Ukraine’s Battlefield Lessons Reshape How Bundeswehr Trains Its Combat Medics

Germany’s armed forces are overhauling the way they train their combat medics, evacuate casualties and protect field hospitals, after closely studying Ukraine’s experience in treating soldiers wounded in a war now dominated by drones. The changes follow a September visit by Surgeon General Ralf Hoffmann, commander of the Bundeswehr’s Central Medical Service, and a team of specialists to Kyiv and to Dnipro, a city in southeastern Ukraine roughly 60 to 75 miles (100 to 120 kilometers) from the active frontlines.JOIN US ON TELEGRAMFollow our coverage of the war on the @Kyivpost_official. According to a report published Monday, Oct. 19 on the Bundeswehr’s official website, Ukrainian figures reportedly shared with the delegation show that drones now cause roughly 90% of combat injuries among Ukrainian soldiers. The Ukrainian doctors also told the delegation that about 100,000 military personnel have undergone amputations since Russia launched its full-scale invasion in February 2022. Wounds above the body armor Ukrainian medics described a front line where close-quarters fighting has become increasingly rare. Surveillance and strike drones cover a zone stretching about 25 kilometers (15 miles) behind the line of contact, making any movement in that area extremely dangerous. The type of wounds has shifted accordingly. According to the Bundeswehr’s report, drones that drop grenades or detonate on impact tend to strike soldiers from above and in front, with the blast often hitting areas left exposed by body armor. Other Topics of Interest Oleshky Evacuation: Russia Announces Kherson Frontline ‘Silence Regime’ Chief of the Russian General Staff Valery Gerasimov announced a date two days earlier than that of the White House, which said the local Oleshky truce would begin Oct. 29. Ukrainian doctors reported a high number of severe wounds to the face, neck, arms and hands, saying that eye injuries now make up a large share of upper-body trauma. Protective eyewear, they noted, is rarely worn in Ukrainian military units. The German delegation concluded that personal protective equipment needs to be reassessed with these new patterns in mind. Medical facilities moved underground Due to the constant threat of strikes, Ukraine’s Defense Forces have moved some frontline medical facilities underground. These include Role 1 facilities, where wounded soldiers are first stabilized, and Role 2 facilities, where surgeons perform emergency operations to save lives before patients are transferred to other medical institutions. In a war where drones can spot and strike almost anything above ground, a visible aid station has itself become a target. According to Ukrainian accounts cited in the report, one of the buried medical facilities in the Zaporizhzhia region was hit by 10 glide bombs without a single member of its staff being injured. The German medical service is now examining how to build and run such treatment facilities, hidden and protected under a persistent drone threat. Following the trip, Hoffmann announced closer cooperation with the Special Engineer Regiment 164, a specialized unit under the Bundeswehr’s Logistics Command based in Husum, whose heavy equipment could be used to dig in field hospitals quickly and test new procedures. The threat is no longer theoretical for Germany. On Wednesday, Oct. 21 Germany’s armed forces raised the Russian sabotage threat to “significant,” the second-highest level on its internal scale, after an explosives-laden drone was found near Wunstorf air base in Lower Saxony mid-September. Increased hybrid warfare tactics from Moscow prompted Berlin to strengthen its protective measures. Up to 12 hours between injury and surgery Because of the dangers a ground evacuation under drone surveillance poses, it can take up to 12 hours before a wounded Ukrainian soldier reaches a medical facility. According to the report, Ukrainian doctors told the German delegation that these delays are a major reason for the high number of amputations. A tourniquet applied on the battlefield can quickly stop bleeding and save a soldier’s life, but if surgery does not follow quickly, the limb often cannot be saved. The long wait has also made the first hours of care far more important, with soldiers and frontline medics now responsible for keeping severely wounded comrades alive for much longer than military medical doctrine traditionally assumed. To limit long-term damage, Ukraine has moved specialists, including eye surgeons and ear, nose and throat doctors, unusually close to the frontline. Early treatment of facial and eye injuries, which are now common in drone attacks, significantly improves soldiers’ chances of recovery. Because of this, the Bundeswehr is now testing both ground and aerial drones for medical use. A first drone sub-unit is being trialed by Medical Regiment 3 in Dornstadt, and Hoffmann said medics will need to learn to operate a range of unmanned systems, potentially including drones that deliver blood supplies. Ukraine is applying the same approach. On Oct. 16, the government approved a pilot project to deliver medicine, medical devices, blood samples and donor organs between hospitals through drones, aiming to make deliveries significantly faster, particularly to remote areas. The Health Ministry’s Heart Institute in Kyiv will serve as the first site of the pilot and it already operates three specialized drones capable of flying up to 700 kilometers (435 miles) and landing at hospital sites. Reshaping German training The Bundeswehr said it has already substantially reworked its first-aid and medic courses based on lessons from Ukraine. New programs, including Combat Life Saver, Combat Paramedic and Combat Physician courses, are designed to prepare frontline troops to keep severely wounded comrades alive for longer before professional medical teams can take over. The courses are being rolled out this year, with the aim of eventually training the entire force. The German medical service said it has worked closely with Ukraine’s Defense Forces for years and plans to deepen the cooperation, covering surgical care, medical logistics, training, drone use and digitization.