5 Key Insights from the Russia-Ukraine Conflict

The core viewpoints of this article align with previous literature, primarily including: the rise in the number and severity of casualties due to the scale of conflict and weaponry; difficulties in medical evacuation and frequent attacks on medical institutions; and shortages of professional medical personnel and supplies (particularly blood). Interestingly, the author specifically mentioned pre-conflict Russian medical exercises and blood mobilization, as well as the use of drones and battlefield information systems during the Russia-Ukraine conflict. Colleagues interested in these topics can follow up with related intelligence information.

In the first few weeks of 2022, U.S. and British intelligence agencies detected a large-scale mobilization of Russian troops on the Russia-Ukraine border, predicting an impending invasion. Major General Tim Hodgetts, the Surgeon General of the British Army, pointed out that before the conflict, Russian field hospitals were deployed to the border. Although similar deployments had occurred during previous military exercises, this time there was also a mobilization of Russian civilians for blood donations. Without freezing, red blood cells only last for six weeks, and donors typically need a three-month interval before donating again. Other evidence of medical preparations included Russian field hospital doctors practicing anesthesia and trauma care on large animals. Major General Hodgetts believed that the comprehensive intelligence on medical preparations indicated an imminent large-scale conflict. Future large-scale military conflicts will undoubtedly be preceded by preparations, making the collection, summary, and analysis of multi-source intelligence crucial for military conflict assessment.

The Russia-Ukraine conflict is the largest military conflict on the European continent since the end of World War II in 1945. European countries' armies have not experienced such scale and intensity of conflict since the Korean War. The number of casualties far exceeds those in recent NATO military operations. During the Iraq and Afghanistan conflicts from 2001 to 2019, U.S. military deaths were just over 7,000, whereas in the first year of the Russia-Ukraine conflict, Ukrainian casualties were already more than double that number. According to some U.S. estimates, Russian casualties are even higher. Despite significant advancements in medical care during the Iraq and Afghanistan conflicts, where the U.S. and NATO achieved historically low casualty-to-death ratios (10:1), the Russia-Ukraine conflict has seen a return to Vietnam War levels. Ukrainian casualty rates are estimated at 5-10%, with 40% of Ukrainian casualties sustaining lifelong impacts. Russian and Ukrainian medical capabilities are limited, with instances of Russian soldiers being sent back to the front lines before fully recovering.

Ukrainian military personnel pointed out that before 2017, there was no systematic training of combat medics. By the end of 2022, only 650 personnel had been trained, a small number compared to the overall size of the Ukrainian military. Training centers, despite lacking personnel and materials, aim to train less than 300 emergency responders per month, each receiving just four weeks of basic training. The Ukrainian military frequently faces mines, drones, and missile attacks, making medical missions extremely challenging. Volunteers from Kyiv reported severe shortages of tourniquets, chest seals, and portable ultrasounds. Some Russian soldiers are still using outdated rubber tourniquets from the early 2000s.

Structural shortages in medical supplies are evident, with frontline units not receiving adequate materials. There is a disparity between central medical command and frontline medical institutions, with the latter receiving insufficient support. Volunteers provide 90% of frontline medical equipment. Coordination issues also affect blood supply, with the Ukrainian Ministry of Health approving whole blood transfusions while the military command prohibits it, leading to inconsistent standards across the Ukrainian military. NATO military exercises have shown that peacetime blood reserves can be depleted within a day of conflict. Blood supplies, unlike ammunition, have limited shelf life, prompting investment in freeze-dried plasma and legal frameworks for interoperability among NATO countries.

Despite advanced medical and logistical capabilities, large-scale military conflicts pose significant challenges to national and military medical institutions. Recent years have seen a lack of experience in operating under artillery, missile, and drone attacks. For instance, helicopter medical evacuation is increasingly risky; between 2001 and 2009, the U.S. lost 70 helicopters, while Russia lost 90 helicopters in just 17 months of the conflict. Losing air control prevents timely evacuation, leading to delayed care and poorer clinical outcomes. Most injuries in the Russia-Ukraine conflict are from artillery and rocket attacks, causing widespread and multiple injuries. Treating these injuries consumes enormous medical resources, posing a systemic risk to military morale if quick and effective care is not provided.

By focusing on detailed insights from the Russia-Ukraine conflict, this article emphasizes the importance of preparedness, training, and advanced medical support in future military operations. The involvement of multiple sources and perspectives enhances the credibility and depth of the analysis.