Ukraine SitRep: Topography Shapes The Battle Field – Abysmal Medical Service Causes Death

Guest Post by Moon of Alabama

The New York Times repeats claims by the Ukrainian government that it ‘liberated’ Robotyne. The account though is more pessimistic than earlier reports:

Ukraine’s military said on Monday that its forces had retaken the southern village of Robotyne, a tactical victory that underlines the immense challenge Kyiv’s counteroffensive faces in punching through deep and dense Russian defenses.
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[T]he Ukrainian counteroffensive that began in early June has advanced only a few miles southward to reach Robotyne, in intense fighting with heavy casualties and equipment losses, and a similar distance on another axis to the east. The ultimate target of the thrust to Robotyne is the city of Melitopol, about 45 miles farther south, and more layers of Russian defenses lie in the way.
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About 15 miles south of Robotyne lies the Russian-controlled city of Tokmak, a road-and-rail hub whose recapture would be strategically significant.But satellite images show that to reach Tokmak, Ukrainian forces will have to breach two more Russian defensive lines made up of trenches, dense minefields, earthen berms and anti-tank barriers.

Those defense lines are not an easy problem to solve. They are on the hills following the contours of the land while the Ukraine army has so far stuck to the low lands.

Big Serge ☦️🇺🇸🇷🇺 @witte_sergei – 19:53 UTC · Aug 28, 2023I love to advance along the floor of the battlespace into a fire bag.

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Being at a higher ground allows one to see further – and to shoot further. A mortar fired from a hill to the ground below will fly further than one fired from the low ground to the heights above. Running and storming uphill is more difficult than running downhill.

Unless the Ukrainians manage to control the hillsides their progress in Robotyne will by a short and bloody endeavor.

The evacuation of wounded soldiers from positions under artillery fire is extremely difficult and Ukraine’s military medical service is not exactly up to date. There are no helicopter evacuations and no tracked medical transport vehicles that could take the wounded out.A lot of wounded will thereby miss the ‘golden hour’ and simply die before they can be brought into effective medical care. We can also assume that the Ukrainian staff only counts the heavily wounded and that people who get patched up and send back to the front line are likely not included here.

Western media had so far avoided the theme. The British Spectator has now breached the silence with an on-the-ground report of the wars first aid crisis:

I am told by those working here that many of those lost in the war die while they are being moved back to safety rather than on the front line. The long journeys to hospital, sometimes up to ten hours, can be lethal, and the availability of adequate first aid is the difference between life and death.Ukrainians believed that the very best care would be available for their soldiers. But the stark truth is emerging: soldiers are dying in their hundreds or even thousands due to poor medical provision. The problem is being ignored by the military hierarchy, whose focus is on sourcing weapons and pushing the counteroffensive rather than prioritising injured fighters.

Ukrainian front line medics are often untrained and are expected to join the fighting until their service is needed. They lack vehicles to evacuate the wounded. Their supplies are unreliable and of bad quality. Bureaucracy and, of course, corruption is unbound:

One example is the proliferation of low-quality medical supplies being used to treat Ukrainian soldiers. A few weeks ago Volodymyr Prudnikov, the head of Ukraine’s Medical Forces Command’s procurement department, was accused of supplying 11,000 uncertified Chinese tactical medical kits to the front line. It is alleged that Prudnikov awarded £1.5 million-worth of contracts to a company co-founded by his daughter-in-law and was attempting to pass the Chinese kits off as Nato standard. He has been fired and now faces an investigation, but has yet to comment.It is just one example of the profiteering that is needlessly risking the lives of soldiers. Another example of corruption occurred last year in Lviv, where 10,000 tactical first aid kits worth £700,000 were sent by American volunteers and then mysteriously disappeared. It was recently reported that the US is investigating this case.

More questions arise when it comes to the contents of the first aid kits that do make it to the front line. Tourniquets are perhaps the most-needed first aid tool, particularly when the evacuation process is prolonged. But if tourniquets are badly made, they can be lethal. There have been complaints from the front line about Chinese-made tourniquets that either gradually lose pressure or come apart, leading to renewed bleeding with fatal consequences. A Chinese tourniquet costs just £2, while a Ukrainian ‘Sich’ tourniquet is £15. An authentic American CAT tourniquet comes in at around £35.

In my last weekly review I had linked to a Ukrainian piece about tourniquets. It reported how a doctor who criticized the bad quality of the supplied tourniquets was punished for speaking out:

Anton Shevchuk, Head of the Medical Service of the 82nd Separate Air Assault brigade, who requested that Medical Forces Command replace poor-quality Chinese tourniquets and asked social activist Oksana Korchynska to help with this, has been given a “severe reprimand.”
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The number of poor-quality tourniquets that the Medical Forces Command initially issued to the 82nd Brigade exceeds 10,000.

The 82nd brigade is fighting within the artillery fire bag around Robotyne.

Tourniquets well applied to wounded arms and legs can cut off blood vessels and thereby stop bleeding. If they can not hold pressure the wounded will bleed to death.

The medical evacuation on the Russian side is reportedly much better. A few months ago Russia’s defense minister Sergei Shoigu stated that the time to a first aid point for a wounded soldier was down to ten minutes while the time to reach a medical operation center was down to one hour (machine translation):

Russian military doctors involved in the special operation achieved a mortality rate in hospitals of less than 0.5% – the lowest figure in the history of military medicine, said at an expanded meeting of the board of the Russian Defense Ministry, the head of the military Department, Army General Sergei Shoigu.”Military medics especially showed themselves during a special military operation. First aid is provided within 10 minutes. The wounded get to medical units within 1 hour, and to military hospitals – within the first day. We achieved a low mortality rate at the stages of evacuation of the wounded. In the hospital unit, the mortality rate was less than half a percent. This is the lowest figure in the entire history of military medicine, ” he said.

I have no way to verify that data. But I also have not found even one complain about medical frontline services on the Russian side while the sorry state of medical help on the Ukrainian side has received some notice.

This only confirms my take that the 10 to 1 artillery superiority on the Russian side and other factors, like medical services, guarantee that the numbers of Russian casualties in the war are much lower than the Ukrainian ones.

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