm_mihir