A fundamentally new level of medical support for the military is needed – address by the President of Ukraine

19 November 2023 – 21:11

I wish you health, fellow Ukrainians!

Today we have an important personnel decision. Upon the submission of the Minister of Defense, I have changed the commander of the Medical Forces Command of the Armed Forces of Ukraine. Instead of Major General of the Medical Service Tetiana Ostashchenko, I appointed Major General of the Medical Service Anatoliy Kazmirchuk, Head of the National Military Medical Clinical Center “Main Military Clinical Hospital” in Kyiv, as the new commander. The task is obvious – and this has been repeatedly discussed in society, in particular in the community of our combat medics – a fundamentally new level of medical support for our military is needed. From high-quality tourniquets to full digitalization and transparency in supply, from high-quality training to sincere communication with combat medics in those units where medical care is organized truly properly and truly effectively. The experience of the effectiveness of specific units should be extended to the entire defense forces. Today, at a meeting with Defense Minister Umerov, we identified priorities, and there will not be much time to wait for results. Changes need to be made quickly.

The second thing for today is that we continue to prepare for the planned international events this week. There will be an important activity – new communication with our partners. The key thing now is to make sure that support for Ukraine will be sufficient next year as well. I thank all the countries considering this issue in the same way as we do. This signal must be sent to Russia: no matter what they do, the world will not get tired of defending freedom and international order.

I would like to recognize the Netherlands today – this week the Dutch government has envisaged more than 2 billion euros for the next year, mostly in security support for Ukraine. Thank you, Mark, Mr. Prime Minister, and I am also grateful to the entire Dutch society. This is a timely signal. It is important to feel that the defense of freedom is backed by reliable and sincere support.

And one more thing. Every week that we pass in this war, in this defense of our independence, is a time when thousands of Ukrainians show the best of their character, the strongest qualities of people. When we are talking about unity in the defense of Ukraine, we are always talking not about something abstract, but about very specific things – about people doing what they have to do, what they should do, what supports others, and ultimately allows Ukraine to stand, fight, respond to the enemy and succeed in battles, in strengthening our state, in saving lives.

Today I would like to recognize the employees of the State Emergency Service of Ukraine – those who save lives every day. Those who risk their lives. Those who were wounded by Russian shelling. I thank the entire staff of the State Emergency Service! And especially Sergeant Vladyslav Dordiy, Master Sergeant Oleksiy Suschevsky and Chief Sergeant Oleksiy Shabal – firefighters and rescuers working in Zaporizhzhia region. They were injured this Wednesday while providing assistance in the village of Zarichne. Guys, I wish you a speedy recovery! Thank you for your service.

Donetsk region. Rescuers who have particularly distinguished themselves in helping people after the Russian attack on the town of Selydove. Sergeant Artur Taranenko and Captain Viktor Kartashov. Thank you!

Kherson region. Sergeants Oleksandr Chastukhin, Yevheniy Tyshyk, Major Serhiy Kovalenko. They were repeatedly involved in the liquidation of the consequences of Russian strikes and always do their best to save as many people as possible. Well done, guys! Well done! Thank you very much!

And, of course, Ukrainian medics. I thank all of you! I would especially like to recognize Tetiana Hurska, head of the Hulyaipole Emergency Department, and Oleksandr Ilyenko, an anesthesiologist at the Zaporizhzhia Emergency Station. Thank you!

Kherson. Volodymyr Pyatyhorets, a surgeon who operated on 16 patients with mine-blast injuries this week alone. And Mykola Stepaniuk, a field feldsher of the Kherson emergency medical unit. He is actively working, actively helping, actively saving people. I am grateful to you and your colleagues who are equally active and caring!

Separately I would like to thank everyone whose concern and efficiency help us return to Ukraine children who were abducted from the occupied territory. Today we managed to return to Ukraine Bohdan Yermokhin, a boy who was taken from Mariupol to Russia. There were many attempts to help him. I am glad that everything worked out. I am grateful to the entire team working on the return of Ukrainian children – the Office, the Ombudsman, and our international partners, including UNICEF. I am especially grateful to Qatar for its effective mediation and assistance. Thank you!

We remember all our people. We are mindful of every corner of Ukraine that is currently under occupation.

And I am grateful to everyone who is in combat, who is at combat posts, who is training and helping, who is preparing for combat! Avdiivka, Maryinka, our entire East, southern directions…

Melitopol direction, Kherson region… Glory to all those who defend Ukraine, who defend independence, who care about people and sincerely try to strengthen us all!

Glory to Ukraine!

