In eastern Ukraine, quiet nights in the dim corridors of a front-line medical post can shatter in an instant. Medics roused from sleep rush to meet another stretcher wheeled in from the Donetsk front.
They work with urgency — chest compressions and shouted commands — until it becomes clear that the soldier arrived too late. The room falls silent as his body is sealed in a white bag.
He could not be saved, the anesthesiologist said, because evacuation took too long. By the time he reached the stabilization point, he was already dead.
It was not an isolated case, but part of a broader shift in the war where medical evacuation has become increasingly difficult.
“Because of drones … that can reach far, the danger is there for the wounded themselves and now for the crews working to get them out,” said Daryna Boiko, the anesthesiologist from the “Ulf” medical service of the 108th Da Vinci Wolves Battalion. “That’s why the main difficulty now is transport.”
In the early months of Russia’s full-scale invasion, evacuation vehicles could reach almost to the front line, giving the wounded a better chance of survival.
Now, the heavy use of first-person-view (FPV) drones, which let an operator see the target before striking, has turned areas up to 20 kilometers (12 miles) from the front line into kill zones. Medics say they have not treated gunshot wounds for months, and most injuries now come from FPVs.
The drones are the most feared weapon, both because of their precision and because they reduce survival chances for those already injured by complicating the evacuation.
For Ukraine’s outnumbered army, that makes preserving crew even harder.
Evacuations in the kill zone
The growing use of FPVs has also made moving the wounded between points more difficult, said the commander of the 59th Brigade medical unit with call sign Buhor, who spoke on condition of anonymity for security reasons.
“Everything is getting harder — the work has to be more mobile, the way we operate changes and the level of safety changes,” he said.
Asked whether those conditions have increased mortality among the wounded, he replied: “Significantly. There’s nothing you can do. Everything burns from those FPVs — everything, even tanks.”
He explained that the munitions carry a charge from a rocket-propelled grenade — a shoulder-fired weapon that launches an explosive designed to pierce armored vehicles. When it blasts, a jet of molten metal and fragments penetrate the cabin at extreme temperatures. The impact can cause anything from minor cuts and burns to severe wounds, including amputations, depending on where the fragments hit and their size.
Buhor said self-aid and self-evacuation are now heavily emphasized during training, but the existence of the kill zone means soldiers can be stuck in position for days or weeks — especially if a wound is not immediately life-threatening.
On foot to safety
When Artem Fursov arrived at the stabilization post late one night with three other soldiers, Buhor inspected his wounds and praised the bandage on his arm, asking who had done it. It was the work of a fellow soldier — and an example of effective self-aid, Buhor said.
Fursov, 38, was wounded on Aug. 4 by an explosive dropped from a drone, but he didn’t reach a medical post until five days later. To get to safety, he had to walk several kilometers. A small wooden cross he wore under his clothes the whole time now hangs against his chest.
“You can’t even lift your head there. This is already a robot war,” he said about the front line. “And the Russians are coming in like it’s their own backyard.”
Valentyn Pidvalnyi, a 25-year-old assault soldier wounded in the back by shrapnel, said that one month on the positions in 2022 was easier than trying to survive one day now as infantry.
“It’s a very hard sector,” he said, “but if you don’t destroy them, they’ll take the tree line, then the town, then the whole region.”
Forced to keep moving
Buhor has worked in the Pokrovsk area since late 2022. When troops are forced to retreat, stabilization points must also move. In the past two and a half years, Buhor and his team have relocated 17 times.
They left their previous location to the sound of FPV drones.
Other stabilization points are facing the same situation.
Boiko from the “Ulf” medical service recalls that at the beginning of winter — when the stabilization point was still in Pokrovsk — there were still gunshot wounds. That meant there was more direct contact between the infantry, the first line of defense, on both sides.
Months later, the situation had changed dramatically.
They try to protect themselves as much as possible — limiting movement, using camouflage, equipping all vehicles with electronic warfare systems. Their evacuation crews go out only in body armor and helmets.
“We try to safeguard both ourselves and the wounded, doing everything we can to hold our position as long as possible. If we have to move farther back, the evacuation route for the wounded becomes longer — and for those in critical condition, that can be fatal,” she said.
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Associated Press reporters Vasilisa Stepanenko, Evgeniy Maloletka and Dmytro Zhyhinas in the Donetsk region and Volodymyr Yurchuk in Kyiv, Ukraine, contributed to this report.
