Military medics don't need "extra duties"

The events of recent years and months in the North Caucasus, and the conduct of a counter-terrorism operation there, have become a serious test for the new Russia, the emerging Russian statehood and democracy. Today, we can say that a decisive step has been taken to strengthen the constitutional foundations in this complex region. This has also been achieved through the courageous and selfless actions of the military personnel of the Joint Group of Forces (forces) in the North Caucasus. Unfortunately, there have been casualties. However, the number of casualties would have been higher if it were not for the highly professional and selfless efforts of the military medical personnel. Lieutenant Colonel Yuri Seleznev, a regular correspondent for the North Caucasus Military District, talks to Colonel Anatoly ULUNOV, Head of the Medical Service of the North Caucasus Military District, about their heroic work in saving the lives and restoring health to hundreds of Russian soldiers and officers.

- Anatoly Dmitrievich, recently, military medics have gained a lot of experience in providing medical assistance to military personnel who have to participate in various local conflicts, including counter-terrorist operations in Dagestan and Chechnya. What is the content and specifics of this experience?

- The main task that we faced since last August was to create a well-organized and effective system of medical and evacuation measures in the region, which would guarantee high-quality medical support for the counter-terrorism operation. Simply put, we had to make sure that no one was injured or traumatized.

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or a sick soldier or officer did not receive timely and effective medical care.

Let me tell you right away: we have succeeded in achieving this. To prove it, I will provide some figures. In military medical practice around the world, the average ratio of fatalities to injuries is 1:3. We have changed this ratio to 1:7, which means that we have successfully saved the lives of four additional soldiers.

Next, again according to established practice, the mortality rate for wounded patients who had already been treated by medical professionals was usually 2.5 to 3 percent. We reduced this figure to 0.8 percent. Behind these numbers are dozens and hundreds of saved lives, which is worth a lot.

We were able to achieve these results mainly by creating a network of expanded medical evacuation stages, from the battlefield to medical facilities, where comprehensive medical care was ultimately provided.

At first, during the repulsion of the Basayev-Khattabov aggression against the Republic of Dagestan, we mainly relied on the military medics of the North Caucasus Military District. In early August 1999, we allocated several medical reinforcement groups for the Buynaksk Garrison Hospital and deployed our district medical special forces unit to the base area in Kaspiysk. His operational groups, consisting of 20 to 25 specialists of various profiles, were deployed in the Botlikh district, the Kadar zone, and the Novolak direction as needed. This led to the creation of a local system of medical and evacuation facilities, with the medical special forces unit and the Buynaksk hospital serving as its main components. Additionally, the forces of the Rostov-on-Don District Military Hospital and the Krasnodar and Volgograd Garrison Hospitals were actively involved.

- With the increase in the scale of the counter-terrorism operation, did the military medics also have to increase their efforts?

- This is natural. When the events in Chechnya began, we were additionally assigned three special medical units.

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The Leningrad, Volga, and Ural Military Districts. In addition, the central military medical structures began to provide very active assistance. In particular, the Military Medical Academy, the Vishnevsky Central Military Hospital of the Ministry of Defense, and others. We were provided with medical and sanitary aircraft such as the An-72 and Il-76 for regular use, and the Skalpel aircraft was used to perform resuscitation and anti-shock measures in the air.

The problem of effective pre-medical and medical care from the first days of the operation was solved by our medical service in a complex. One of the aspects was its maximum possible proximity to the battlefield. I'll make a reservation right away: this does not mean that we tried to promote our doctors directly to the battle formations. This practice, alas, took place in 1994-1996 and, in my opinion, despite the heroism and courage of military medics, often led only to unjustified losses in their ranks. Judge for yourself: what kind of qualified assistance can even the most experienced doctor provide under heavy enemy fire, amidst the explosions of mines and shells? At best, he will perform the functions of a medical assistant or paramedic, but there is a high probability of his death. Who will provide qualified assistance to the victims at the next evacuation stages?

