1/ A Russian military doctor has spoken frankly in an interview about the atrocious state of Russian military medicine and the lack of medical training given to soldiers. Most of the wounded die, he says, and doctors themselves are treated as 'slaves' by the Russian military. ⬇️
2/ The Russian Telegram channel Transformer has published a lengthy interview on the experiences of Dr. Alexander Moiseevich Z (a pseudonym). He volunteered for the army at the age of 62 in October 2022 and resigned in June 2024 when he reached the mandatory retirement age of 65.
3/ Alexander first workied as a military doctor in the 1970s, during the Soviet era. He says that things were very different then. The Soviet-style military system effectively persisted in Russia until the reforms of then-Defence Minister Anatoly Serdyukov were enacted in 2008.
4/ Serdyukov's reforms were intended to professionalise the army and reduce it in size. While some of these objectives were achieved, Alexander says that "the medical component of the armed forces was recognized as excessive and was cut," decimating the military medical service.
5/ "Under Serdyukov, hospitals were liquidated en masse, the system of sanatorium and resort treatment was almost completely destroyed, and the system of personnel training was cut." This turned out to have very negative consequences in the current war, as Alexander notes.
6/ "Military medicine is something that can be quickly destroyed, and it takes 10-15 years to restore. The problem is aggravated by the fact that civilian medicine has also been optimised to the point of incapacity, which the pandemic has demonstrated to us in all its glory."
7/ Alexander says that civilian doctors are unfamiliar with the type of injuries received in warfare and are at a loss when presented with a complex case that needs to be rapidly triaged, such as prioritising which pieces of shrapnel to pull out of a wounded soldier's body first.
8/ Evacuation on the Ukrainian battlefield is usually difficult and often impossible due to the constant threat of drone attacks (see the thread below for a more detailed perspective on this). Alexander highlights the importance of self-care for soldiers.
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9/ "Each soldier must be able to provide first aid to himself and his comrade. And in a comprehensive manner – it is necessary not only to apply a tourniquet, pack the wound, but also to relieve pain, properly fix the limb, disinfect.
10/ "What difference does it make whether a soldier dies from blood loss or from an infection? But most are sure that it is enough to stop the bleeding - and then let the doctors figure it out. The level of sanitary training in the troops is extremely low.
11/ "And this is the main reason for wound mortality.
Of course, the thing is that now any training of soldiers, including the one based on providing medical care to themselves on the battlefield, is pure profanation!
Of course, the thing is that now any training of soldiers, including the one based on providing medical care to themselves on the battlefield, is pure profanation!
12/ "They will show you how to tie a tourniquet, but that's all the training you get. At the same time, it is IMPOSSIBLE to use what is issued to soldiers as a standard!
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13/ "The cheapest Chinese tourniquet (and probably also expired) immediately breaks, and the soldier is forced to die from blood loss."
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14/ A "catastrophically low level of medical training in the troops" is the leading cause of the loss of limbs. According to the Kalashnikov Center for Tactical Medicine, a third of amputations are due to improper tourniquet usage. Alexander comments:
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15/ "An applied tourniquet or tourniquet is not a way to stop bleeding, it is a way to stop the blood supply to the limb."
The safe time is an hour, and every 15 minutes the tourniquet must be loosened.
The safe time is an hour, and every 15 minutes the tourniquet must be loosened.
16/ "But with us, as often as not, a wounded person comes, and his arm is already purple. The tourniquet was applied two days ago, and it was never removed. Well, that's it - now it's time to cut."
17/ Soldiers are often not provided with medical kits and have to buy them at their own expense. Additionally, painkillers are often missing from aid kits because bored or addicted soldiers consume them as recreational drugs.
18/ As a result of all of these issues, battlefield mortality is very high. Alexander gives the example of a shell which explodes and strikes ten men with shrapnel, injuring all of them.
19/ One man dies immediately. Two more will die within half an hour from unsurvivable wounds. Three could be saved if given prompt treatment within an hour. This usually isn't possible due to the inability to carry out evacuations by helicopter.
20/ Of the five remaining, three have received immobilising injuries. They could be saved if given first aid by their comrades and evacuated within 4-5 hours. However, because of the constant threat of drones a timely evacuation is often not possible. So the immobilised die too.
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