Ukraine's military medical care has been superior to Russia's, but the lasting Soviet doctrine of simply throwing waves of soldiers at your enemies could help make up for it

Russian military cadets take part in a rehearsal for the Victory Day parade on Dvortsovaya Square in Saint Petersburg on April 25, 2023.
Russian military cadets take part in a rehearsal for the Victory Day parade on Dvortsovaya Square in Saint Petersburg on April 25, 2023. Olga Maltseva/AFP/Getty Images
  • Military medicine experts told Insider Ukraine's medical care in war has been better than Russia's.

  • Russian troop are lacking basic first aid supplies, like gauze and effective tourniquets.

  • But Ukraine's medical advantage could be undercut by the sheer number of potential Russian soldiers.

Ukraine has provided superior medical care to its soldiers during the war compared with Russia's, two experts in military medicine told Insider, but the sheer number of potential Russian soldiers — and a historical willingness to relentlessly throw them into battle — could help soften Ukraine's medical advantage.

Dr. Aaron Epstein, a former defense contractor and founder of the Global Surgical and Medical Support Group, said Ukraine as a country has a good medical system that is on par with many other European countries. After Russia invaded, Epstein's group sent physicians to Ukraine to help train the public on treating combat injuries and to give surgeons with other specializations crash courses on being trauma surgeons.

But when it comes to Russia, Epstein said its medical care for its troops has been "somewhat horrendous," adding, "It seems like they're lagging decades behind when it comes to adequate treatment of their own forces."

In July, the UK Ministry of Defence said that up to 50% of Russian soldiers being killed in combat were dying preventable deaths.

Even the most basic first aid kit materials seem to be lacking with Russian soldiers on the frontlines, Epstein said, noting a video he saw that appeared to show a Russian barracks commander telling troops that if they're shot they should shove a tampon in the hole. The UK's MOD said last year that Russian soldiers were being advised to use women's sanitary products as first aid supplies. A video that circulated on Telegram appeared to show a Russian military staffer telling recruits to "ask your wives, girlfriends or mothers for sanitary pads."

Another video, cited by Epstein and Tanisha Fazal, a professor at the University of Minnesota who studies medical care in war, appeared to show Russian soldiers using essentially what amounted to a piece of rubber as a tourniquet, the kind of equipment the US military had evolved beyond decades ago.

"They might as well be using their belt," Epstein said.

Fazal said she was also surprised to see Russia using such dated tourniquets and apparently lacking basic supplies like gauze, especially because "hemorrhage is the primary cause of preventable battle deaths."

Another concern when it comes to battlefield medical care is how close the wounded are to a hospital. If the higher levels of care are far removed from the frontlines, he said, the only way you would survive long enough to actually make it there is if your injury isn't very severe in the first place. Otherwise, you'd already be dead.

The Ukrainians have been resourceful in setting up care close to combat, using the basements of blown-out buildings as treatment centers or doling out care from trucks that can move at a moment's notice, he said. Because Russia has targeted hospitals with strikes, Ukraine has also been somewhat forced to seek out more hidden spots to issue treatment.

Still, Russia has one clear advantage over Ukraine that could compensate for their inferior medical care: the sheer number of potential soldiers, coupled with the long-standing "Soviet military doctrine" of throwing "waves of people at your enemy," Epstein said.

"There has historically been, frankly, little care for Russian or Soviet lives in combat," he added.

For a comparison, Epstein said the US will not deploy somewhere unless the medical logistics chain has been established, including how to evacuate someone, where the different levels of care are located, and how much time it will take to get wounded soldiers where they need to be for treatment. But for Russian and Soviet soldiers, medical support has largely seemed to be an afterthought.

Russian soldiers and their families have said as much throughout the war, with some complaining that conscripts are being thrown right into battle unprepared, without the proper supplies or training.

Fazel said reports of poor medical care tracked with reporting about how Russian soldiers "see themselves as cannon fodder, which implies that they don't think they're going to be cared for if they fall ill or become injured."

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