UkraineWarfightingactivity:

Epidemiologicalsnapshotassessment
April2015

MedicalservicesintheATOhasjumpedleapsandboundsinaccessforwarfightersandin
standardsofpracticesincethestartoftheconflictinEasternUkraine.Notably,theincreasein
injurypreventionwiththebuildingofhardprotectivestructuresatroadblocksandencampments,
thewidespreaduseofmoderncombatpersonalprotectiveequipment(PPE),thebudding
introductionofmodernandmakeshiftarmoredvehiclesthroughouttheregionandcombat
medicalsuppliessuchastheindividualfirstaidkit(IFAK),combatappliedtourniquets(CATs),
combatgauzeandpressuredressings.Althoughthedistributionofindividualfirstaidkits
(IFAKs)andthecorrespondingTacticalCombatCasualtyCare(TCCC)/CombatLifesaver
(CLS)trainingremainslowandbetween1015%,andmanymedicsinterviewedand
trained/retrainedhavegonethroughsometrainingandcarryIFAKwithCATtourniquetsmuch
remainstobedoneinstitutionallyatUkraineMoD.Bestdistribution/trainingwasfoundwithunits
ofAZOVandRightSector.However,theseunitsconstituteasmallpercentageofthefighting
forceandthismaynotraisethepenetrationofTCCCideologyorequipmenttotherequired
levelstobeadequatelyeffectiveatconsistentlystoppingpreventabledeathonthebattlefield.

NewmilitaryunitsfromboththeNationalGuardandUkraineMoDthatrecentlyrotatedintothe
ATOhavelowratesoftrainingandIFAKorothermedicalequipmentonhand.Thisnewfound
gapinmanyrotationsandtheneedtohaveasustainableMoDledTCCCprogramand
equipmentprocurementsystemisonceagaingreatlyneeded.ThecontentsoftheIFAKvary
andsomepersonnelhadreceivedanIFAKwithouttrainingorasfoundinonecasetraining
fromarelativewhoadvisedthereceivernottocinchthetourniquettootightoryoudrestrictthe
circulation.OneMoDreconunithad100%IFAKaccessandusebutlessthan5%trainedto
usetheequipment.ManyofthemedicalunitshaveattendedMedsanbatsCombatMedic
trainingand/oraTCCC/CLScourseandlookforwardtomoretraininginthefuture.The
requirementofacontinuumofcaretoincludenotonlyTCCCforallwarfighters,butalsothe
manyotheremergencymedicalstagesofcareisacutelyneeded.Theemergencymedical
combattrainingandequipmentforunitsoftheMinistryofInternalAffairs(MoIA/MVS),who
manmostofthecheckpoint/blockposts,arevirtuallynonexistentandremainsagravepriority
astheseunitshaveaccesstomultipleunitsandtransportsofthecriticallyillandinjured.

Evacuationtimetoasurgicalunithasdecreasedwiththeintroductionofforwardsurgicalunits
atallofthefrontlinehospitals,manyofthemwithin30minutesofpotentialhotspotsandsome
evenwithinareasthathavebeenorcontinuetobeprobedandshelled.However,theseunits
areverysmallandlackadequatelogistical,communicationandresupply.Nowordscan
adequatelydescribethosefrontlinemedicsthathaveperformedheroically,withsoftskin
vehicles,limitedairevacuationandpoorcommunicationsnetworksandinmanycaseswith
outdatedorlittleornomedicalsupplies.Assuch,theconversationthatisrepeatedthroughout
theATOistheneedformoretraining,modernmedicalequipmentandarmoredevacuation
vehiclestofulfilltheneededcontinuumofcareforbattlefieldmedicine.

ThedatabelowisthemostrecentandaccumulatedlargelyoverthemonthofAprilinallsectors
(A,B,C,M)oftheATO,fromreceivinghospitals,frontlineunitsandthemilitarymobile
hospitals.Thereceivinghospitalswithoutexceptionallareimmenselygratefulforthemilitary
doctorsthatnowsupplementtheirstaffsbutalmostallareinneedofadditionalormodern
hospital/surgicalequipmenttobetterperformintheirnewrolesasforwardoperatingsurgical
unitsandthemilitarymobilehospitalscontinuetolackallthetoolsrequiredtoassistthemin
theirduties.TheintroductionofmodernMobileFieldHospital(MFH)alongwiththenecessary
equipmentandtraining,astandardizedfleetofambulanceswithdriverandattendanttraining,
evacuationMRAPs,criticalcarehelicoptersandacommunicationnetworkareoftheutmost
priority.

TheabilitytohandleamajorsurgeisalsoofconcernaswitnessedduringtheBattleof
(1)
Debaltsevewheretherewerereportsofpatientsabandoned
duringtheemergencyevacuation
ofthecityandmanytransportedinopenvehiclesinwinterconditionswithlittleornocareand
destroyedambulancescaughtinthefighting.Theabilitytobetterdistributethewoundedto
nonimpactedhospitalsthroughtheuseoflegitimateMedicalCommandandControlvia
communicationsystems,computerizedsystemstatusmanagement,medicalcommandand

controltrainingandresourceallotmentbetweencompetingvolunteerandmilitaryunitsrequires
immediateredress.

Thegeneralpublicperceptionthatonlyvolunteergroupsareresponsibleforemergencycarein
theATOmustbeimmediatelychanged.Althoughmanyofthesegroupsdoprovidemuch
neededassistance,themedicalunitsfrommanyoftheMoDBattalionsaretheunsungheros
andtheiraccomplishmentsandpositiveresultsneedtobeidentifiedandpraisedinboththe
mediaandonsocialmediaaseffectivelyasthevolunteerunits.

DistributionofcombatmedicalsuppliescanbefacilitatedthroughtheMFHinSectorBandC
duetotheircloseproximitytothefrontandpossiblySectorAandinMariupolthroughthe
NationalGuardMedicalUnit.Butitremainsproblematicduetotheinabilityofanyagencyto
interactanddistributesupplieswithotherunitsnotpartoftheirorganizationthishadledto
duplicationofservicesandineffectivesupport.ItisrecommendthattheMoDtakealeadership
roleandsortthroughthebureaucracytobetterenableandcapitalizeonthesynergyajoint
medicalcommandstructureprovidesandthesharingofresources/trainingwouldhaveonthe
careandevacuationofallthewoundedintheATO.Additionally,theassignmentofTCCC
certifiedTrainingOfficersateachofthesepotentialdistributionlocationswillalsoacceleratethe
traininganddistributionofIFAKstofrontlinetroopsalongwithimmediateestablishmentofa
TCCCtrainingprogramatallmilitarybases.

