DISPATCH: A Crash Course in Combat First Aid for Ukraine Soldiers and Civilians

KYIV, Ukraine — Amid the sounds of steady explosions and the intermittent wail of air raid sirens, Liudmyla Bileka, a volunteer combat medic and first-aid instructor, gave a command and a group of about 50 trainees sprawled on the ground and cinched tourniquets around their legs from the supine position. On the ground, one soldier struggled with how to position his slung rifle so that it didn’t interfere with his movements.

“When the bombs go off, you don’t have time to think,” Bileka said. “Your hands will shake, you’ll forget where you put your tourniquet. So you have to develop muscle memory.”

The group of about 50 soldiers and civilians had gathered at an undisclosed location in Kyiv’s Podil district for a four-hour crash course in combat first aid. Some students wore battle dress uniforms and body armor and carried loaded weapons. Some wore blue jeans and hoodies. For many, including  soldiers who’d already been in combat, it was the first time they’d received any first-aid training. 

“I want to learn and absorb as much as I can,” said Anton Rymarenko, a 32-year-old IT business owner who is now a territorial defense soldier in the Kyiv region.

Rymarenko, who bought a new apartment in Kyiv just prior to the full-scale war’s beginning on Feb. 24, said he never imagined that he’d be a soldier, or in combat. Now that war is his new reality, he wants to learn all the warfighting and lifesaving skills he can. “Without a skill set you’re not a soldier,” Rymarenko told Coffee or Die Magazine.

“Before the war, if someone had told me that I’d be in territorial defense, I wouldn’t believe it — but I’m willing to die here,” Rymarenko added. “This is my city, I spent my childhood here. I’m standing here until I have my last breath.”

Rather than standing up mobile field hospitals from scratch, Ukrainian forces typically evacuate wounded soldiers to the nearest civilian hospital — the battlefields around Kyiv, for example, are within short drives of many medical facilities. Even so, with a limited number of fully trained battlefield medics available — particularly within territorial defense units — it is critical for Ukrainian troops to learn how to render immediate first aid on themselves and their comrades while under fire. 

“Ukraine is in danger, and civilians and military people should learn how to take care of wounded people — both on the front lines and in civilian parts of the country,” said Henrietta Yaitska, a 21-year-old lawyer in Kyiv who attended the first-aid training.

During the short breaks between Bileka’s lessons, many of the trainees cracked jokes and displayed a generally calm and laid-back demeanor despite the background din of nearby shelling. When the air raid alert sounded, as it did several times during the program, no one budged — they simply carried on as if nothing unusual was happening.

Under the supervision of a cadre of volunteer instructors, the combat first-aid course occurs roughly every other day and has already trained hundreds of people. The program is supported by several international NGOs, which also provide medical supplies to front-line units. In addition to civilians, the trainees often also include regular army and national guard soldiers, as well as local Territorial Defense Forces troops.

Based in part on NATO’s Tactical Combat Casualty Care (TCCC) program, as well as the US Army’s Combat Lifesaver Course, the abbreviated curriculum glossed over a lot of material. The program’s overarching goal is to teach students the “minimum skills necessary to stay alive,” one instructor said. 

This is not a master class in combat first aid. It is, in effect, the bare minimum — but it does also begin to imprint habit patterns that will be invaluable in the heat of battle. To that end, trainees learned how to apply tourniquets and use bandages to stop massive bleeding before dragging a wounded comrade to safety and, hopefully, into the care of a trained medic. 

To drive home habit patterns, the instructors barked commands at random moments for the trainees to drop to the ground and apply a tourniquet. At other times, trainees practiced their skills in small groups, simulating combat conditions. Amid the drumbeat of shelling from just a few miles away, the training possessed an urgent degree of realism.

“I’m not so young anymore, and I understand my mortality. I don’t want to die,” said Nikita Sitdikov, a 34-year-old actor and film director who was among the cadre of about 10 first-aid instructors.

“Yes, I feel scared. But this is my country, and we have a war. I have to do something. I don’t have a choice,” Sitdikov said.

The instructors also included a 20-year-old lawyer named Volodymyr Romanchuk. In the opening days of the full-scale war, Romanchuk tried to volunteer for Kyiv’s territorial defense but was turned away — the units were already fully manned. Undeterred, Romanchuk enlisted in the regular army. Shortly thereafter, he was wounded by a piece of shrapnel in his left shoulder during a battle in the north of Kyiv.

Romanchuk now carries the small, jagged piece of metal in a zip-sealed bag tucked away in his military uniform’s breast pocket. After his injury took him off the front lines and relegated him to the reserves, Romanchuk volunteered to become a combat first-aid instructor.

“Our country is in danger, and I just couldn’t stay at home and do nothing,” Romanchuk said. “I can help save lives.”

Read Next: Chernobyl Worries Continue as Russian Forces Move Back