MOAS medics: Racing against death

MOAS medics transport fighters with the most severe injuries from stabilization stations to hospitals

Abdominal injuries, head injuries, amputations, lots of amputations — it is very hard to see this day after day, sometimes a few times in a row. And it is even harder to explain to the wounded guys what is wrong with them, to find the right words, to calm them down. Handling those who could not be immediately evacuated from the frontline because of shelling is particularly difficult.

The Ukrinform team spent a day with medics from the MOAS charity organization, who pick up wounded soldiers from stabilization stations or field hospitals and transport them to army hospitals where they are provided with all the necessary aid.

The largest MOAS base is located in the Donetsk sector. Intense fighting continues in this area of the frontline; so, medics have their hands full.

“WE PICK UP THE MOST DIFFICULT ONES WHOM NO ONE ELSE WOULD TAKE”

We arrived at the base when it was relatively calm and the medics had some time to rest.

“We try to give everyone a chance to rest, but it all depends on the situation at the frontline. Everyone understands why they are here. Most of the wounded are evacuated straight from the operating table. This is due to the fact that these field stabilization stations are under a heavy load, with patients arriving all the time, and they need to have some free space. Just the other day we had all our teams busy, while some teams were even doing a second round. An active phase has begun at the front, so we have more wounded,” says Artem Bildii, Head of the Donetsk Section of MOAS.

Artem Bildii

The base where we arrived has ten teams with three persons in each. Four more teams comprising 12 medics are located closer to the front line. They provide assistance directly at the stabilization stations, deliver emergency aid to the wounded and transport them farther, following which the remaining teams join in.

“Our operation is fully coordinated with the military. The area where we operate has one of the longest evacuation paths. It is about 300 kilometres one way. The road takes 9 to 10 hours from the moment we leave the stabilization station and until we return to the base. It can even be longer sometimes. Depending on the patient’s condition, sometimes it is necessary to stop at hospitals on the way to have blood transfusion. A single evacuation would then take 11 to 12 hours,” explains Artem.

When the full-scale war began, the MOAS team comprised foreign medics, but they were gradually replaced by Ukrainian personnel.

“Ukrainians must do it. That is why we are here. We have our own excellent professionals with extensive experience who can save people. Our team comprises professional doctors, all of them — medical school graduates. All our teams are anaesthesiology ones, and some of their members have experience as combat medics. Most teams have been working in these sectors of the front for more than a year," explains Artem.

Artem is 34. He was born in Dnipro. Before the war, he worked as an ambulance paramedic. He joined the charity foundation’s team for three months — like most people, he hoped that the war would not last long and would be over soon. The bosses at his “civilian” job did not want to keep his position waiting for him, so he had to make a choice.

“I am useful to the max now. In civilian life, the most difficult cases involved saving children, usually in car accidents. Here, it is really exhausting to see all this, for example, patients with amputations who remain conscious. Once I had no sleep for two days and couldn’t remember the rest,” the man tries to joke.

Since the start of the full-scale invasion, the MOAS team has evacuated more than 35,000 wounded soldiers, including critically injured.

“All of our vehicles are resuscitation ones with ventilators and all the necessary medical equipment to support the patient’s vital functions. That is why we’ve been tasked with handling the most difficult patients, those whom no one else can take. There are non-transportable patients who may have a chance in regional hospitals. So, we have to take risks,” says Artem.

“Do people thank you often?” I ask.

“They do. We often hear that we are the only ones. This is inspiring. It gives you strength,” he answers.

It felt uncomfortable to ask him if he was tired. Of course, he was. His wife and 8-year-old son are waiting for him at home. Every time the child sees a car with the MOAS inscription in the city, he would proudly say that his father is driving.

The boy went to the first grade during the war, but Artem missed that, as he missed many other important moments in his son’s life.

The man tries to communicate with his family every day, but realizes that it is impossible to make up for lost time. Not a single messenger, no matter how advanced, can substitute for live communication.

“I am here for my family. Most of the wounded whom we evacuate also have families, and we tell them to fight for their lives for the sake of their loved ones. Many of the guys, despite the severity of their injuries, are determined to return. Some even ask, will I be able to shoot without an arm?” adds Artem.

There is a never-ending sound of sirens wailing at the base, which also was heard while we talked. This sound is perceived as an ordinary noise, ignored by everyone.

GOLD STANDARD

Meanwhile, in the corridors of the base we see a young man. His name is Nazar, and he is an anaesthesiologist, back from a nightly trip. By the way, local medics never say “shift” because it implies something normal, with a beginning and an end. They refer to “trips” here.

Nazar has been with the MOAS team for a little over six months, taking part in thousands of evacuations.

