Meanwhile, people keep dying in Ukraine. Russian aggression delivers mass death by a ghastly mixture of modern technology, chiefly drones (now nearly 50 per cent of Ukrainian deaths in battle), and Great War-style bombardments.
During his Oval Office set-up of President Zelensky last Friday, Donald Trump said that men were dying because of “a lot of bullets”. Actually, bullets achieve only two per cent of the deaths.
In the past three years, the number of Ukrainians killed probably matches the 58,000 Americans who died over 20 years in Vietnam. There may be four times as many dead Russians.
The only cure is a just peace, but deaths can be reduced now – a precious achievement, militarily and morally. Last week, after following the politics in Kyiv, I travelled east, to the Zaporizhzhia oblast, to see lives being saved at the front.
Time is key, loss of blood being the biggest single cause of avoidable death. In Afghanistan and Iraq, the British defined the “Golden Hour” in which a wounded man could be helicoptered out. No such luxury exists in Ukraine. Any helicopter entering the zone would be destroyed.
Far from sparing medical operations, the Russians target them. Wounded lying on the battlefield are observed by Russian drones and attacked when they and their rescuers emerge from hiding. Sometimes they are trapped in freezing foxholes for days, long enough for the tourniquets designed to save them to induce organ failure and death.
The Russians constantly bomb stabilisation points – “role one” in the sequence of medical treatment – and military hospitals.
I met the charismatic Lt-Col Roman Kuziv, the officer commanding medical services in the east (scene of most of the fighting for 500,000 soldiers), aged only 36 but a general by acting rank. Though Ukrainian, he trained as a doctor in Catalonia, where his wife and two young daughters live. He has been at the front for three years this month.
We drove to one of his 150 stabilisation points, seven miles from the front. Suddenly our armoured vehicle descended a steep incline, passed through strips of camouflage and parked 20 feet below ground. “When we were on the surface,” said Col Kuziv, “The Russians bombed us 16 times, killing one, injuring nine. So I dug this.”
We entered a hall supported by wooden pillars, a log cabin. Off it lay several rooms, each protected by corrugated iron, containing one well-equipped hospital bed.
Patients are divided into “red” (or “hard-wounded”), “yellow” and “green” (minor injuries). Ten per cent of the wounded are red. Once stabilised, they are transported to surgery, a journey that can take four hours. Such is the efficiency that the facility can manage, at maximum, 200 patients a day.
That particular day, the local front was quiet, so we drove on to another stabilisation point, a makeshift mini-hospital in what resembled large tents within a semi-derelict building. Though overground, it was concealed. No ambulance dares linger. An emergency bunker was being dug.
Here I witnessed what I had come to see – the work of my hosts MOAS (moas.eu), a charity, international and British-registered, which began quite differently. Its initials stand for migrant offshore aid station. It was set up to help refugees in the Mediterranean.
Several years ago, however, its charismatic founder-leader, Christopher Catrambone, decided there were more lives to be saved in Ukraine. MOAS became the main casualty evacuators (“casevac”) for the Ukrainian army, conveying, by this month, 67,648 casualties, overwhelmingly red patients. None has died during their evacuations.
The key to success is that MOAS’s people are trained doctors and paramedics. Col Kuziv trusts them to transport the patients, continuing to stabilise them as they go.
I saw it happen. At the stabilisation point, a “hard-wounded” 50-year-old soldier was being treated by six army medical staff for more than an hour. He had shrapnel in both legs, one hand, his abdomen, spleen, thorax and face. He looked a bloody mess.
Once stabilised, he was gently trussed up for the journey, wrapped in foil against hypothermia (the outside temperature was sub-zero) and handed over to the MOAS ambulance and staff.
I travelled beside the wounded, oxygenated, unconscious man on the half-hour journey to the hospital which could operate. Attending to him throughout were a paramedic and Dr Inna, a tiny young anaesthetist, both from MOAS. As we bumped along the war-damaged roads, they found their way through a seemingly impossible tangle of wires to keep him stable.
The patient must be too ill to live, I thought, but Dr Inna, as she transferred him, said, with perfect confidence, that he would be all right.
MOAS’s expanding operations cost a lot and money has not kept up. The British government, though supportive, has not cut the bureaucratic Gordian knot about which department should pay. There is talk of needing a “demand signal” from Ukraine, yet Col Kuziv, the man who knows the most, has written to our Government to plead for MOAS.
The next day, I met Alina, a resolute 29-year-old woman who commands a MOAS team of 20 quartered every night underground to escape bombardment.
She longs to go home to the safer western Ukraine and start a family. With a volley of oaths, she tells me how she hates this war. But she adds, “I’m here because I need to be here.” She is a volunteer, but her commitment is such that she feels she has no choice. I wish I could put her in front of President Trump. He might understand better if he met more Ukrainians.
