Field Reports from an Aussie Paramedic in Ukraine - Field Report 3

· Lived Experience,Field Reports

Late last year Australian based paramedic Jack Dear embarked on a journey that would take him to the front lines of the war in Ukraine. Having previously worked as a paramedic in Australian Capital Territory, London Ambulance Service, and Cape Town South Africa, Jack as also previously worked as a security/medic in the Australian Embassy in Kabul and as a soldier in the Australian army armoured corp. But in his own words, his deployment to Ukraine was destined to be unlike anything he had experienced prior.

In this final field report, Jack documents his experience briefly to capture the experience of an Australian paramedic working in Ukraine.

Field Report 3. 

Day 15. East Kupyansk.

After seeing the UAF push further east, forcing a Russian withdrawal and liberating more villages, we decided that we would venture over the Oskil river. This meant stepping off the already beaten (and cratered) track, onto muddy roads forged by advancing tanks some days ago. Once across the river we headed for a particular housing block that we knew had an elderly couple who hadn’t seen medical attention since occupation. Like on our previous missions, the villagers seemed to spring out of the ground at the prospect of friendly faces providing care. Lead by our esteemed local doctor Olena we attended to the couple and made several other house-calls, before dispensing our supply of medication to the villagers that waited patiently.

In my career as a paramedic in Australia, I’ve on occasion received a hug from the odd patient. Here in Ukraine however, a hug and a tear after every house-call seems customary. ‘Babusya’ is Ukrainian for grandmother and one of the few Ukrainian words I’ve committed to memory. Babusya’s give amazing hugs.

Once we exhausted our medication supply, we hurried back to the Kupyansk Bridge to rendezvous with our other crew.

Our second ambulance, crewed by our resident German Alex and Ukrainian interpreter Eugene spent the day covering the Kupyansk bridge. There they assisted the slowing stream of evacuees over the crumbing concrete and broken asphalt that is the foot bridge. All crossing experience the foul senses of war. This was reaffirmed by witnessing as one poor soul with a tourniquet still tight on his leg baking in the sun on the eastern side, abandoned by his retreating comrades and overlooked unapologetically by the advancing Ukrainians. Despite the heat, many of the evacuees wear heavy winter coats, knowing the months coming will see freezing temperatures. The children wear their hand-me-down one-size-too-big jackets dragging their child sized luggage.

Olena tells us that when she enquired about the medical treatment that the villagers saw under occupation, they reported only a single instance of a Russian doctor entering the town. Villagers also reported that the local Kupyansk doctors, good people and respected members of the community that had not fled, were hired by the Russians. They were forced to sign contracts detailing their employment with the Russian army, treating their soldiers and receiving a salary. The crazy part is that those doctors and their families then fled east into Russia as the UAF advanced. I can’t fathom the dilemma faced by those doctors. Were they afraid of reprisals by the Ukrainians? Were they sympathetic to the Russians? Or were they just afraid of the fighting that surrounded them? Whatever their reasoning, the ramifications of their choice will be felt by them and their future generations for decades.

As I write this, I’m once again lounging in the back of the ambulance, hurtling south towards Dnipro, keen for a shower and bed. We recently passed through Kharkiv, and the experience of driving through a darkened city under curfew is eerie. It makes me think of the London Blackout during the Blitz in 1939. As an ambulance we get speedy access through most of the many military checkpoints which seem to appear suddenly out of the dark. Yet despite this, the bumpy hours ahead dont inspire much hope for a mid-transit nap. Thankfully I have enough ketamine, morphine and midazolam to sedate all the worlds remaining elephants, plus one paramedic.

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Day 16. Retaliation.

After my ‘rest’ day, we were straight back out into the field. The crew had enjoyed a rewarding day without me. Their mission to a new village was a massive success and at times a sea of people had crowded them into their vehicles. In the evening they found a critically ill Babusya with a severe arrhythmia. A lengthy and frustrating evacuation commenced, resulting in her eventual admission at a Kharkiv hospital. She will most likely need ablation but due to financial and medical constraints, it’s even more likely she will suffer on without.

Today, as expected, we saw Putin’s response to the Kerch Bridge bombing. Attacks were seen in all the major cities and appeared indiscriminate in their targeting. Over 61 missile strikes, 32 air strikes, 92 MLRS shells were seen in 30 settlements. Almost like a petulant child lashing out, these attacks appeared to be driven by anger and intended solely to insight fear.