ThelinksbelowgiveaccesstomapsofthemajorreceivinghospitalsintheATOandthecurrent
situationasofApril25thintheATO.Theresumptionoffullscalehostilitieswillinfluenceand
mayaddadditionalfacilitiesnotcurrentlyvisitedorlistedonthismap.Asnotedonearlier
reports,MechnikovDnipropetrovskRegionalClinicalHospitalremainsamedicalcenterof
excellenceandthemajorreceivingpointandtreatmentforevacuationofthecriticallyinjuredout
oftheATO.Additionalinformationonhospitalsnotlistedinthissummarycanbefoundin
UkraineWarfightingactivity:epidemiologicalsnapshotassessmentMarch2015.

ATOHospitalandAirports

ATOSituationalMapApril,25,2015

MedsanbatMedicTraining
andMobileFieldHospital,TraumaTraining

AllfourMobileFieldHospitals(MFH)werevisitedonthistripinAprilaswellasMedsanbat
providingCombatMedictrainingforunitsoftheMoD,NationalGuard,BorderGuards,MoI,
volunteerbattalionsandvolunteersatselectlocationsintheATO.Thecommentswerenearly
identicalfromall:moreequipmentandtraining,withhighpraiseforthetrainingalready
providedbyMedsanbatandotherorganizations.Additionally,fromtheMFHandhospitalstaff,
requestsforsurgicalandfieldhospitaltrainingwasrepeatedthroughouttheATO.
TheMFH
equipmentwasatonetimeusedbytheMinistryofCatastrophesandisnotsuitedtoworkwith
combataction.

Doctorsdonothavealltheequipmentsuchasmicroscopes,lamps,portableultrasoundandIO
equipmenttomentionjustafew.Thecurrentequipmentlisthasnotchangedsince1994,many
moderntoolsanddevicesarenotevenonthelist.Modernmedicalcombattrainingisvirtually
nonexistentandresourcesmateriallimited.Medicalintelligenceaboutmedicalfacilitiesis
lacking,sooftenthestaffdoesnotknowiftherestillisaclinicinacertainvillage,typesof
availableequipmentorifitwasshutafterreform.Theexpectedarrivalofadditionalfully
equipped,modern,internationalstandardMFHhospitalwillgreatlyenhancetheMoDsHealth
Sectorsabilitytosupplementexistingstatichospitalsandtheeaseofmobilizationwillimprove
theirsurgeresponsecapacity.

MobileFieldHospitalsintheATO
61stMFH,SectorM
AftertheLviv66thwasdeploye
dtoKrasnoarmiis'k,the61stwaspulledbacktoitscurrent
locationin
Kuibysheve,ZaporizhzhiaregionoutsideoftheATO,becauseitcouldreceive
patientsfromthenorthandsouthofSectorM.Howeveritnowonlyreceivesminorpatients.
Beforetheunitwasmoveditwasthetopreceiversofbothcriticalandminorpatients,treating
manyofthevictimsfromtheBattleofIlovaisk
(IlovaiskKettle)
andatthattimereceivedair
evacuation(beforehelicopterservicewasshutdownbecauseofthethreatofManpads).
CriticalpatientsarenowtransportedtoMariupolandVolnovakha,thenairevacuatedto
DnipropetrovskandfromthatlocationtoOdesa,Kyiv,Lviv,KharkivandVinnytsia.The61st
rarelyreceivespatientswhichweretreatedwithcombatmedicsuppliessincetheyseepatients
aftertheirinitialtreatmentinthestatichospitalsandarenotusuallymadeawareofprehospital
caretreatmentwithinthepatientsmedicalrecords.

66thMFH,SectorB
LocatedattheRailroadUnionHospitalinKrasnoarmiysk.CTscanisavailableatacivilian
hospital.Transporttimeisaboutonehourfromthefrontlinearea.Itreceivesbothcriticaland
minorpatients.ArrivedintheATOtoitscurrentlocationmidFebruaryfromLviv.

Fromthe66thpatientsareeitherair
evacuatedortransportedbygroundtoMechnikov
DnipropetrovskRegionalClinicalHospital,butoccasionallytoKharkivbyair.SelydoveHospital
tookthebruntofthepatientscomingoutofPiskiandtheongoingbattleforfullcontrolofthe
DonetskAirport.CurrentlyinApril,the66threceivesminorinjuriesevery
day,every23days
theyreceivecriticalpatients.Mostoftheirpatientsaredeliveredbythe93rdGuards
MechanizedBrigadeorRightSectorMedicsbuttheyalsoreceivepatientsfromthe95thAir
Mobile,25thAirMobile,NationalGuard,SBU,etc.
BetterequippedthantheotherMFH,the
picturesbelowarefromitsTraumaResuscitationRoominthesectionofthehospitalequipped
andmanagedbymilitarystaff.Muchoftheirmodernequipmentwasrecentlydonatedthrough
theactionsofvolunteers.

TwoPatientTraumaBay66thMobileFieldHospital

ProbablyoneofthebettermanagedMFH,ithasatriageareaoutsideinatent,armedsecurity
withcommandstaffradiosandsomehardcoverincaseofanattack.Picturedbelowisofthe
Triageareaandtent.

TriageTentat66thMobileFieldHospital
(PhotoCredits:PatrickChellew)


SomerecentSectorBcasesreceivedfromthefield:
Patientwithtwohighlegamputations,multiplefraginjuries,burnsofthefaceandairwaysand
hadtwoCATtourniquetsapplied.RightSectorMedicsbroughtapatienttohospitalwith
Nasopharyngealairwayusedforcricothyrotomythetubewascutdowntofewcentimeters.The
patientatfirsthadnorespirationsandwasthoughttobedeadbutthemedicwhoexaminedhim
notedsignsoflifeandperformedanemergencycricothyrotomy.Medicalpersonnelattacheda
bagvalvemask(BVM)tothenasopharyngealairway(NPA)andmanagedtogetchest
expansionandsavethepatient.MostpatientsbroughtbyRightSectorhadIVs,NPAsandchest
sealsasneeded.Mostpatientsarrivinghavetourniquetsappliedandwoundsaredressedwith
Israelipressurebandages,tourniquetsstayonandarenotusuallyreleasedinthefield.

IntubatedpatientloadedintoMi8nonmedicalhelicopterbycrewfrom66thMFH
MoDFBpage

56thMFH,SectorC
LocatedatArtemivskCentralDistrictHospital.Thishospitalisoneofthelastremaining
hospitalsthatcanbeconsideredaLevelIIIfacilitygivenithasCTaccessandfullsurgical
abilities.ItreceivesbothcriticalandminorpatientsandofalltheMFHsistheclosesttothe
combatareas.Thecivilianhospitalalwayshadgreatlocalsupportandmaybethebestfacilityin
theNorthernregionintheATO.AirevacuationbyhelicopterisusuallytoKharkivbutuses
Dnipropetrovskaswell.Theareahasbeenshelledandwillbereadilyshellifanotherpushis

attemptedoutofDebaltseve.ItisalsosupplementedbytheNationalGuardMedicalUnitand
PirogovVolunteerMobileHospital.