Meanwhile, people keep dying in Ukraine. Russian aggression delivers mass death by a ghastly mixture of modern technology, chiefly drones (now nearly 50 per cent of Ukrainian deaths in battle), and Great War-style bombardments.
During his Oval Office set-up of President Zelensky last Friday, Donald Trump said that men were dying because of “a lot of bullets”. Actually, bullets achieve only two per cent of the deaths.
In the past three years, the number of Ukrainians killed probably matches the 58,000 Americans who died over 20 years in Vietnam. There may be four times as many dead Russians.
The only cure is a just peace, but deaths can be reduced now – a precious achievement, militarily and morally. Last week, after following the politics in Kyiv, I travelled east, to the Zaporizhzhia oblast, to see lives being saved at the front.
Time is key, loss of blood being the biggest single cause of avoidable death. In Afghanistan and Iraq, the British defined the “Golden Hour” in which a wounded man could be helicoptered out. No such luxury exists in Ukraine. Any helicopter entering the zone would be destroyed.
Far from sparing medical operations, the Russians target them. Wounded lying on the battlefield are observed by Russian drones and attacked when they and their rescuers emerge from hiding. Sometimes they are trapped in freezing foxholes for days, long enough for the tourniquets designed to save them to induce organ failure and death.
The Russians constantly bomb stabilisation points – “role one” in the sequence of medical treatment – and military hospitals.
I met the charismatic Lt-Col Roman Kuziv, the officer commanding medical services in the east (scene of most of the fighting for 500,000 soldiers), aged only 36 but a general by acting rank. Though Ukrainian, he trained as a doctor in Catalonia, where his wife and two young daughters live. He has been at the front for three years this month.
We drove to one of his 150 stabilisation points, seven miles from the front. Suddenly our armoured vehicle descended a steep incline, passed through strips of camouflage and parked 20 feet below ground. “When we were on the surface,” said Col Kuziv, “The Russians bombed us 16 times, killing one, injuring nine. So I dug this.”
We entered a hall supported by wooden pillars, a log cabin. Off it lay several rooms, each protected by corrugated iron, containing one well-equipped hospital bed.
Patients are divided into “red” (or “hard-wounded”), “yellow” and “green” (minor injuries). Ten per cent of the wounded are red. Once stabilised, they are transported to surgery, a journey that can take four hours. Such is the efficiency that the facility can manage, at maximum, 200 patients a day.
That particular day, the local front was quiet, so we drove on to another stabilisation point, a makeshift mini-hospital in what resembled large tents within a semi-derelict building. Though overground, it was concealed. No ambulance dares linger. An emergency bunker was being dug.
Here I witnessed what I had come to see – the work of my hosts MOAS (moas.eu), a charity, international and British-registered, which began quite differently. Its initials stand for migrant offshore aid station. It was set up to help refugees in the Mediterranean.
Several years ago, however, its charismatic founder-leader, Christopher Catrambone, decided there were more lives to be saved in Ukraine. MOAS became the main casualty evacuators (“casevac”) for the Ukrainian army, conveying, by this month, 67,648 casualties, overwhelmingly red patients. None has died during their evacuations.
The key to success is that MOAS’s people are trained doctors and paramedics. Col Kuziv trusts them to transport the patients, continuing to stabilise them as they go.
I saw it happen. At the stabilisation point, a “hard-wounded” 50-year-old soldier was being treated by six army medical staff for more than an hour. He had shrapnel in both legs, one hand, his abdomen, spleen, thorax and face. He looked a bloody mess.
Once stabilised, he was gently trussed up for the journey, wrapped in foil against hypothermia (the outside temperature was sub-zero) and handed over to the MOAS ambulance and staff.
I travelled beside the wounded, oxygenated, unconscious man on the half-hour journey to the hospital which could operate. Attending to him throughout were a paramedic and Dr Inna, a tiny young anaesthetist, both from MOAS. As we bumped along the war-damaged roads, they found their way through a seemingly impossible tangle of wires to keep him stable.
The patient must be too ill to live, I thought, but Dr Inna, as she transferred him, said, with perfect confidence, that he would be all right.
MOAS’s expanding operations cost a lot and money has not kept up. The British government, though supportive, has not cut the bureaucratic Gordian knot about which department should pay. There is talk of needing a “demand signal” from Ukraine, yet Col Kuziv, the man who knows the most, has written to our Government to plead for MOAS.
The next day, I met Alina, a resolute 29-year-old woman who commands a MOAS team of 20 quartered every night underground to escape bombardment.
She longs to go home to the safer western Ukraine and start a family. With a volley of oaths, she tells me how she hates this war. But she adds, “I’m here because I need to be here.” She is a volunteer, but her commitment is such that she feels she has no choice. I wish I could put her in front of President Trump. He might understand better if he met more Ukrainians.