Here’s more details on the firing of the Medical Forces commander:

Defense Minister @rustem_umerov says of his appeal to Zelensky to dismiss head of Medical Forces: The move was “obvious to everyone fighting in the ranks of the defense forces, and everyone who is helping them.” Also: “There is simply no place for…subpar tourniquets.” pic.twitter.com/EV1kwJpSBI

— Christopher Miller (@ChristopherJM) November 19, 2023

Here’s a screen grab of Defense Minister Umerov’s statement:

And here are further context from The Financial Times reporting from October 2023:

A Ukrainian soldier with shrapnel wounds to his legs howled in pain as medics lifted him off a bloodied gurney and on to Volodymyr Veselovskyi’s operating table.

“You will live. You will probably keep your legs, too,” Veselovskyi, an army surgeon, told the soldier. He tugged on the tourniquets fastened around the soldier’s thighs that had kept him from bleeding to death. “These are good,” he said. “You’re lucky.”

At this “stabilisation point” about 10 miles west of the battlefield at Bakhmut, Veselovskyi works alongside other volunteers who traded their medical practices for military fatigues after Russia’s full-scale invasion of Ukraine 20 months ago. Dozens such emergency units have been set up along the 600-mile frontline, serving as critical first stops for wounded soldiers needing emergency treatment before being evacuated to larger hospitals.

Ukraine’s soldiers have received praise for their acts of valour on the battlefield, where they are locked in a David-versus-Goliath fight against the much larger and more powerful Russian army. But Ukraine’s doctors, nurses and paramedics are no less important, as they wage a daily battle of their own to save the lives of their country’s defenders.

“This is the second frontline,” said army surgeon Bohdan at a different stabilisation point in Pokrovske, a town about 25 miles north of the main focus of Ukraine’s counteroffensive in the southern Zaporizhzhia region.

More than 20 months into the intense all-out war, Ukraine’s medics are in constant need of crucial supplies. More than a dozen combat medics interviewed since the start of Ukraine’s counteroffensive in May expressed frustration that defective medical equipment and a lack of medical training were costing soldiers’ lives.

The soldiers’ injuries are predominantly shrapnel wounds caused by artillery fire and landmines.

Veselovskyi said he performed seven amputations in less than 24 hours, removing the limbs of soldiers who came under enemy shelling while advancing through a minefield during an assault north of Bakhmut, the Donetsk city captured by Russia after 10 months of intense, attritional fighting. They all lost limbs but their lives were saved, thanks to good-quality tourniquets, the surgeon said.

But he and other medics have increasingly had to work with poor-quality medical supplies, making it tougher to keep patients alive. At one stabilisation point, a “museum of killer tourniquets” was on display with over a dozen broken devices that failed to save the lives of their wearers.

“I’ve seen this first-hand when a soldier had a defective tourniquet which broke and the soldier lost his life,” said Rebekah Maciorowski, an American nurse who volunteered as a medic with the Ukrainian army in March 2022.

Cheap tourniquets, many made in China, have flooded Ukraine and made their way into soldiers’ first-aid kits, Maciorowski said. With a bad tourniquet, a soldier could bleed to death in three minutes, she added. “This is not something to save money on.”

Ukraine’s Medical Forces Command was made aware of the issue in early summer and Anton Shevchuk, one of the top medical commanders, requested in July that the cheap tourniquets be replaced immediately. He said such devices were found in more than 5,000 first-aid kits issued by the military.

Shevchuk said he was “severely reprimanded” for his comments, but “I could not let the guys go into battle with the Chinese tourniquets”.

The scandal sparked a rare public discussion about military procurement. Since Russia’s full-scale invasion, publicly criticising the armed forces has been largely taboo and seen as unpatriotic by officials and citizens alike.

Public broadcaster Suspilne recently asked the Medical Forces Command why soldiers still received “poor-quality” first-aid kits and tourniquets. In late August, the Ukrainian military received an order to issue 80,000 new tourniquets meeting US military standards, Suspilne reported. It is unclear whether those were obtained and distributed among soldiers.

The Medical Forces Command did not respond to a request for comment.

“What is lacking [is] any kind of standardised reviewing of first-aid kits,” Maciorowski said.

As important as having good quality materials is knowing how to use them — and many medics say better first-aid training for soldiers is needed.

“A large portion of tactical medical training is just entirely omitted,” Maciorowski said, including when Ukrainian troops are being trained abroad. In addition to soldiers, medics have also been receiving training in the US, UK and other allied countries. “Because there’s such a push to get guys to the front, they can be given a month of training [with] maybe one or two days of tactical medical training. They’re not going to remember that.”