PatientsunloadedfromopentruckinArtemivskMFHfromtheBattleofDebaltseve2/15/15.Photo:
CatherineBolshakov
FB

SectorCPreHospitalCare
PrehospitalCareisprovidedbythevariousmilitary,NationalGuard,
17thGuardsTankBrigade
andvolunteerunitsinthesector.TheUKR30thbrigade,reconunitassistedwiththeevacuation
fromDebaltseve.Theunitprovidedcareto126casualtiesevacuatingfromredtoyellowzone.
About8victimsweresevere.Aidincludedapplyingtourniquetsandbandages.Equipmentwas
limitedtomainlychestsealsandsovietbandagekits.Evacuationfromtheredzonewasdone
onBRDM(combatreconpatrolvehicle).Itwasdoneeitherbythesoldiersthemselvesorby
theirreconunits.Requestscouldbemadebyanyonewhohadradio.Commanderreceived
callsanddeployedresources.Intheyellowzonepatientsweretransferredtosanitary
vehicles,socalled"tabletka(tablet/pill)
UAZ452
anoldervehiclefirstdesignedin1965.
Medicalequipmentwaslimitedtothatcarriedbyafeldsher/medicworkingonavehicle.

TabletkaambulancelocatedinShchastya
(PhotoCreditPatrickChellew)

Thentheyweretakentothebase(approximately3kmawayfromfrontline)andthento
Artemivskandthenfurthertootherhospitalsasrequired.Although~70%hadmassiveblood
loss,onlyabout6%ofcasualtieshadIVsonprehospitalstageasmedicslackedIVsolutions.
Alsotheylackedotherdrugs,especiallyTXA.

59thMFH,SectorA
LocatednexttotheSvatoveHospitalandistwoplushoursfromthecombatareasoverbadly
damagedroads.Mostofthepatientshavereceivedinitialtreatmentfromoneoftheforward
civilianhospitals.Minorpatientsaretreatedoradmittedhere.Allcriticalpatientsfromwithin
SectorAaretransportedbyhelicoptertoKharkivfromthecivilianreceivinghospitals.Mostof
thepatientscomefromtheShchastyaregion.Shchastyahospitalwasdamaged,isindireneed
ofadditionalequipment(seebelow).ThecivilianhospitalinSvatovehas100beds,novascular
surgery.ThisfacilitymayreceiveasurgeoninJulyAugust2015.Hasoneneurosurgeon,
commanderswanttomovehimtoArtemovsk.Ultrasound,Labsavailable.Mostofthe
equipmentisfrom60s.NoMRIorCTscanavailableatthislocation.HasO2fromthreesmall
oxygenconcentrators,coulduseamorepowerfulsourcelikeanoxygenstation.Treatscivil
populationwithoutformaldocumentationandforwardsthemtocivilhospitalsastheyarenot
allowedtotreatcivilpatients.HospitalhastwobrigadesoncallandstandingbyinNovoaidar
andSeverodonetsk.

RoadthroughoutSectorAandmanylocationsintheATOareinseriousstateofdisrepair

SectorAPreHospitalCare:
Mostlybandagesandpainmanagement.Inbestcasespatientsaresplinted.Hospitalwas
receivingpatientsinprofoundshockandtheheadofthehospitalaskedsoldierstostartIVs
earlyonandsincethenthen
umberofIVsestablishedinthefieldhasincreased.Prehospital
careisprovidedbyAidar,92ndMechanizedBrigade,80thAirmobileRegiment,20thbrigade,
BorderGuards,SBU,etc

SectorATransport
:
TheMilitaryUnithasAutomobileBattalionworkingwiththemsotheyaretransportingpatients
themselvesfromalldistricthospitals(Lysychansk,Severodonetsk,Shchastia,Novoaidar,
Bilovodsk).
TransporttimestoSvatovo:
Shchastia:2,5/h
Lysychansk:1.5/h
Severodonetsk:1.20/h
Novoaidar:2/h
Bilovodsk:2.53/h
Roadsareonlygettingworseandtransporttimeincreases.

EvacuationByMilitary:
MilitarypatientsaresenttoKharkiv,usuallybyhelicopter.Civilpopulationreceivesonly
consultationcare.Mechnikovahospitalisusedasalternativebutveryseldom,only23%
patientsweresentthere.Patientsaresentthereifflightisimpossiblebecauseofweather
conditionsorifneurosurgeryisrecommended(spinalandheadinjuries).Transporttimeto
Kharkiv:ground5h,air1h.Hospitalhasfiveambulances,fourofthemaredonatedfrom
volunteers(theyareinbadcondition).Oneportableventilatorwithbottles.Sanitarycompanyis
workingwiththehospitalanditalsohasitsvehiclesbuttheyareempty.Hasreceivedsome
anonymousaid.

Needs
:
DigitalportableXray
Newambulancewithequipment
Biochemicalanalyzer
Psychiatrist
Oxygenconcentrator(station)

Informationfrom
theheadofthe59thMFH,PodolianYuriy,y_podolian59@ukr.net,
0676039916

AmbulanceTransport
Patientsareevacuatedbyanyvehicleavailablefromthefrontlines.Therearefewavailable
armoredmedicalvehicles.Severalsoftskinambulanceshavebeendestroyedandmedicshave
beenkilledinthefighting.ThephotosisthelatestexampletakenonApril25thnearMariupol
andtheotherfromMarchintheBattleforDebaltseve.

Mariupol

Debaltseve

PhotocreditandadditionalFBphotos:
AnatolyVinogrodsky
PhotocreditandadditionalFBphotos:
TarasEschenko


Atthestartoftheconflictmanyoftheevacuationsweredonebyvolunteers.Aremarkablestory
ofoneofthosevolunteers,
TarielMuradov.
Anambulancedriverwhoevacuatedthewounded
fromtheLuganskAirportbattleandthroughouttheconflict,wasoncecapturedandlater
releasedandwasrecentlywoundedevacuatingwoundedfromDebaltseve.Thepicturebelowis
hisambulanceontheroadtoLuganskwithhiscallsign
(Karabakh)paintedonthe
rearofhisambulance.Hesurvivedondonationsoffood,gasandequipment.

(
Karabakh)
SincetheBattleofDebaltsevetherehasbeenalargeinfluxofused,softskinambulances.The
ambulancesweregivenandtransportproviderscomefromallunitsincludingtheNational
Guard,BorderGuards,MoDbattalions,volunteerbattalionsandprivatevolunteerssuchasthe
ViteretsandKhottabych.
Butunfortunatelyalmostallambulanceswerestrippedofanymedical
equipmenttoexpeditetheirtransferovertheborderintoUkraine.