We could hear the shelling in Kharkiv as we struggled to buy our medication at the pharmacy. By candlelight, we bought out their entire supply of amlodipine with cash, as card was not an option. Top tip - warzones quickly become cash economies when the power goes out. Thankfully, the team and I were headed out into the country side for the rest of the day, away from the major targets. The weather had turned the roads into muddy quagmires, churned up by manoeuvring tanks. Getting bogged was at the top of my worries, as a night in Kupyansk was not a safe option.

We arrived at our destination later than planned, and a small crowd was already waiting. Simon kicked into gear, working through each patient’s needs. One lady, soaked to the bone, waited patiently for her leg wound to be redressed. Visible necrosis and exudate spilled from her calf. Despite the circumstances, her wound was not the result of trauma, shrapnel or violence. Caused by a minor scratch, neglect was the real enemy.

As Simon worked, Eugene, Alex and I made house calls. In a dark house, we treated a partially paralysed man who had suffered a stroke several month ago. Pressure sores had developed on his back and had become infected, in addition to a fungal infection on his feet. It was a learning experience for all. Alex, a novice but eager clinician cleaned and dressed the wounds, and we coached the patients family on some basic occupational therapy techniques while Eugene relayed to me the experience of the patients family and how they had overcome the challenges of being cut off. I dressed the man’s wounds with a padded dressing and we managed to supply him with betadine, hydrozole, and paracetamol before heading on our way.

In Ukraine, they use a local topical ointment called Diamond Green which is a synthetic aniline dye supposedly similar to betadine. It’s Forrest-green colour is distinguishable from a distance as it stains the skin terribly. However, its benefits are limited and it can severely burn the dermus, especially in children. Despite this, it’s use is almost faith based and a pet frustration of Dr Olena’s.

The sun was getting low as Simon’s crowd slowly dissipated. We needed to get out of Kupyansk and onto sealed roads (excluding all the pot holes).

Driving at night is nerve racking as many armoured coloums move swiftly past without lights, only distinguishable by their clanking tracks and thunderous engines. Rain hadn’t help either with puddles concealing deep craters. Thanks to some reactive driving, we exited the town without getting bogged. Cautious not to draw to much attention to ourselves, we’d driven slowly without our headlights, using the fading dusk light.

We were out and could release our collectively held breaths. Back to Kharkiv. With phone reception restored, we learnt of the countries attacks and a flurry of messages form love-ones pinged in our inbox. Another successful day behind us, I crashed into bed, ready to do it all again tomorrow.

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Day 17. Kucherivka.

Today was to be our last visit to the Kupyansk region, at least for the time being. Tonight we would take the long road south, back to Dnipro, where we intended to plan new missions southeast to the Kramatorsk/Izium/Lyman region.

We set off early, intending to follow-up and resupply a few patients that would not see fresh dressings for some time. One lady desperately needed her sutures removed as they were beginning to fester. Earlier in our week, she had presented to us with an oozing wound, stitched up by a Russian medic. Strangely, a latex glove was inlayed under the sutures as a makeshift drainage system. Probably set with the intention of removal after a few days, the wound was neglected and the glove forgotten. Thankfully the patient didn’t advance to septicaemia and Simon was able to irrigate and reset the wound. After completing the dressings and saying our farewells, we seized the opportunity to swing through Kucherivka, a village east of a Kupyansk. We found it’s beautiful church partially damaged and the evidence of a fierce tank battle surrounding it. In the debris I found a blackened spanner which ill gift to the blokes back at the Mens Shed in Canberra, who had generously donated towards my cause.

If the spanner could talk, it would tell a tale of birth in the USSR, use by many a Russian tank driver, tightening numerous nuts on armour plates, till one day it was bent askew by a Ukrainian antitank weapon, and finally picked up by a curious Australian paramedic.

With Kupyansk behind us, Im thankful that my time there was safe and fulfilling. We wish to return, but should not. I hope the town is rebuilds and the bridge is restored. This towns earth is waterlogged with the blood of many past conflicts. It needs rest. The people of Kupyansk deserve a chance to rebuild and a future of unending monotonous peace.

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