Much more at the link!

Here’s Rebekah Maciorowski’s thread explaining how you can get proper tactical medical gear into the hands of Ukrainian medics and troops in case anyone is interested:

Many ask this question, so I did a 🧵. Have a look inside. pic.twitter.com/byMW8HMXOG

— Rebekah Maciorowski (@bekamaciorowski) September 26, 2023

Kyiv:

For the second night in a row Russia attacks Kyiv region with drones. Air alert lasted for almost 5 hours. 15 drones out of 20 intercepted. Infrastructural object in the region was hit pic.twitter.com/Rn0nyDQ8Gq

— Maria Avdeeva (@maria_avdv) November 19, 2023

Bakhmut:

Brief update south of Bakhmut:

Russia is trying to improve its tactical situation from Bakhmut to Kurdyumivka. No signs of a large-scale operation yet, but the situation is still developing. The enemy likely aims to regain the strategic initiative across the frontline.

— Tatarigami_UA (@Tatarigami_UA) November 19, 2023

Significant action occurs almost daily there. It rarely gets covered, but both Russian attempts to assault and our troops' counter-attacks have been frequent. It's hard for public to keep attention over the area when there are no visible map changes

— Tatarigami_UA (@Tatarigami_UA) November 19, 2023

Not with the forces they have right now

— Tatarigami_UA (@Tatarigami_UA) November 19, 2023

The drone teams of the 92nd Brigade of the Ukrainian army released a compilation video, showing 4 hit Russian SPGs at the Bakhmut front, partially with impressive secondary explosions:

1x 2S19 Msta-S
1x 2S1 Gvozdika
2x 2S9 Nona

Source: https://t.co/O6FcKme2z2…#Ukraine… pic.twitter.com/UgmBESwFC2

— (((Tendar))) (@Tendar) November 19, 2023

Tarasivka/Brylivka, Russian occupied Kherson Oblast:

/2. Also, you can actually see a pair of strikes pic.twitter.com/b3ep2QVATK

— Special Kherson Cat 🐈🇺🇦 (@bayraktar_1love) November 19, 2023

Since some are asking, the planes are old and probably not functional, neither they were the target. The target was the hangar which was a base of operation in this sector, especially regarding the events around Krynky.

Regarding the used missile I was only speculating.

— (((Tendar))) (@Tendar) November 19, 2023

Chaplynka, Russian occupied Kherson Oblast:

This Russian Pantsir was destroyed near Chaplynka, around 50km from the Dnipro river and deep inside Russian-occupied territory.

Considering the fact that this so-called “drone killer” was spotted by a drone so far from the current frontline and while being operational, just… pic.twitter.com/b2fxAQ2tJh

— (((Tendar))) (@Tendar) November 19, 2023

This Russian Pantsir was destroyed near Chaplynka, around 50km from the Dnipro river and deep inside Russian-occupied territory.

Considering the fact that this so-called “drone killer” was spotted by a drone so far from the current frontline and while being operational, just adds up to the long list of air defense failures of this Russian piece of hardware.

Source: https://t.me/operativnoZSU/123971

#Ukraine #Kherson #Chaplynka

 

/2. Pantsir-S1 geolocation. 51km from the front line
46.338669, 33.503070 https://t.co/Rx2MhoyvqF

— Special Kherson Cat 🐈🇺🇦 (@bayraktar_1love) November 19, 2023

Avdiivka:

This Russian armored assault south west of Avdiivka ended in at least 3 destroyed armored vehicles, including a turret toss.

The date of that footage is unclear and it could have been any time since the renewed offensive in this sector.

Source: https://t.co/e2CyQyxgmY#Ukraine… pic.twitter.com/iHHxE16WsQ

— (((Tendar))) (@Tendar) November 19, 2023

/2. On 0:58 an interesting modification of MT-LB with equipment for self-digging is targeted. pic.twitter.com/bJVaZFJ4gk

— Special Kherson Cat 🐈🇺🇦 (@bayraktar_1love) November 19, 2023

 

Israel-Hamas update:

Let’s start with Barak Ravid’s English language reporting. (emphasis mine)

Negotiations to secure a deal for the release of dozens of hostages being held in Gaza are back on and showing modest progress after a pause lasting several days, three sources with direct knowledge of the issue tell Axios.

Behind the scenes: Yahya Sinwar, the Hamas leader in Gaza, went silent and stopped engaging with Hamas representatives at the talks in Doha after the Israeli military raided Gaza City’s Al-Shifa hospital last week, leading to a suspension of the talks. Within the last 24 hours, Sinwar has re-engaged, the sources say.