Manyaresmall,designedforpatienttransferandnotCriticalCare,allarewithoutonboardO2
andsuctionandequipmentvariesfromunittounit.Manyofthecrewshavelittleorno
ambulancetrainingandthetendencytotreatwithdieselisthecommondenominatorbetween
allandresultinginseveralcrashesandtheatleastonereporteddeathofapatient.Giventhe
verydiversenatureofthedonors,(fromasfarasBrazil)itwillbedifficulttoretrofitallwitha
commononboardO2equipmentandsuction.Buttheproblemcouldberesolvedwithmodern
airwaybags,portablesuctionunitsandanamplesupplyofportableoxygen.AfewMoDunits
havereceivedolderventilatorsfromanemergencycacheasshownbelow.

9(DP9)ventilator

Typicalexampleofaworkingdonatedambulance

Noneoftheambulanceshavehospitalcommunicationequipmentandmuchoftheirdispatch
andcoordinationisdonebycellularphone.IntroductionofacommonregionalMednet
communicationsystemforcentralizeddispatch,hospitaltohospitalandambulancetohospital
communicationsintheciviliansectorwhichcouldbeeasilyaccessedbythemilitary

SelectCivilianHospitalsoftheATO(SectorA&M)
ThefollowinghospitalsaremajorreceiversofvictimsfromtheATOinSectorAandSectorM
andallimpactedbytheactionsintheATO.Manyhospitalsintheareaofthefrontlineswere
damagedand/orclosedimpactingnearbyhospitalsandrestrictingtheirabilitytotransfer
patientstohigherlevelofcare.Mostnotableofthesefacilitiesarethehospitalsthatonceused
Luganskastheirregionalcenterandnowareforcedtotransportmanyurgentandcritical
patientstoKharkivoverbadroadsandinsomecaseeighthoursaway.Allhospitalsin
governmentcontrolledareasoftheATOarenowsupplementedbymilitarymedicalpractitioners
withvascularandneurosurgeonsatseveralkeylocations.
Butthemilitarystaffisreliantonthe
medicalequipmentavailableinthehospital.

The
PirogovFirstVolunteerMobileHospitalhasreportedlysetupaverylimitedMFHin
Popasna,LuganskOblast,butwewereunabletovisitthisfacilityonthistrip.Severalhospitals
aresituatednearfunctioningairportsbuttoourknowledgetheuseoffixedwingevacuationare
currentlyonlydonefrom
DnipropetrovsktomilitaryhospitalsoutsideoftheATO.Additional
informationonfrontlineATOhospitalsinSectorBandCnotmentioninthissummarycanbe
foundin
UkraineWarfightingactivity:epidemiologicalsnapshotassessmentMarch2015.

Severodonetsk
Severodonetskisanindustrialcityof110,000peopleinLuhanskOblastandnowthe
administrativecenterfortheLuganskOblast.
Severo
donetskmultispecialityhospitalhasthe
capacitytofunctionasaLevelIIIhospitalwiththeadditionofsomeadditionalequipmentand
staff.Ithasanairportsuitableforfixedandrotarynearby(seemapbelow).Itslocationand
proximitytothefrontlineareas,itssizeandtheabilitytomovepatientsbybothfixedwingand
rotaryaircraftappearsthatitwouldbeabetterfitforafrontlineMFH.
640beds.
ICU:6beds,10bedsforcardiologyICU
10bedsinneonatalpathologyunit
30bedspediatric,80%occupancy.Hospitalhasstatusof"Childfriendly".
Pediatricdepartment,pediatricdepartmentforinfectiousdiseases.Hospitalhascertifieddoctors
butprovidesonlyurgentpediatricsurgery.OtherpediatricpatientsaresenttoLysychansk
RegionalPediatricHospitalwhichmovedstafffromLuganskspediatriccenterandopenedlast
month.

Availableresources:
Neurologydoctorandprofessor.
CTscan:private,locatedoncampus
LabsMRISurgeryunit.
O2:localmedicaloxygenstationandconcentrator
Bloodbank(storageandbloodprocessing)
NO
vascularsurgery,nocoronarysurgery.

AsaresultofATOthenumberofdisplacedpeoplegrewsignificantlyupto25%.
WartraumapatientsarestabilizedandsenttoSvatovo,KharkivorDnipropetrovskbutmostlyto
Kharkiv.Sincethebeginningofconflictlessthan150warinjuriesreceived.Airevacuationby
helicopteronlyavailableforthemilitary.

Transportationtimes(groundevac)
:
NovoaidarSeverodonetsk40/km=1/hour
SeverodonetskKharkiv=6/hours
SeverodonetskLysychansk=3040/mins

Desiredequipment:
CTscan
Photofluorography
Angiography(trainingforpersonnelrequired)
Airwayequipment(anesthesiology).Hospitalhasfourventilators.
Airwayequipmentforpediatricpatients
Incubatorsforneonates(havetwo)
Gastroscopesatleasttwo.


Severo
donetsk
Hospitalhassomeofthelistedequipmentbutitisoutdatedandold.
HasreceivedsomeaidfromDoctorswithoutBorders,InternationalRedCross,butlittlefrom
otherNGOs.AttemptedtoreceivesomeaidfromSwitzerlandneverhappenedbecauseof
someproblemsatcustoms.ThereisaFeldsherBrigadesandDoctorBrigadesworkingon
ambulancesforurgentcareinthecityandtransferstoneighboringhospitals.Thereisa
separateambulancestationinthecitybutcivilambulancesdonotrespondtofrontline
positions.

Google Map, Severodonetsk Airport

Shchastya
PriortotheATOthehospitalservedapopulationofabout15,000.SinceJune15,18,000
displacedpeoplehavemovedfromLugansk.16,500peoplefromdistrictsthatreceived
emergencycareinStanytsyaLuganskaDistrictHospitalarealsonowservedbythishospital.
Currentlythereis
scatteredfighting,in
Trehizbenka,StanytsiaLuhanska,Kryms'keand
ShchastyawasagainshelledintherecentweekofApril25thandonthe26threportedthe
heaviestshellingsincethelatestceasefiretookeffect.Ofnote,thereisamajorpowersupply,
VoroshilovgradElectricPowerStation
locatedintheareaandownedbyRinatAkhmetov
throughhisDTEKenergyholding.Itemployeesfivethousandworkersandamajorsupplierof
electricitytoLuganskintherebelheldareaandmostoftheLuganskOblast.Adealwas
brokeredsothatfuelfortheplantstillarrivesfromLuganskbuttheplanthasbeendamagedby
shelling.