So, figuratively speaking, is it worth cracking nuts with a gold seal? I won't hide the fact that in the recent months of the operation, the slogan "Everyone to the front line" has been heard more than once. As the head of the medical service, I presented my point of view to the commander of the Joint Forces Group. I received his support.

We did it differently. At various stages of the operation, depending on the need, we deployed up to 30 medical companies and medical stations. Together with medical assistants and paramedics, they ensured the evacuation of the wounded directly from the battlefield and their initial medical treatment. This allowed our specialists to fully assist the soldiers and officers in need. The entire chain, including first aid, medical treatment, and specialized care, was typically effective.

We were able to achieve such coherence by strengthening medical battalions and companies, and by equipping medical special forces units with first-class personnel from the district military hospital and a number of garrison hospitals. This allowed us to bring qualified medical care with elements of specialized care closer to the battlefield. When necessary, the chief surgeon of the North Caucasus Military District, Colonel Sergey Tatarin, an Honored Doctor of the Russian Federation, and Lieutenant Colonel Artur Oganov, an experienced surgeon, worked around the clock near the front lines.

We were also lucky with the commanders of the medical special forces detachments, Lieutenant Colonel Alexander Ushakov, Lieutenant Colonel Sergei Koshcheev, and Lieutenant Colonel Anatoly Targonsky. They turned out to be not only excellent doctors, but also skilled administrators and organizers of the medical evacuation process, which is very important in combat conditions. I'll give you an example: by normal standards, qualified medical care should be provided to the wounded no later than 8-12 hours after the injury. So, during the battles for Grozny, and it was during this period that the most seriously wounded were brought in, those in need received qualified assistance with elements of specialized care on average... one hour later!

From the very first days of the counter-terrorism operation, especially when its intensity and scale increased, we were provided with all the necessary evacuation means, including a ground transportation unit and, most importantly, several aircraft. I have already mentioned the planes. In addition, we were assigned a permanent helicopter. Two more helicopters were on duty around the clock. I must say that we owe a great debt of gratitude to the members of these crews. They were always ready to evacuate wounded soldiers from the battlefield. This is the crew led by Major Igor Streltsov. The hero was and will remain in the memory of thousands of people, the commander of the regiment Nikolai Maidanov, my personal friend and battle brother, who became a legend of the Russian Air Force during his lifetime. One of these flights into the skies of Chechnya was his last...

I can add that Anatoly Dmitrievich wrote an epitaph poem for his comrade's death.

Song interrupted,

broken strings,

Orphaned

combat helicopter.

Just clouds

over your grave

Your phone number

silent flight.

Remembers Afghan

sultry sky,

Knows Chechnya

and keeps Dagestan

Glory of the Russian

sokola-asa,

Feat of which

honorably rewarded.

From the mountain range

deadly sting

A shot rang out

the pilot in the chest.

And to heaven

your soul called,

To continue

through eternity is the way.

Mourning rally,

farewell to the Hero,

Grief overwhelmed me

our hearts.

My friend is gone,

the eagle in the sky,

And the family of a dear father.

Song interrupted,

broken strings.

Orphaned

a helicopter without you.

But not for long:

sons grow up -

Eternal in life

your flight will be yours.

- Anatoly Dmitrievich, in addition to the circumstances related to combat operations, the health of military personnel was determined, as one might expect, by a number of factors.

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Are there any other factors that could affect their combat readiness?

- Of course, combat clashes were not the only factor affecting the health of soldiers and officers in the North Caucasus. People are people, and they tend to get sick from time to time, even in peaceful conditions. What can we say when most of the soldiers and officers in the group had to live in tents and dugouts on the outskirts of settlements or in the middle of the mountains for weeks? In such conditions, it is not easy to cook food, let alone rest, wash, or put uniforms in order. Add to this the fact that a significant portion of the military phase of the operation took place during the cold winter months, and the picture becomes quite clear.

However, we managed to keep the situation under full control. It is commonly believed among medical professionals that out of 1,000 randomly selected individuals, 50 are almost certain to suffer from various infectious diseases at the time of examination. This is a significant percentage in normal, peaceful circumstances. However, during the entire operation, this figure was not exceeded among the personnel of the Joint Group.