• Sinwar sent a new response to the Qatari mediators which indicated a narrowing of some of the gaps between the parties, but not yet enough to reach a deal, according to two of the sources.

Catch up quick: More than 240 people, including several Americans, were abducted during the Oct. 7 Hamas terrorist attack.

• Four hostages, including two Americans, have since been released, one has been rescued and two others were found dead.

State of play: The talks between Israel, the U.S. and Hamas are being mediated by Qatar.

• Qatari Prime Minister Mohammed Bin Abdulrahman al-Thani said on Sunday that he is confident a deal is close and the gaps between the parties are small and mostly of logistical nature.
• Two sources tell Axios the details of the deal haven’t been fully determined yet and there are changes every day. “Sometimes there are changes every hour,” one source said.

Details: If a deal is reached it will be implemented in two phases, the sources with direct knowledge say:

• In the first phase, Hamas is to release around 50 women and children in exchange for a five-day pause in the fighting.
• As the five-day pause continues, Hamas will locate more women and children that it claims are being held hostage by other factions so that they could be released in a second phase.

Sinwar has agreed in principle to increase the number of women and children who will be released under the two-phase deal to more than the 50 he originally agreed to, according to two of the sources.

• But Sinwar is demanding that Israel halt its aerial surveillance of Gaza for six hours per day during the pause so that Hamas operatives will be able to locate hostages without being spied on by Israel, the sources said.
• Sinwar is also demanding that Israel release all Palestinian women and children held in Israeli prisons, two of the sources said. There are roughly 150 Palestinian women and minors held by Israel for taking part in attacks against Israelis.

Between the lines: Hamas is not holding all of the Israeli and international hostages taken on Oct. 7. Some are believed to be held by other militant or criminal groups.

• Israel doesn’t know the exact number of women and children Hamas is holding or is aware of, but Israeli officials believe there are around 20-28 more than the 50 Hamas has said it’s holding.

• Israel has demanded to know as part of the agreement the exact number of women and children that are being held hostage in Gaza, the sources say. One source said Israel won’t just accept a general agreement that Hamas will release more hostages, but wants to know specifically how many will be released in the second phase.

Another sticking point is the number of aid trucks that will enter Gaza through Egypt each day under the deal.

• Hamas is demanding that 400 trucks per day be allowed in, and that those trucks provide fuel for hospitals and bakeries in addition to other humanitarian goods.
• The Israeli side says the Rafah Crossing can’t process 400 trucks per day for security reasons.

Driving the news: President Biden’s senior Middle East adviser Brett McGurk arrived in Doha on Saturday night and met with the Qatari prime minister to discuss the effort to release the hostages.

• In interviews with CBS and NBC on Sunday, U.S. deputy national security adviser Jon Finer said a deal was getting “closer” but some issues remained unresolved.
• Israeli Ambassador to Washington Mike Herzog told ABC that there are serious efforts to get a deal and stressed he is hopeful that a significant number of hostages could be released in the coming days.

As was the case with the off the record statements that drove WaPo’s terrible reporting last night, there are still a lot of conditional phrases in Ravid’s reporting. But there’s something even more significant: Hamas DOES NOT have all the hostages and Hamas DOES NOT know where all the hostages are. Especially the women and children! This is a major problem.

More from Ravid in response to Arab Israeli journalist Roi Kais:

בכירים ישראלים ואמריקנים טוענים שהדיווח אינו נכון https://t.co/8zmQcCoVcD

— Barak Ravid (@BarakRavid) November 19, 2023

Here’s the translations:

Ravid: Senior Israeli and American officials claim that the report is not true
Quote

Kais: The Al-Rad Binarabi channel reports from a Hamas source that according to the apparent deal, the ceasefire is expected to begin tomorrow at 11 a.m.

Another complication is that the Times of Israel reported this out earlier today. Tweet thread first, then excerpts from their published reporting:

WARNING!! WARNING!! SOME OF THE VIDEO IS GRAPHIC!! WARNING!! WARNING!!

https://twitter.com/talschneider/status/1726310948737077707

An abducted person is being led into the hospital by terrorists, even though he is not wounded. You can see the same terrorist (read shirt r others) getting outside from cars including IDF military jeep, entering the hospital, and delivering the abducted people. pic.twitter.com/UT8cyTpzla

— ‏Tal Schneider טל שניידר تال شنايدر (@talschneider) November 19, 2023

Israeli cars inside the hospital after fleeing from Israel into Shifaa at 10:44 am & 10:53 am on the atrocities of Black Saturday, oct 7th, 2023 pic.twitter.com/JDm4phmxQs