Nazar

“For example, yesterday we transported a patient who was fully conscious. He had a head injury, a basal skull fracture. He was, as we say, a ‘code red’ patient, that is, he had to be evacuated first. Before that, we had a patient with small and large intestine injuries, massive bleeding. We were transporting him in an extremely grave condition, giving him blood transfusions on the way. This was a very severe case. Generally speaking, massive amputations, shrapnel wounds — there is no such thing in civilian medicine. Combat traumas are extremely difficult and incomprehensible; therefore, we need to learn all the time,” says the medic.

A special cabinet with cells stands near the exit from the room. Each has a team number on it, the same as on the vehicles. The things that medics take with them are kept here. Oxygen cylinders, which are also taken on every trip, are lined near the cabinet.

It takes the team 7 minutes to assemble. They say that this is the gold standard, so to speak.

“NO MATTER HOW MANY OF US ARE OUT THERE, IT WILL ALWAYS BE TOO FEW”

Another medic, anaesthesiologistNatalia, has returned from the evacuation trip. She hails from Khmelnytskyi, and switched from civilian to military medicine in May 2022. She says she really wanted to help the military. These thoughts were on her mind all the time until she passed an interview at MOAS.

“When I told my family about my decision, they told me that they had expected me to do so, knowing from the very first days that it was going to happen. They let me go without any obstacles,” she says.

Natalia

Like most of her colleagues, Natalia thought she would be back home in a few months. She told her son that she would come back when the war was over.

“The first time I came back was eight months later, without any warning. My child saw me and asked, ‘Mom, is the war over?’ There was so much joy and tears! Leaving gets harder every time. But I feel my son’s support. He is proud. He is only 10 years old, but if he were older, he would do the same. I know that. I do not want our children to live and grow up in war. I don’t want them to fight,” Natalia says.

Unlike Artem, Natalia is expected back at work. She says that every time she visits, her colleagues would ask, “Natalia, maybe you’ve had enough? Maybe it’s time to stop?” And she answers,

“No matter how many of us, medics, are out there at the frontline, it will always be too few. Strength is needed, we are needed.”

They always carry a bulletproof vest, helmet, and individual first aid kit. Natalia jokingly says that she wouldn’t mind even sleeping in her vest. She says it feels more like a personal item.

“I don’t feel that weight anymore. Although it weighs somewhere around 7 kg or maybe more,” she adds.

While at the base, we had time to see the conditions in which the medics live. We noticed a lot of plastic bottles in the corridors. It turned out that the base had no stable water supply, and medics have to stock up all the time.

While talking to Natalia, I ask her about everyday life or, to be more precise, how difficult it was to adjust.

“The boys in the trenches have nothing at all. And we are used to having water from flasks. I come home and it seems to me that I could bathe in a bowl with a ladle. That flask gives me enough water. I miss my family, but we talk all the time. If there is a lot of work, they say, ‘Just drop us a smiley face and we’ll know everything is fine,’” she says.

She was on a night trip and returned in the morning. The guy who was being transported had post-tourniquet syndrome that develops when a tourniquet has been applied for a long time and kidneys start to fail. The wounded man was put on ventilation. On the way, the team had to stop at hospitals for blood transfusions. He was delivered to a specialized hospital in a stable condition.

“Our boys are heroes. Every day I want to wake up and find out that there’s peace. Then you think, well, peace will come after summer ends; then autumn is around and you think that there’d be peace finally. Now there’s winter coming… The war will end in an unexpected way,” Natalia adds.

ALWAYS KEEP YOUR EYES ON THE WOUNDED

While we are talking to the medics, Artem receives information that two teams are to pick up the wounded from field hospitals and deliver them to hospitals in the Dnipropetrovsk Oblast.

It actually takes the team only a few minutes to assemble. The medics quickly get into the cars. We rush after them. Or at least try to keep up.

They are going to pick up the wounded and let us get into one of the cars.

“This is the ‘code red’ patient. He is on ventilator. This man had a penetrating shrapnel wound, with damages to the abdominal and respiratory systems. He went through shock, heavy blood loss, and underwent a blood transfusion. His life was saved, and now other surgeons have to save his health,” says anaesthesiologist Alla.

Alla

She hails from Zaporizhzhia, and used to work at a maternity hospital ― a perinatal centre.

“There are such complicated and bad cases that other teams would not take, but we have the opportunity to pick them up and deliver them. We make such trips every day, sometimes twice. When there are many wounded, we work without rest. More than once we had to go without sleep for 24 hours. We would spend about 10 hours on the road, three of which are with the patient, stabilizing him, supporting his vital activity, keeping an eye on him,” she explains.

We have to get out of the car, as medics have to work, and it’s better to do it without onlookers.