Entranceto
StanytsiaLuganska,
bulletriddlesignage
Replacementwindowsandscarredwall,StanytsiaHospital
PhotoCredit:PatrickChellew

ThenearbyhospitalinStanytsiaLuganskaisalmostoutofservice,brokenwindows,no
heating,personnelleftasitislocatedonthefrontline.Onlythepolyclinicisinservice.
Priortotheconflictemergencycarewasprovidedonlytill16.00atthemainhospitalin
ShchastyaandthenpatientsweresenttoLuganskhospitalsabout10/kmaway.Nowthey
providecare24/7.

ShchastyaHospitalwasdamagedintheearlierfighting,allwindowswereblownoutandhave
beensubsequentlyreplacedbutthehospitalstillshowsignsofdamageandgeneral
maintenanceappearslacking.UrgentsurgeryisprovidedinShchastya.Usuallyhospital
receivesabout160patientvisitsadaywith1416patientsforinpatientcare.Nowtheylogabout
1215inpatientsaday.Priortotheconflictthehospitalreceivedmainlypatientswithacute
conditionsofchronicdiseasesorseasonaldiseases.Sincethebeginningoftheconflict
ShchastyaHospitalreceivedabout1200traumapatients,morethan900majoroperationswere
done.Sometimestheywouldreceiveupto30criticalpatientsanight.Currentlyprovides
urology,gynecologyandthoracicsurgery.Notavailable:neurosurgeryandvascularsurgery.

Thehospitalisreinforcedwithdoctorsfrom59thMFH.Ithasfourregularstaffsurgeonsand
threesurgeonsfrom59th,plusonesurgicaltechnician.Militarymedicswerefirstsenttherein
September.AlsothemedicalserviceofAidarBattalionissituatedinthehospital.Hospital
receivespatientsfromallbattalionsdeployedintheareasuchasthe92ndand80thaswellas
civilpopulation.

EvacuationfromShchastya
Militaryvictimsdonotremaininthehospitallongerthanadayandnoncriticalpatientsare
evacuatedto59thMFHinSvatovo.CriticalpatientsaregroundevacuatedtoNovoaidar
HospitalandfromthatlocationareairevacuatedtoKharkiv.Directairevacuationsfrom
SchastyahasnotbeendonesinceearlyNovember,2014.AirevacuationtoKharkivtakesabout
1.5hours,groundevacisabout8hourstoKharkiv.Civilianpatientsareevacuatedto:pregnant
womenaresenttoStarobilsk(70/km,80/min),criticalpatientsthatrequirespecializedcareare

transportedtoSeverodonetsk(80/km,1+hour),patientswithsevereburnsareevacuatedto
Kharkivbyroad(usuallytheyhavetodrivealongerroutethroughIsiumasitisfasterbecause
ofthequalityoftheroads).

EquipmentAvailable:
2ventilators:5(197080),21(Phasa21)(1990s).
O2supplybottleslocatedoutsidewithpipestoORandICU.Oxygenisprovidedbythe
VoroshilovgradElectricPowerStation
locatednearby.Thisisindustrialoxygen,althoughthe
staffstatesthatitsqualityisbetterthanthatofthemedicalO2theyreceivedearlier.
EKG:12leadportablestaticmachine,bothreceived3yearsago.Keptin
oneofofficesandbroughtintoORs.
1defibrillatorinOR.
Xray:1digital,receivedinsummer.TwooldXrayswhichareoutofservice.
Ultrasoundwithoutdopplers.
Digitalfluorography

Labs:workinghours,08001400andnoweekends.Generalbloodanalysis(hemoglobin,white
andredbloodcells),generalurineanalysis.Noelectrolytesandbiochemistry(senttoKharkivif
required).Photochromicbloodanalyzerwaspurchasedandistobedeliveredintwoweeks.
BloodbankwascreatedandisstoringbloodandplasmafromBloodTransfusionStation.

Plannedimprovements:
Hospitalisworkingonhavingitsbiochemistryandneeds4centrifugesforblood:2for6,000
turnsand2for4,000turns.AkhmetovfoundationdonatedanXraypurchasedfromKorea
whichistobeinstalledinearlyMay.Photochromicbloodanalyzerwasboughtandistobe
deliveredandstartworkingintwoweeks.

Equipmentneeds:
Laparoscopy
Labselectrolytes
Morgue:autopsytablesandtools.
Endoscopy
Threecomputersorlaptopsforadministrativework
Ilizarovdevicesforexternalfixation
Centrifuges
Externalfixationdevices
Barexternalfixationdevices(usedtogetthosethreefromKharkiv,butmostly
usingpersonalconnections)

OtherIssues
Thereisaseriousproblemwithpersonnel.Maintenancewasprovidedfromtechnicianslivingin
occupiedareas.Forthreemonthsthehospitalhasbeenunabletolocateafulltime
anesthesiologist.Militarydoctorsarealsoburdenedwithrestrictionswhileworkinginthe

hospitalandarenotallowedtoworkwithnarcoticsandothercertainpharmaceuticalsdueto
localpolicy.ManyofthehospitalsdoctorslivedandworkedinLuganskandareunableorrefuse
tocrossthebattlelines.

Aidreceived
Therewasalargeproblemwithdiabeticpatientsamongthedisplacedpopulation.International
RedCrosshassuppliedthehospitalwithinsulin.Afuelcompanyprovidedaidwithresuscitation
unit,operatingtables.AkhmetovfoundationdonatedaKoreanXraymachinewhichistobe
installedinearlyMay.

PreHospitalCare
SergiyFillipov,MedicalChiefofthe
92ndbrigade,Shchastya.
Latelymostlyshellingsinjury,onecaseofboobytrap.Traumapatientswerenotsevere.Several
casesofsuturinglacerationsinthefield.Kramersplintsusedcoupletimes(didnothaveSAM
splints).NoNPAsused.Casestudy:acapturedseparatisttreatedwithlunginjury,theymadea
sealfromIndividualBandageKitpackage.30/minslaterhearrivedatthehospitalandoperated
onbythestaff.

Informationfrom
theadministratorOlegSuprun,bolnicaschastya@ukr.net,
380
960642,0956819941andmilitaryandcivildoctorsworkinginthehospital.

Novoaidar
NorthofLuganskthefirsthospitaloutsideoftheactiveareaoffightingintheSchastyaregionis
NovoaidarDistrictTerritorialMedicalHospital(
).ItislocatedabouttenmilesnorthofShchastya.Althoughsofarisolated
frommilitaryaction,anareamilitarybasewasseverelydamagedbyareported
RussianSmerch
rocketattacklaunchedfromRussiainSeptember2014andagunfightwithterroristinMayof
2014.

PriortotheconflictmanyoftheirmorecomplicatedpatientsweretransferredtoLugansk.Now
thatLuganskisnolongeranoption,transferringpatientsisabitmoredifficult.Forexamplethey
currentlyhavethreeciviliansinneedoforthopedicsurgicalassistanceawaitingsurgical
interventionbutnofacilitywillingtoacceptintheadjoiningdistrictandnolocalfundstoprovide
forthesurgerycare.

