For the sake of every life: how Hospitallers save Ukrainian soldiers

The medical volunteer organisation of paramedics, Hospitallers Medical Battalion, was founded in 2014 by Yana Zinkevych. Today, the battalion has more than 360 paramedics working on the front line, providing medical care to volunteers and the military. The hospital crews evacuate, stabilise and transport the wounded from the red zone to stabilisation units or frontline hospitals.

Svidomi asked the Hospitallers why they had chosen to join the battalion and how they worked during the full-scale war.

Taras Livinskyi is a sixth-year student at Danylo Halytskyi Lviv National Medical University, public dean of the Student Council of the Medical Faculty No. 2, co-founder of the NGO Reformers of Medical Education, which provided volunteer assistance to the Armed Forces and donated blood - "Give blood for a warrior". 

In 2021-2022, he entered the military department and studied to become a combat medic. In addition, he has experience in trauma and surgical interventions, which he gained in the emergency department, where he worked for four years. 

"I was preparing for the war. On the eve of the invasion, I already had my things packed. The first thing I did was organise people in Lviv by blood group and Rh factor at the railway station to donate blood," says Taras Livinskyi.

He and his team helped those brought by evacuation trains in early March. 

"Wounded soldiers and civilians came, and we evacuated them to hospitals in our cars and were on duty there 24/7. Then, after setting up the logistics in Lviv so that everything would operate without me, I called the Hospitallers. Then, in April, I completed my training and went with the 38th crew on my first rotation to Severodonetsk," says the paramedic. 

Taras Livinskyi explains that he is too much of a freedom-loving person to be mobilised into the Armed Forces. Hospitallers work voluntarily and do not receive any assistance from the state. They stay at the front for up to a month and then have a break. This allows Livinsky to visit his old grandmother.

"The advantage of the Hospitallers is freedom, above all. When you have completed your rotation, you are sure that you will have the opportunity to return home for some time: to rest, rethink what you have experienced and seen and come back with renewed vigour. This is the opposite of when you work at your best, and after a while, your efficiency drops because you are morally, mentally and physically exhausted," the paramedic says. 

The Hospitallers use Casevac and Medevac. Casevac is a vehicle that transports directly from the ground. It requires only those necessary resources to ensure a person's primary survival. They work according to the MARCH protocol, which may last 15-20 minutes. 

Medevac is an ambulance that provides assistance by qualified medics. The primary task is to prepare a person for primary surgical procedures. Then, the Medevac conducts a secondary examination and prepares the person for being taken to a stabilisation unit in 10-20 minutes, where primary surgical interventions will be performed to enable the person to get to the hospital.  

Taras Livinskyi first worked on a Casevac, then on his second rotation at a stabilisation point, and now he is part of the 5th crew on a Medevac. 

"It's fun to work on Casevac because you get under fire, and then it can often be a one-way trip," says Livinskyi.

He has had to evacuate dead soldiers more than once. 

"And this is one of the worst things because you become close to them in just a few days. This closeness has to be cut off because later it shows up," he says. 

In Bakhmut, the soldier was hit by a blast wave against a wall. He lost consciousness while being taken away. Seven minutes before he was to be taken to the stabilisation centre, his heart stopped. 

"In hospital, we shared the principle of never giving up and pumping to the last. And then, having injected adrenaline, I started cardiopulmonary resuscitation. Finally, after six minutes of resuscitation, his heart started. It was a moment of euphoria for me. Then, after another 40 minutes, he came round — he opened his eyes and started talking," says Liutiy.

Since 2014, German lived in Germany, where he worked as a doctor in a private clinic. When the full-scale war started, he quit his job and sold everything to come to Ukraine. 

"Mobilisation to the Ukrainian Armed Forces was impossible - I don't have Ukrainian citizenship. So I chose the Hospitallers. Since May 2022, I have been a part of the 5th crew," he says. 

German explains that there is more freedom in working with the Hospitallers. For example, you can choose the order of your rotations and who you work with. This freedom allows you to build teams and work more efficiently. 

Many of the Hospitallers have jobs in civilian life, and this freedom is essential to them. 