— ‏Tal Schneider טל שניידר تال شنايدر (@talschneider) November 19, 2023

In the following screenshot, the abducted person is not wounded, yet taken into the hospital by the Hamas terrorists. pic.twitter.com/4dkWRxDbz8

— ‏Tal Schneider טל שניידר تال شنايدر (@talschneider) November 19, 2023

IDF Spokesman Rear Adm. Daniel Hagari says Cpl. Noa Marciano, 19, who was held hostage in a hideout apartment near Shifa Hospital in Gaza City, was killed by Hamas, and not an Israeli airstrike.https://t.co/vo2ykqdsX2

— ‏Tal Schneider טל שניידר تال شنايدر (@talschneider) November 19, 2023

2) The video shows a hospital run by terrorists with at least one abducted person not wounded yet taken in there. What for? Medical staff is part of the scheme!
3) Noa Marciano was wounded lightly but was executed on the hospital grounds. Is this under doctor's oath ethics?

— ‏Tal Schneider טל שניידר تال شنايدر (@talschneider) November 19, 2023

ALL CLEAR!!!

From The Times of Israel:

The Israel Defense Forces on Sunday released surveillance camera footage from Shifa Hospital showing Hamas terrorists bringing a Nepali and Thai citizen who were abducted from Israel on October 7 to the medical center in Gaza City, and accused the Palestinian terror organization of murdering a kidnapped Israeli soldier there.

It also shared new footage of the underground network of tunnels and bunkers it says is buried under the hospital, as Israeli forces continue to operate in and around the facility. The army says Hamas uses Shifa and other hospitals as protection for its terror activity, and has specifically singled out Shifa as a key underground operations center for the group.

Israeli officials have been intent on producing evidence of Hamas’s misuse of Shifa to the world, to back up their assertions that the terror organization uses civilians and civilian infrastructure to shield itself, and thus shore up support for Israel’s ongoing offensive.

The three hostages featured in the IDF’s Sunday briefing were among over 240 people seized in the Palestinian terror group’s onslaught six weeks ago, when Hamas-led terrorists breached the Gaza border under the cover of heavy rocket fire and killed some 1,200 people — most of them civilians — as they rampaged through southern communities and a music festival.

Over the past week, the military has been operating in and around Shifa, uncovering what it has said is evidence of Hamas’s use of the site for terrorist activities. The IDF has said it was working to evacuate as many patients as possible from the compound.

In the footage published Sunday by the military, one of the hostages is visibly wounded in his arm and is brought in on a hospital bed, while the second is forcefully dragged into the hospital on his feet.

“These findings prove that the Hamas terror organization used Shifa Hospital on the day of the massacre itself as terror infrastructure,” the IDF said.

The IDF said it had notified “relevant authorities” about the footage.

Further images released by the IDF from the surveillance cameras at Shifa showed Hamas terrorists inside the hospital and outside the rooms of the hostages, as well as stolen IDF vehicles brought to the medical center.

The army also released an infographic showing the locations near the Shifa complex where the bodies of hostages Yehudit Weiss and Cpl. Noa Marciano were found several days ago.

Much, much more reporting and imagery at the link!

I’m not sure this is definitive proof that Hamas has a command and control bunker below the hospital, but these videos and still images from the hospitals own surveillance cameras are going to increase the pressure to root out Hamas and find and return the hostages.

When you combine this with the fact that Sinwar and his Hamas forces neither have all the hostages, nor know where they are you have a major inflammatory problem. Additionally, it is unclear exactly how much control Sinwar has over the behavior of his own militia, let alone that of the Palestinian Islamic Jihad or any independent actors that decided to join the raid. Even if Sinwar can find all of just the women and children being held hostage, what do you think is going to happen when they get returned to Israel and they recount any abuse they may have received while they were held captive and/or their are physical signs of abuse? Things will go from worse to galactically, horribly terrible in short order.

Right now, despite all the happy talk they’re not close to a deal because Sinwar can’t deliver on his end because he doesn’t have, let alone know where, all the women and children are being held hostage. Until that’s resolved, their won’t be a deal.

That’s enough for tonight.

Your daily Patron!

There are no new Patron tweets or videos tonight, so here is some adjacent material from the Ukrainian Ministry of Defense.

Our mission is to defend everyone who is in need.

📸: 43rd Mechanized Brigade pic.twitter.com/poFTHLCzzD

— Defense of Ukraine (@DefenceU) November 19, 2023

Open thread!