"Be a man – lose your leg"
In the spring, a large-scale advertising campaign for contract service in the Russian army began. In state-financed institutions, near metro stations and public transport stops, leaflets were handed out with phone numbers for registering for a volunteer recruitment point and a description of the benefits of the service. Posters and billboards appeared on the streets of cities, and Z-publics published an uplifting commercial depreciating civilian professions: “Did you dream of becoming such a defender? You are a man – be him! Serve under contract.
What actually awaits the soldiers on the front line, the recruits are not expected to be shown. But doctors in military field hospitals and hospitals that receive wounded Russian soldiers are well aware of this. As well as volunteers who provide medical institutions with medicines and tools. In the help gathering chats, every third photo or video is of Russian soldiers in hospital beds, who have lost or almost lost their limbs. Volunteers post such pictures in an attempt to convince subscribers to donate more funds for doctors and hospitals. First of all – front-line, which are experiencing an acute shortage of medicines and equipment.
According to the observations of doctors interviewed by The Insider, the largest flow of wounded was observed in the last months of the Bakhmut meat grinder, these are February and March. It was then that Russia launched an active campaign for recruitment for contract service in order to cover the losses. The flow also increased in June, doctors and Z-volunteers talk about it. This is consistent with British intelligence , which claims that the Russians are now suffering the highest casualties since March 2023.
The largest flow of the wounded was observed when Russia launched an active campaign for recruitment for contract service
Almost every day in the help collection chats, they ask to pray for the dead and donate funds to the doctors who treat the wounded. The diagnoses include mine-explosive injuries, shrapnel and gunshot wounds, including the head, requiring the intervention of highly qualified neurosurgeons.
The Russian authorities failed to organize the supply of both border hospitals and military hospitals for a year and a half of hostilities. Doctors still receive consumables, medicines and instruments from volunteers.
Doctors of military hospitals and border hospitals receive consumables and medicines from volunteers
Calls for help, photos of severed or almost severed limbs of soldiers in fundraising chats alternate with jingoistic videos, pro-Russian videos from TikTok, congratulations on Russia Day and other public holidays.
In early June, volunteer chats in the Belgorod region received information about the wounding of conscripts who were standing on the Russian-Ukrainian border. The border points were then stormed from the territory of Ukraine by the "Russian Volunteer Corps" and the "Legion of Freedom of Russia" under the auspices of the Armed Forces of Ukraine. Officially, there were no reports of injuries or deaths of conscripts.
“The news is hard. The guys fought off several attacks. Gathering, gathering, gathering,” wrote one of the Z-chat volunteers, attaching a photo of a bloody medical bed. "Well done guys!" — wrote another of the participants in the dialogue.
Help is not for everyone
“When a soldier is injured, he is taken out of the fire, stabilized and sent to the military field hospital located closest to the front line. This is a “forward base”, they begin to provide assistance there,” a doctor from a hospital in Voronezh told The Insider. – Then the victims are "sorted" and sent further depending on the injuries. This is a "staged treatment" – a system for providing medical assistance in the process of moving through the stages of evacuation. If necessary, the wounded are sent to regional central hospitals in the occupied territories or in Russia, some to stationary military hospitals run by the Ministry of Defense.” (More about what this system looks like through the eyes of doctors – here .)
The General Staff of the Armed Forces of Ukraine claims that recently only officers are subject to evacuation to hospitals of the Ministry of Defense of the Russian Federation. Sergeants and privates are allegedly treated in the occupied territories, regardless of the severity and complexity of the injuries, so hospitals have to be set up in kindergartens and schools. According to the Ukrainian side, in the village of Azov, Zaporozhye region, a local school was equipped as a hospital, and as of the end of May, fifty Russians were being treated there. “In Mostiki between Svatov and Starobelsk, on the territory of a local school, the invaders set up a field hospital, where more than 100 Russian military are now being treated,” wrote the head of the Luhansk OVA Artem Lisogor.
There are not enough doctors in the military medical medical institutions located on the territory of Russia. Residents of Belgorod complained that the military polyclinic in the city was overcrowded with patients. A surgeon out of 40 people manages to see only 10 per day.
“It takes 40-60 minutes for one patient, they write everything by hand, as in the ancient century, there are no computers. The guys line up before opening. As a result, after sitting all day, they cannot get an appointment, ” said one of the residents of the city. The governor of the Belgorod region, Vyacheslav Gladkov, then replied that he could not send additional doctors there, since the polyclinic was military and was subordinate to the Ministry of Defense. But he promised to solve the issue “systemically”.
Without anesthesia, air conditioning and medicines
The supply of civilian hospitals is carried out by the Ministry of Health, the supply of the military – by the Ministry of Defense, namely the Main Military Medical Directorate (GVMU). There are problems both in the first and in the second. Reports of shortages of medical supplies emerged immediately after the start of Russia's full-scale invasion of Ukraine in March 2022. For almost a year and a half of the war, the situation did not improve.