"Our crew fully supports the battalion [Hospitallers], but we also take independent help from volunteers. That is, the basis, 90% of the equipment, comes from the battalion," says the paramedic. 

According to German, the cooperation between the Hospitallers and the Armed Forces is based on trust. 

"All our locations are hot spots, and a lot could go wrong. Therefore, the direct trust of brigade and unit commanders is important. Commanders send requests to our battalion commander Yana Zinkevich. Then they assign us to the units where they need us as reinforcements. As a result, we have proved that we can save lives," the paramedic explains.

German works for Medevac. When a wounded person appears, they radio in and tell him where to go. 

"Our commander, Ms Cheka, works for Casevac — she does all the first aid to save lives. Then she quickly brings the wounded to us; we take them in and save not only lives but health. If, for example, there is an amputated limb, our task is to fix it so that this limb can be saved. After that, we take them to a stabilisation unit and hand them over to the wounded," says German.

Kateryna Halushka joined the Hospitallers while seeking an opportunity to join the security forces. She was considering the National Police and the National Guard. 

"After talking to my military friends, I came to the conclusion that before signing a contract for half my life, I needed to check whether I was able to withstand the work on the front line, the stress, both psychological and physical. So when I completed the Hospitaller training and realised a critical shortage of paramedics, I decided to stay with the battalion. Firstly, being a paramedic is critical for saving the lives of the military. Secondly, the battalion has already become my family, and I didn't want to leave it," says the paramedic.  

"I have a month of rotation and one or two months of rest. So I can shape my time the way I want, choose the dates and duration of my rotations, come back and go to work," says Halushka.

At the Hospitallers, separate people are involved in fundraising and communication with fundraisers. In addition, they deal with businesses, philanthropists, and organisations abroad. 

"That's why we tell and show our work. When you raise money from people, they need to see the results," says Kateryna Halushka.

Sometimes the crews raise funds for their own needs. For example, Halushka adds that when she needed to buy clothes for the crew quickly, she raised funds by herself to make the process go faster. 

"I have a certain audience on social media. Accordingly, I use this media to promote our support headquarters," she says.

She says that not receiving support from the state is a choice. 

"After the Anti-Terrorist Operation was transformed into the Joint Forces Operation, most volunteer battalions became part of the defence forces. "The Hospitallers chose to be independent. The absence of state funding and support from donations of caring people is also about freedom of action," she says.

The Hospitallers have a range of responsibilities, but it is now standard practice for a particular unit to make a request. They send this request to the battalion, examine, evaluate and analyse it. 

"It's about constant communication and cooperation with battalion commanders: we are on the ground together, and we see each other daily," says Kateryna.

She adds that sometimes the Hospitallers fully cover medical needs, sometimes partially or when asked individually to stay for a while due to the number of wounded or lack of paramedics.

Halushka says that the Armed Forces often need more paramedics. If the Armed Forces could cover all their medical needs independently, there would be no need for the Hospitallers at all. 

"This is not something critical or a bad trend. Normally, there is a limited number of people because the Armed Forces system is designed in detail. However, as the war has become tougher since February 24 and, accordingly, larger in terms of wounded, the need for paramedics has increased," the paramedic explains.

"My tasks are to stop the massive bleeding, check if the person is breathing, if not, to ensure breathing, check if there is air circulation if these are wounds where you can't apply a tourniquet, and monitor all the wounds to bring the person to the next stage," she says.

Usually, Kateryna's team takes out not just one wounded person but several. However, sometimes there are five or seven wounded, and at the same time, there may be dead in the exact vehicle. 

"Sometimes we go to pick up a wounded person, but before we reach the next stage of evacuation, he dies on the way due to the difficulty of getting there, shelling, and injuries. So sometimes you go to pick up one dead person and end up picking up several," says Halushka.

Nevertheless, according to the protocol, the life of a medic is more valuable than the life of a wounded or dead person. Accordingly, if a paramedic is likely to be injured, may not reach or get out of the position afterwards is more than 50%. Therefore, the crew or unit commander sometimes has to decide to wait.