Ukrainian trauma surgeons and combat medics have accumulated a trove of “unfortunate expertise” in treating complex battlefield injuries since Russia’s full-scale invasion in 2022.
On Tuesday, two such experts — Dr. Yuriy Yarmolyuk, the chief traumatologist of the Armed Forces of Ukraine, and Dr. Valentyn Rohozynskyi with the National Military Medical Clinical Center in Ukraine — visited San Antonio as part of a medical exchange program to share their experiences with local surgeons.
“If you’re not in the medical field, this may sound harsh or almost brutal, [but] war is the time when medicine gets better, because of the amount of human suffering and the concentration of injuries,” said Dr. Andriy Batchinsky, a Ukraine native and military medicine researcher based in San Antonio. “If it wasn’t for visits like this, we would not have the communication [and] direct interaction with the physicians.”
There are several ways that the physicians are learning from one another. While the Ukrainian doctors have taken medical devices and knowledge from American plastic surgeons on facial reconstruction back to the front lines, U.S. doctors — both military and civilian — are taking notes on the surgical adaptations made under dire circumstances during the war.
“We talk about solutions we have for their problems, they talk about adaptations that previously didn’t exist,” said Dr. Joseph Alderete, an orthopedic surgeon, Army veteran and director of a limb salvage and amputee care laboratory at UT Health San Antonio.
“That may be an ‘aha’ moment for us: Knowledge transfer is so important in dealing with battlefield injury, [but] everything I did on the battlefield, I can translate into an I-10 disaster here,” Alderete explained.
The Ukrainian physicians gave presentations and mingled with local health care providers at the Tuesday night event. The medical exchange program, known as Co-Pilot, is run by Razom for Ukraine, a humanitarian and advocacy organization that has raised over $200 million in aid for Ukraine since 2022, according to its website.
This was the Co-Pilot program’s first stop in Military City USA, home to the Brooke Army Medical Center, the U.S. Army’s leading medical institution and one of two level 1 trauma centers in the city.
Learning curve
Since Russia’s invasion, Ukrainian forces have suffered roughly half a million casualties, which includes killed, wounded and missing, according to an estimate by the Center for Strategic and International Studies.
Russian forces have struck Ukrainian hospitals and medical facilities throughout the four-year war, as well as the country’s power grid. At the same time, there isa severe demand for medical providers.
“We have a shortage of people at hospitals, of everybody: surgeons, all medical staff, registered nurses,” said Yuliia Shama, Co-Pilot’s project manager. “People evacuated because they don’t want their kids to live under constant bombing. We have a shortage of … also, hospital infrastructure. In Kyiv, the main kid’s hospital was hit by a missile directly.
“So we don’t have infrastructure, no electricity, no heating, no people, but still everybody is trying to do their best work.”
Razom for Ukraine organizes about 150 international medical trips to Ukraine every year, bringing physicians from around the world to near the front lines of the battlefield.
‘Horribly difficult’
On top of the infrastructure and medical personnel challenges, the advent of drone warfare in the conflict has led to a plethora of “horribly difficult, complex surgeries,” said Alexandra Domaradsky, a project coordinator with Co-Pilot.
As Morrison and other doctors who served in the Middle East explained, the last four years of the Russo-Ukrainian War has rewritten the rules of battlefield surgery and emergency care that Western forces have become accustomed to.
In Iraq and Afghanistan, for example, the U.S. and allies operated highly organized, quick-acting trauma care systems made possible by controlling those airspaces.
“Our conventional ideas … may run into problems with the advent of drones, and the use of drone warfare requires any military to ascend the learning curve,” said Jonny Morrison, a vascular surgeon who has volunteered in Ukraine. “And the Russians are going up that learning curve as we speak.”
Morrison is a British Army veteran who was stationed in San Antonio for two years and now lives in Boston. He has been to Ukraine twice, performing surgeries as close as 50 miles from the fighting.
“We could evacuate anyone, at will, as fast as in 30 minutes — faster than you can bring sometimes a trauma patient from an accident on I-35 to University Hospital,” added Batchinsky, who didn’t serve directly but who previously worked with the U.S. Army Institute of Surgical Research.
In Ukraine, explosive-rigged drones used by both countries make airspace control largely impossible. As a result, injured troopsare going without intensive care for dozens of hours to several days. “Nobody will rescue you during the day, because all rescue missions will just be killed immediately,” Shama said.
According to Shama, Ukraine has started training more troops in advanced combat medicine as a result, so that frontline personnel can have a better chance of survival after being wounded when combat medics can’t reach them.
“When you see how people drive in San Antonio, we have plenty of trauma on the roads,” said Szeremeta, the ENT surgeon at University Hospital. “It has applications for how we do surgery, how we deliver health care, how we use antibiotics. We have the potential here to learn a lot from what’s happened, and those are huge applications. It’d be sinful to waste the memory of all those people who gave their lives and not be able to use that knowledge to help people all over the world.”