This was facilitated by a comprehensive system of preventive and therapeutic measures. Since the beginning of the hostilities in the region, the district sanitary and epidemiological unit and 12 mobile sanitary and epidemiological groups, led by Colonel Mikhail Nikitin, Chief Sanitary Doctor of the North Caucasus Military District, and Colonel Valery Demenev, Commander of the unit, have been working to provide assistance to every military unit and even every individual unit. They have not shied away from any task, helping commanders to organize timely showers for their personnel, monitoring the preparation of food, and providing water disinfection products. Special attention was paid by the specialists of the detachment and mobile groups to the fact that the military personnel observed the basic requirements of hygiene. On the advice of our employees, they participated in events to improve the immunity of the military personnel. And the best prerequisite for this is a good-quality diet, including the consumption of fruits and vegetables. If necessary, vaccinations are carried out.

- By the way, were there any problems with that?

- In general, no. The issue was taken under control by the Main Military Medical Directorate of the Ministry of Defense. The region received large amounts of bacterial drugs and medical equipment, as well as funds for their local procurement. Voluntary sponsors also provided significant assistance, particularly in the Krasnodar Territory, Rostov Region, and Volgograd Region. This assistance was specifically directed to military hospitals.

- Comrade Colonel, I often heard from the servicemen in Chechnya, and I have met some of them myself, who, after recovering, were eager to return to their units and join the ranks as soon as possible. Please tell us about such cases.

- There were plenty of examples like this. I'll tell you a story that I personally experienced. We had just arrived in Mozdok from Chechnya by helicopter. As soon as we got out of the helicopter, we met two paratroopers who asked us for help getting to Chechnya. I told them that we had just arrived from there. As I looked at them, I realized that I had seen them before. I remembered that they had been on the same helicopter with us the day before."The guys were on their way to the Mozdok hospital, and they had some signs of an infectious gastrointestinal disease. The doctors took the first measures and planned to evacuate them to the Budyonnovsk garrison hospital for a more thorough examination and treatment, and they provided them with their uniforms. However, the guys felt a little better and decided to sneak back to their battalion. This was understandable, but from a medical perspective, it was unacceptable. They needed to complete their treatment, without a doubt. I reproached them. They replied that they had heard that their battalion was preparing for a march, and they were mechanics and drivers. Who would take their place at the controls of the combat vehicles? By the way, these guys were my fellow Siberians from Yurga and Novokuznetsk.

In general, the problem of returning lightly wounded and lightly ill soldiers to active duty is a serious one. To address this issue, we have established specialized wards in hospitals located near the combat zone, significantly increasing their capacity. For example, the Mozdok Hospital has expanded from 75 to 500 beds, while the Stavropol and Vladikavkaz Hospitals have added 15 to 200 beds each. As a result, by the fourth month of the counter-terrorism operation, the number of soldiers who had returned to their units had reached 85-90 percent.

- Anatoly Dmitrievich, the combat situation probably created frankly non-standard situations for military medics. How did your subordinates act in these cases?

- It would be better if there were fewer such situations. We have enough "standard" situations. The very practice of working near the battlefield already requires the highest level of professionalism and the mobilization of the best human qualities from the doctor. I have already mentioned the maximum possible approach to the victims for qualified medical care, which includes effective anti-shock and resuscitation measures, such as intensive pain relief, stopping bleeding, administering blood-replacing fluids, and more. The puncture of the subclavian vein is particularly important. In modern medicine, this is a common medical procedure, but it is usually performed by highly qualified specialists in a hospital setting. However, almost every doctor has learned to perform this procedure in the field. This has saved dozens of officers and soldiers' lives.

As for non-standard situations, they, of course, arose. Once, during the battle for Grozny, specialists of the medical special forces from the Volga Region, Lieutenant Colonel Yakimchuk and Major Antonov, had to help a soldier who got stuck in the armpit area... an unexploded small-caliber mortar mine. The sappers were called. the wounded man's condition worsened, the bleeding increased, and it was necessary to act urgently. In short, the doctors did not wait for the arrival of the sappers...

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