A TEAM OF RESCUERS ― ONE FROM RUBIZHNE, ANOTHER ONE ― FROM MALTA

It was already completely dark outdoors and quite late when we decided to return to Zaporizhzhia. Suddenly we get a call from Artem: another team has left for evacuation, and we could meet them at the hospital where the wounded serviceman was to be delivered. We decide to go there.

An operating room at the hospital is all prepped up, waiting for the patient and medical staff. The MOAS team drives into the yard. Carefully, but quickly, the guys carry the wounded on a gurney.

“His condition is serious, caused by a spinal injury. There is contusion and compression of the spinal cord. The patient cannot maintain blood pressure on his own, and his cervical vertebrae are fractured. He was wounded this afternoon. It is very difficult to transport such wounded. You have to anesthetize him and make sure he breathes on his own and remains conscious at the same time. The guy is talking to us, he realizes that he can’t feel his limbs, has no sensitivity or mobility. He is tetraplegic, his arms and legs are paralyzed. This is a mine blast injury,” MOAS doctor Oleksandr reports to his colleagues.

In the hospital, these teams are affectionately called “Moasics”.

“They started calling us that in Zaporizhzhia, and the nickname got picked up in Dnipro. The attitude towards us is very good. They know that if a MOAS team comes, it will deliver someone in a serious condition, but he would have been treated and more or less stable. We handle serious cases. We have oxygen, ventilators, medicines ― we are one of the best in this field,” says Oleksandr.

Oleksandr

After the patient has been admitted to the operating room, we can talk for a few minutes while the team takes a little rest before leaving again.

Oleksandr has been on the team for three months. He is from Rubizhne in the Luhansk Oblast. Oleksandr is an anaesthesiologist and resuscitator, who previously worked in a hospital at the intensive care unit. When the war began, he helped the Ukrainian military, and with the shifting frontline, more civilians would be admitted to the hospital.

“Shelling continued day and night. I stayed there because my grandmother, brother, and mother were there. On March 9, 2022, a shell hit our house. I was at work, and my mom and brother were at home. That was when he got a head injury. I was treating him. Then there were a lot of wounded civilians. There was also an evacuation route available through Lysychansk, I could have left, but I couldn’t take my mother and brother then, so I stayed,” the man says.

Some time later, a doctor with whom Oleksandr worked was seriously wounded: he was on the balcony when the shelling began.

“The balcony was hit straight from the ‘LPR’ positions, and my colleague was seriously injured. His spine was damaged by shrapnel, there was a severe contusion, he was unconscious and without blood pressure. When he came to, I was already evacuating him to Lysychansk. He is now in Germany. He had a lot of surgeries, including on his eardrum, and had a lot of shrapnel in his body,” the medic recalls.

He was held captive in Rubizhne for a few days. The invaders kept Oleksandr in the basement. Then they captured his mother…

As soon as the opportunity arose, he and his family left for Europe via Russia and Belarus. He spent ten months in Germany with his brother, followed by three months in Latvia. Then he returned to Ukraine.

“What’s the hardest part of your job now?” I ask, because hardly anything can surprise him.

“Oh, if the guys at the frontline hear this, they will laugh at me. Sometimes, when we come back at 3 a.m., there may be no time to rest at all, because I’ll hear on the phone, ‘Can you make another trip?’ And we’ll go without hesitation,” he says.

“Do you know that you’re a good lad?” I ask him again.

“That’s what my mother says,” he replies shyly.

“That’s what I’m telling you too,” I shake Oleksandr’s hand.

While he is packing, we have a few minutes to talk to the driver. They call him “Malta” because he returned from there after the war began. He was on a MOAS team there as well, rescuing people on the water.

“Malta”

“The war started, and I decided to return to Ukraine. My boss said that MOAS would also be helping there and offered me a place in the team. We stayed in Zaporizhzhia, and then got transferred to the Donetsk area. Here, the distances to hospitals are larger, and the journey takes longer,” he says.

He is from Lutsk and had never been to the country’s east before the war.

“I saw the mountains, and they were beautiful, the sea, and it was beautiful, but when I came to the east and saw fields, steppes, I thought they were incredible,” says “Malta”.

The men get into the car and ask us to jinx them by wishing them good night.

P.S. Most of our interlocutors are not quite sure what they will be doing after the war, but they are confident that our medics and their experience will be very valuable to the world.

MOAS teams would sometimes work in the de-occupied cities; they arrived there in the first weeks after the liberation. They say that it is very scary to see big cities empty.

“You know that thousands of people used to live there, but now there are only a few left and there is nothing there ― no water, no electricity, and ruins instead of houses. People used to dream of seeing the world, but now Ukrainians dream of traveling around Ukraine. And our medics dream of just going home,” said Artem, the coordinator, at the end of the conversation.

Olha Zvonarova, Zaporizhzhia

Video by the author

Photos by Dmytro Smolienko