NovoaidarDistrictTerritorialMedicalHospital
Civilianpatientwithmakeshifttractiondevice
PhotoCredit:PatrickChellew

NovoaidarBasicInfo
Averywellmaintainedandmanagedfacilitywith130beds,designedfor600visitsadayand
currentlyreceivingabout400visitsaday.DuringactiveATOreceivedabout1216trauma
patientsadayforatotalof800traumapatients.

Hospitalisworking,buthasnoanesthesiologists(muchoftheregularstafffledtheareaorlive
inrebelheldterritory)onlyamilitaryanesthesiologist(andvolunteerswhoworkaweekortwo).
Limitedtraumacare,abdominalandchestinjuries,surgeryisonlypartlyfunctional,neurological
andvascularsurgerynotavailable.Civilpatientsrequiringhighlevelofcare(andwhocanafford
it)aresenttoSeverodonetsk,militarypatientsaresenttoSvatovo/Kharkiv.Pediatricandburn
patientsmaybetransportedtoKharkiv.

CandobasiclabsbutnotcertaintestslikeHIV(theyaresenttoSeverodonetsk).Lab
equipment2025yearsold.Usuallytheyonlysendpregnantwomenandhighriskgroup.
Haveone(old)portableultrasoundbutlacksdopplertransducers.Helicopterevacuationsare
usuallydonenowfromStarobilsk.Usedtodo12aweekfromNovoaidar,nowonlyverycritical
patients(military)receiveairtransport.Threebasicambulancesavailableforlocalusebuttodo
usuallygointoareasofactivefighting.

CatchmentPopulation:
25,000intheregulardistrict+4,500fromSlovianoserbskDistrict(acitywithahospitalinthe
occupiedterritory),plus13,000fromShchastyaDistrict.

TransportTimes
ShchastyaNovoaidar=34min
NovoaidarKharkiv=78hours
Sectionsoftheroadsareinextremelypoorshapemakinggroundtransportverydifficultandin
somecasesalmostdoublingthetimerequiredtomoveapatientontheground.

EquipmentNeeds:
Ingeneral:CTscan,Xray,ultrasound,operatingtables,surgicalkits,autoclave,distiller.
ThehospitalhasanewportableXrayfromtheRedCross.Traumadepartmentindireneedof
externalfixationdevice,shafts,antibiotics,medicinefornerveblocks.50%ofpatientsare
displacedpeopleandcannotaffordoperationswhichcoststartatabout2,000hryvnias.

Otherhospitalsintheregion:
Shchastia,Petrivka,Starobilsk,Svatovo,Bilovodsk,Lysychansk(pediatrictrauma)and
Severodonetsk

Allinformationisfrom
theChiefadministrator,DrNinaTorba,
novoajdarskoe.rtmo@yandex.ua
+380997344311

MariupolCityunderSiege
MariupolisacityofoblastsignificanceinsoutheasternUkraine,situatedonthenorthcoastof
theSeaofAzovatthemouthoftheKalmiusriver.ItisthetenthlargestcityinUkraineandthe
secondlargestintheDonetskOblast.(
Wikipedia
).
Thecitybordershavefundamentallychange
withduginroadblocks,manyreinforcedwitharmoredvehicles,antitanktrenchesandmines
andheavyarmedtroopsdeployedthroughouttheregion.Thesoundofdistantartilleryandof
antiaircraftfireattemptingtodownRussiandronesisaconsistentremainderofthepresenceof
Russianforcesoutsidethecity.Theairportontheoutskirtsofthecityisagainusedfor
helicopterevacuationsofpatientstransferredfromlocalhospitalsrequiringhigherlevelofcare.

(2)
FortificationonHighwayH20,NorthofMariupol

PhotoCreditPatrickChellew

MariupolATOPatients,EquipmentandStaff
Currentlymostofthepatientscomeoutofthecontinuedfightingin
Shyrokyne,23/kmfromthe
city.
EmergencyCareHospitalinMariupolreceivedmostofvictimsfromtheconflictintheirareaand
VolnovakhaintheNorthernregionof
SectorM
receivingpatientsfromtheSouthernreachesof
theDonetskOblast.
SinceAugustMariupolEmergencyCareHospital:
Treated1540militarypatientsingeneral
340ofthemwereoperatedforwarinjuries
1620ofthemrequiredvascularsurgery
4myocardialinfarctioncases,1patientdiedbecauseoflackofnecessary
equipment
Civilpopulation:
About80civilvictimswithwarinjuries
About620myocardialinfarctions,about500requiredshunts.

TherearetwobudgetCTscansavailableinthecityand3commercial(private).OnebudgetCT
isinOncologyHospitalandanotheronewillbeavailableinSecondCityHospital.Giventhat
therearemanyCTScansinthecity,MariupolEmergencyCareHospitalwouldbemore
interestedinreceivinganangiography,GEInnovaIGS530(GeneralElectric)fortheincreased
vascularsurgeriesandthelargequantityofcardiacsurgeryrequiredfromthecivilian
population.

MilitarydoctorshavebeensupplementingthehospitalsinceNovember.Beforetheyweresent
thesituationwasdifficultfortheciviliandoctorswhooftenhadtoworktwoshiftsinarow.Atthe
time,iftheyrequiredavascularsurgeontheyhadtocallonefromZaporizhzhiawhichwould
take23hourstoarrivetothehospital.Thecurrentmilitarymedicalgroupincludesasurgeon,
anesthesiologist,twovascularsurgeons,aneurosurgeonandatraumatologistfrom61stand
66thMFH.Thiscurrentgroupwespokewithhasworkedinthehospitalforaboutthreeweeks
now.

CurrentStatus
Noneofthecivilianpersonnelleftthehospitalbecauseofthecombataction.
T
hereisenoughmedicalsuppliesforthecivilpopulation.
HospitalreceivesaidfromICRC,Doctorswithoutborders,MinistryofHealthand
volunteers.
Stillreceivingpatientsfromthefightingeverydaywithcriticalcaseeveryfew
days.

PrehospitalcareprovidedtoMariupolHospitalpatientsinthelastthreeweeks
:
AlmosteverybodyarriveswithCATtourniquets,rarelypatientshaverubber
tourniquetsapplied.
Chestsealsarewidelyused.Needledecompressionwasperformedtoone
patientwithfraginjuries,laterXrayprovedthathehadpneumothorax.
Doctorshaven'tseenanypatientswithSAMsplints,howevermanypatientshad
improvisedsplints(e.g.AKs,sticks)
IVsarerare.
TheBorderGuardsaddedaarmoredmedicalevacuationvehicleinthelast
week.