The hospital in Valuyki (this is the Belgorod region), where the Russian military enters in large numbers, belongs to the Ministry of Health. As employees told The Insider, the hospital is experiencing severe shortages of everything from supplies like wipes to prescription drugs. The hospital is helped by the whole world – numerous volunteer groups regularly send tons of medical assistance there. The situation worsened after the start of the Ukrainian counter-offensive.
“We are very glad that they are helping us, we need a lot of things: clothes, shoes, medicines,” says a doctor at a hospital in the city of Valuiki, Belgorod Region. We receive everything, everything reaches us, we put everything into action. Without this help, it is difficult for both doctors and patients.”
The large flow of the wounded requires a constant replenishment of medical records, which are also brought by volunteers. They are paper – there is no talk of digitalization here. There is a lack of disinfectants such as chlorhexidine and hydrogen peroxide, solutions for IVs, tubes for decompression of the gastrointestinal tract, drainage systems for the chest, gauze bandages, bandages, painkillers of various types. There are no tools, doctors complain and ask to buy surgical scissors, clamps, staplers and staples for suturing wounds and internal organs, hemostatic sponges to stop bleeding, and tablets to determine the blood type.
Some high-quality drugs and consumables became inaccessible to doctors after the start of the war.
“Russian syringes made by Yelets are good, they don’t leak, they don’t leak, but sometimes they get stuck on dispensers. Volunteers bring them to us,” says a doctor from one of the hospitals in the border area. – There are Chinese syringes, they are much softer. Previously, there were also “Brown” ones (produced by the German B.Braun) – the best ones. But we haven't received them in a long time."
Periodically, there is a shortage of funds for anesthesia, which are spent especially actively in intensive care. Propofol, rocuronium, the muscle relaxant arduan, which is used during intubation and surgery, are also bought by volunteers.
Periodically, there is a shortage of funds for anesthesia, which are spent especially actively in intensive care
“The flow does not stop, the drugs fly at great speed,” complained one of the nurses of the military field hospital. “The consumption in intensive care is about two ampoules per hour, now we need about 70 thousand rubles more.”
Not only preparations fly, but also instruments for amputation. This is one of the most frequently performed operations in border hospitals. A significant part of the injuries are mine-explosive, in which it is impossible to save the damaged limb. And not only because of the nature of the injury, but also because of the mistakes of paramedics on the front line when providing initial assistance, because of the inability of the military to properly apply a tourniquet, or in general because of the lack of high-quality tourniquets in the military’s first aid kit.
In one of the hospitals, doctors complained about the lack of air conditioning in the operating room, despite the fact that it faces the sunny side. It became difficult to do operations with the onset of summer.
And although the needs of Russian border hospitals are growing, there are fewer and fewer people willing to help, volunteers say.
“People are tired of the SVO, every month fewer people send us money,” complained a volunteer from the Moscow region. “The amounts that people transfer have also decreased.”
Another The Insider's interlocutor linked the reduction in aid to the events in Shebekino. When the war came to the territory of the Russian region, its residents needed volunteer help, many of whom lost their homes. This has diverted resources that were previously directed to help hospitals. Instead of hospitals, the Russians began to send money to the evacuated residents of Shebekin and residents of border villages.
Real losses
The Russian side does not disclose data on losses. The last time the Ministry of Defense spoke about this was almost a year ago, in September, when it was about 6,000, but these figures are very far from reality. The fact that the Ministry of Defense hides the real number of dead is said not only by Ukrainians (their estimate of Russian losses is 220 thousand, including the wounded and prisoners), but also, for example, by Prigozhin, who during the putsch said that during the seizure of the General Staff building in Rostov, new evidence of an underestimation of the number of deaths at times. What are the real losses?
Analysts of the BBC Russian Service and Mediazona have found confirmation of the death of 26,000 Russian soldiers, but by their own admission, they find less than half of the real number of dead, so the real figure should be more than 50,000 killed. The American Center for Strategic and International Studies estimates Russian losses at 200-250 thousand people, specifying that 60-70 thousand of them are dead.
Thus, in the first year and a half after the full-scale invasion of Ukraine, the death toll was about five times higher than the death toll of Soviet soldiers in Afghanistan in nine years.
No wonder front-line hospitals are overwhelmed. Approximately a quarter of servicemen are admitted to hospitals in serious and extremely serious condition. Another half of the victims are in a state of moderate severity, Dmitry Trishkin, head of the military medical department of the Defense Ministry, said . But this is the data for December last year, even before the start of the counter-offensive of Ukraine and even before the intensification of fighting around Bakhmut. Data on the wounded is also classified. But it is known that the low level of training in the field of first aid clearly contributes to the mortality of Russian military personnel. The founder and head of the Center for Tactical Medicine of the Kalashnikov Concern, Artyom Katulin , said that more than 50% of all deaths did not occur from life-threatening injuries, and more than 30% of amputations were due to improper tourniquet application. On the Ukrainian side, these indicators are better due to better general training of paramedics and better medical support.