StateBorderGuardServiceofUkraineCasevac
PhotoCredit:PatrickChellew

Wholebloodisnotusedinthehospital,onlyitscomponents.Bloodtypecanbecheckedin20
minsandthenarequestissenttotheBloodbank(5kmaway).OnApril20,2015theMedical
ChiefofSectorMinMariupol,VasylTybenwasaskedtohelpprovidebloodforthebloodbank
and16soldiersdonatedblood.
Thehospitalisrequestingmoretrainingonwoundcare.

Informationfrom
SergiyOrleanskyi,HeadoftheEmergencyCareHospital+38098315
0500,
marbsmp@rambler.ru

Mariupol/VolnovakhaPreHospitalCare
Azov.
April,1.DuringshellinginShyrokinoatankshellhitawindow.Onesoldierhad
hemothoraxfromafragthatenteredunderscapulaandwentoutofhisneck.Evacuationwas
delayedfor30minutes.AidprovidedincludedHalochestseal,IVwithabout1000ccofsaline,
TXAandtheuseofIndividualBandageKit.

Carexplodedamineresultingintwodeadandtwoinjured.Usedanambulanceforevacuation.
Oneofthecrewhadalegseverelyinjured,lateritwasamputatedbelowtheknee.About10
daysbeforetheMinskIIceasefire,AzovsufferedmanycasualtiesinShyrokino63injured,10
dead.Halochestsealswereused,butnoneedledecompressions.Mostpatientswere
transportedtoMariupolEmergencyCareHospital.

AzovfirstuseofTXAwasabouttwomonthsagoandsinceuseditin68cases.Beforehaving
TXAtheywereusingEtamsylatiim,whichislesspotentthanTXA.IVswerestartedin
ambulancesiftherewasapossibilitytodoso,assometimestheyweretransportingmorethan
nineinjuredinonevehicle.CATmostoftenusedtourniquets.Wideuseofsplints,soldiersuse
improvisedsplintsandKramersplintsarecarriedinambulances.Onecasewhereasoldier
injuredhistrachea,itwasbandagedwithanIndividualBandageKit,whichwhensoakedwith
blood,partiallysealingthewound.Thepatientcoughedbloodbutwasrelativelystableonarrival
athospital.

54thRecon
,onlyunitwithaCLSinstructor,andatopmediccrew,oncefullyIFAKtrainedbut
withrecentrotationandthemergerwithanotherunit,IFAKtrainedwillbeatlessthan30%.
RequiresimmediateresupplyofIFAKandthehelpoftrainerstoelevatealltoCombat
Readiness.
Recentnotablecasesfromthe54th:
ConfirmedFieldSave:throughandthrough

neckwound,cardiacarrest,IV,TXA,combatgauzewithwoundpackingx5fortwowounds.
Patientwitharminjury,tourniquet,IV,TXAandthenremovaloftourniquettorestorecirculation
andagastricbleedgivenIVandTXA.

79thAirmobile
IV,TXAgiveninfield
.Onepatientwithmultiplefraginjuriesononesideofhis
body,bloodpressuredroppedfrom100to90andcontinuedtodrop,althoughnomajorbleed
wasseen,TXAwasgivenasaprecautionmeasureincasehehadinternalbleeding.
NearShyrokinoasoldierwasinjuredreportedlybyasniper.Bulletwentinbetweenthe5thand
6thrib,missingtheheartandexitingtheshoulder.Chestsealused,woundpackedwithCelox
powderwrappedinregulargauze.Bloodpressurewentfrom90/palpto80/palp,IVstarted.
Patientnowonrehabilitationleave.WhendeployedontheKalmiusriverassistedother
battalionswiththeircasualties,mostlyfrommortarshellings.

Gospitaliers
(RightSecto
r).About20patients,5ofthemreceivedIVs.Nopatientsforlasttwo
we
eks.OrderedsupplyofTXAforfielduse,receivingshipmentthisweek.In
Volnovakha,
Kyiv2PoliceBattalion
,oneofthemanyTerritorialDefenceBattalion
s,underthecommandof
theNationalGuardandprobablytheonlyonewithCLSinstructorwasresponsiblefortriage/
treatmentof
the10killedand20injuredpassengers
involvedinaGRADattackonabusattheir
blockpost.TheyreportedtheuseofIVs.chestseals,combatgauze,(theyarenowredeployed
toSectorA)

NationalGuardMedicalUnit,AZOV,RightSector,MoDunitssuchasthe79thAirmobile
Brigade,54thReconand
the129threcon,StMariaBattalionandVolunteersalsotransported
patientsbutwewereunabletomeetwithallfortreatmentinfo.

KeyRecommendations
ThetrainingandadditionofcertifiedTCCCtrainersinallunitsofthe
armedforcesofUkraine,includingtheMoD,MoI,BorderGuards,National
GuardandMFH.
MoDUkrainetoleadandmakeTCCCideologywithinitsdoctrine

TCCCtrainingforalluniformedtroopsandwarfighters
100%coverofTypeII,IFAKsandassociatedTCCCtrainingforall
warfighters
ContinuedTacticalCombatCasualtyCare(TCCC)mentorshipand
trainingwithNATOcountries,specialforcesunitsandNATOaligned
countries
MobileFieldHospital:
1
Role2
withdamagecontrolsurgicalcapability
toserveasacenterformedicaltraining,CLS/TCCCtraining
andmentorship,disasterpreparedness,medicalcommand
traumasystemdevelopmentanddatacollection
Continuedfixedwingmedicalevacuationfromtheatretorole4facility
(increasesurgecapacityforMoD,MoHandMoI)toNATOandNATO
alignedcountries
Standardizedfleetofarmouredambulanceswithdriverandattendant
training
NATOcountryprosthesissupportandrehabilitationmentorship
(occupational,psychologicaletc).
PortablemonitorsforCriticalCareTransport(ECG,pulseox.,
temperature,BPandcapnography)
Ventilators
PortableUltrasound:ExtendedFocusedAssessmentwithSonographyin
Trauma(eFAST)

FAST1IntraosseousInfusionSystem

SKEDCOstretchers

TalonStretchers
Medicalsupportequipment
:
ArmoredHumvees/MRAPsforCASEVAC(40)
Asdescribedin:EmergencyWarSurgery2014,OfficeoftheSurgeonGeneral,
BordenInstitute,USApages1728
1

 Armoredtrackvehicles(40)
Advancedmedicalcommunicationssuite(land,airandsea)
multipleunits
GabionHescobarriers(90,000squaremeters)
Additionalnonlethalassistanceshouldinclude:
Counterbatteryradars
Unmannedaerialvehicles(UAVs)
ElectroniccountermeasuresforuseagainstopposingUAVs

DefinitionsofJuniorMedicalPersonnel
Sanitar
medicalworkerthatfulfillssupplementaryfunctions.Doesnotrequiremedical
educationbutmayneedspecialtrainingdependingonthework.
Duties:Sanitaryandhygienicserviceincludingdisinfectionofroomscleaningmedical
instrumentspatientcare,transportation,changingtheirclothesandbedsheets,informing
nursesanddoctorsaboutchangesinpatientstatushelpingmedicalpersonnelwithprocedures.

Midlevelmedicalpersonnel
Saninstructor
juniorsergeantpersonnelofmedicalserviceinmilitaryunits.Inwartimehe
organizesmedicalsupplyofhisunitusingsocalledcombatsanitars,whoareeitheraddedor
assignedfromthesoldiers.Saninstructorisobligedtoknowthecombattaskofhisunit,
locationofthebattalionorregimentclinic,providemedicalreconhehimselfprovidesprimary
medicalaid.Togetherwithsanitarshehastoorganizeselfandbuddyaid,searchand
evacuationoftheinjuredfromthebattlefield.Heidentifiesandprovidesfirstaidtosicksoldiers,
controlshygieneofthepersonnel,teachestherulesofselfaidandbuddyaid,supplies
personnelwithfirstaidtools.Saninstructorreportstothecommanderofthecompanyand
battalionclinicaboutthemedicalsituation,numberofwoundedandnecessaryaid.His
equipmentconsistsofacombatmedicbagthathasequipmentforfirstaidandanevacuation
strap.
Feldsher
specialistwithpostsecondarymedicaleducationwhoisauthorizedtodiagnose,
provideindependentcareordirectthepatienttoadoctorandprescribe.Onambulancesbeing
apartofafeldsherbrigade,feldsherisaresponsibleproviderofallworkbeingapartofa
doctorbrigadetheyworkunderthecommandofadoctor.Intheabsenceofadoctormaydo:
CPR,automaticdefibrillation,intubation,cric,obstetricaid,punctureofexternaljugularvein,
prescribingmeds.
Clinicalresponsibilitiesmaybeconsideredmidwaybetweenthoseofphysiciansandthoseof
nurses.InInternationalStandardClassificationofOccupations,2008isinthecategoryof
paramedicalpractitioners.
Medsestra
doctorsassistantintreatmentandprophylactics,performstheordersofadoctor
orfeldsher.Givesorderstojuniormedicalpersonnel(sanitary).Dependingontheirwork,may
workasadministratorsortakecareofpatientsaccordingtotheprescriptions,startIVsand

infusions,assistswiththemanipulationsthatonlydoctorsareauthorizedtodo,assistsduring
operations,preparingsurgicaltools,suturesanddressingsetc.

Seniorpersonnel
:Doctorandotherprofessionalswithhighereducation.

MedsanbatMedicalTraining
www.medsanbat.info
https://www.facebook.com/medsanbat

0913October2014,KyivKyivMilitaryHospital
1522October2014,Orlivshchyna(Dnipropetrovskregion)
1416October2014,GarthGlimmerTraintheTrainertwodayairwaytraining
1820October2014,LvivMilitaryMedicalHospitalAirwayTraining
2224October2014,KhmelnytskAirwaytraining
2225October2014,Mariupol
2526October2014,Kuibysheve61stMFHtwodaytraining
2628October2014,Zhytomyr
2731October2014,Sloviansk
1114November2014,Kyiv
1823November,Kharkiv120militarydoctors
28November,KyivTrainingforJournalists
November2014,yivGarthGlimmer,Airway
37December2014,Cherkaske(Dnipropetrovskregion)
913December,Dnipropetrovsk
14December,Kyivtrainingforjournalists
1620December,Kyiv
2428December,Chernigiv
2630December,Mykolaiv
28February,Zaporizhzhia300students
1228February,ATO:Krasnoarmiysk,VelykaNovosilkaZelenePole,Artemivsk300students
1116February,evacuationtraining150militarystudents
17March,Gorodok350militarydoctors
1015March,Kyiv300students
1415March,Kyivtwoonedaytrainingsforjournalists
1622March,Ochakiv220SFstudents
723April,ATO:SectorsA,B,C,M,Artemivsk,SvatoveShchastiaNovoaidar,Zoria300students

Totalnumber
ofpeopletrainedismorethan3500students.
Bagsgiven
:300

100level2bags

150level3bags

50kitsasresupplies

3TalonII90C

Unitstrained:
25thSeparateAirborneBrigade,

1stSeparateTankBrigade
7thSeparateMedicalCompany
93rdSeparateMechanisedBrigade
79thMykolaivAirMobileBrigade
17thSeparateTankBrigade
72ndSeparateMechanizedBattalion
57thMechanizedInfantryCompany
20thTerritorialDefenceBattalionDnipropetrovsk
26thBerdychivArtilleryBrigade
17thSeparateMechanizedInfantryBattalion
44thSeparateArtilleryBrigade
74thSeparateReconBattalion
54thSeparateReconBattalion
95thSeparateAirmobileBrigade
54thSeparateMechanizedBattalion
92ndSeparateMechanizedBrigade
78thSeparateUnit
OperativeCombatBorderGuardCommandCentre
KrasnoarmiyskPoliceDepartment
129thReconBattalion
80thSeparateAirmobileBrigade
30thSeparateMechanisedBrigade
43thSeparateBattalion
101stProtectionBrigade
59thSeparateMechanizedInfantryBrigade
140thCentreofSpecialOperations
13rdMechanizedBattalion
73rdCentreofSpecialOperations
NationalGuardSF
NationalGuard3028,1241,3002Units
8thSFRegiment
3rdSFRegiment
Myrotvoretsbattalion
GorynBattalion
Dnipro1Battalion
Kyiv1Battalion
AidarBattalion
AzovBattalion
RightSector
SaintMarybattalion
DonbasSFBattalion
SokilSFTeam
AlphaSFTeam
56thMFH,59thMFH,61stMFH,66thMFH
MinistryofCatastrophesService
WhiteBeretsVolunteerOrganisation
PyrogovVolunteerMobileHospital


References
(1)

http://www.nytimes.com/2015/02/19/world/europe/ukraineconflictdebaltseve.html?_r=0
WHOUkrainePublicHealthSurvaillance:
https://ukraine.emro.info/
UkraineStateBorderGuards:
http://dpsu.gov.ua/ua/
TerritorialDefenceBattalions:
http://en.wikipedia.org/wiki/Territorial_defense_battalions_%28Ukraine%29
VolnovakhaGRADAttack.Jan13,2015
http://humanrights.org.ua/en/material/investigation_of_deadly_incident_near_volnovaha_on_13_january_201
5
(2)
MilitaryFortificationincreasedaroundMariupol:
http://news.liga.net/photo/politics/5647663vokrug_mariupolya_stroyat_novuyu_liniyu_ukrepleniy_foto.htm#2