How to Save a Life Under Fire
Medics from the Royal Army Medical Corps are currently teaching Ukrainian medics how to save lives on the battlefield. The course is the first UK-led combat medical training for Ukrainian Armed Forces, and sees British medics working alongside medics from Iceland and the Netherlands to teach Ukrainian medics vital combat medicine.
Captain Williams is the course director for the training programme, with 15 years’ experience as a combat medic and nearly ten years as a paramedic; he believes there is nothing nobler than saving a life, and teaching others to do the same. He explains more here:
I think when you join the Army at 16 years old, you don’t quite know what you want. I had high aspirations to join my local infantry battalion, the Argyll and Southern Highlanders however I was very much guided by the careers officer into the Royal Signals. While I enjoyed it and I got a lot out of it, I got to a place where it wasn’t really what I wanted to do.
I’ve always had a keen interest in the medical side of things, especially with the work that was going on in Afghanistan at the time and having been out there and seeing first hand what the medics do.
There’s nothing better than saving someone’s life, it’s one of those key noble acts in the world, I think.
My first tour as a medic was Op Herrick 15, and then Iraq. In Iraq I was the chief medical instructor on Op Shader, which was delivering everything up to non-invasive advanced clinical skills to the Iraqi Armed Forces in their fight against Daesh. We trained 6,500 members of the Iraqi security forces and produced 90 Iraqi medical instructors over six months.
Q: So, training the Ukrainian Armed Forces in combat medicine isn’t your first experience of teaching clinical skills to a foreign force?
Medicine sort of transcends everything. So, what we’re doing with medicine is saving lives, that’s the bottom line, up front. Our rules of eligibility are we treat the most serious casualty, it doesn’t matter what nation they are. And so, delivering that to other nations, I can’t think of a more noble profession, other than saving lives and teaching people to save lives.
So, I get huge amount of satisfaction and gratification from being able to do that and especially with the Ukrainians, a nation that is so proud and keen and patriotic as they are. And just that keenness that they come here with: they just want to learn as much as possible; save as many lives as they can; and ultimately, liberate their homeland from this quite horrendous invasion they’ve been subjected to.
It is massively important; I don’t think the importance of it can be understated. They have horrific casualties. And whilst I don’t know the exact numbers it is clear to everyone that — both the Ukrainians and the Russians — the people are suffering massively, both military and civilians. By teaching Ukrainians life-saving battlefield techniques, also upskilling them to teach basic battlefield first aid, it is immeasurable the amount of good we can do, because these people will go back and save lives.
Q: Did you volunteer to deliver this life-saving clinical training to the Ukrainians?
I was officially tasked on to this training programme. But if it hadn’t been formal orders I would have a hundred percent volunteered, because I genuinely can’t think of a time within my 25 years in the Army, so far, where I felt the utility of what I do permeate my soul so to speak. You can see the benefit and I can speak for the training team for how worthwhile we find doing this.
Q: What is it about this particular conflict, the war in Ukraine, that permeates your soul so much?
I think it is the naked aggression of it, the naked aggression of Russia. To invade a sovereign country, and not just invade but deliberately target the civilians and medics, and one of the things I see with the medics here and one of their main fears is they are actively targeted by the Russians.
Our doctrine requires us to put big red crosses up to identify us as medics under the Geneva Convention, the Russians are not signatories to the Geneva Convention and they do not recognise that [medics are protected under the Geneva Convention] and they actively target the medics, Ukrainian med facilities are actively targeted, which resonates quite strongly. I suppose that is quite a strong motivating factor for my emotion on it.
Q: How do you, as a trainer, feel about the fact these medics you are training are heading back out to the frontline where they are not only operating in a war zone but where they are targeted?
As a clinician myself, I have coping mechanisms for dealing with people who are injured, dead etc. And certainly from the students’ point of view, I am friendly towards them, but I’m not their friend. That might sound like an overly harsh way of stating things, but it is important for myself and the instructors not to get too attached.
And it is easy to get attached because they are very, very good people, very personable, great sense of humour and I would quite happily go and have a beer with any of them, if the situation allowed it. But we have to be cognisant to the fact that these people are going back to war and some of them will die, and that’s the harsh reality of it.
Many of them have carried the wounds of the battlefields, both mentally and physically. They have been injured. They’re very experienced. I mean, I can guarantee that they’ve seen a lot more battlefield trauma than I have just because the intensity of the conflict in Ukraine.
So, it is hard not to get attached.
Whilst this is the first time the UK has hosted and delivered a dedicated combat medic programme to Ukrainians, similar training is being delivered across Europe by partner nations, to help fill the need for combat medics in Ukraine. And as with Op Interflex — the infantry training of Ukrainian Armed Forces — Capt. William’s course is being delivered not just by UK instructors but alongside medics from other nations.
We have two Icelandic instructors and two Dutch instructors. The Icelandics are typically Scandinavian and good at everything, and they’re really nice with it as well, which is even more annoying [jokes Captain Williams].
They are both advanced paramedics [in the UK definition] they’re firefighters, they’re counterterrorism team operators, they’re also extremely nice and just brilliant human beings, to be honest. And the way they deliver the course, the way they relate to the students, is phenomenal. The students really love them.
And that’s equally so for our Dutch instructors, we have two Dutch nurses and they’re fantastic. They’ve been a real force multiplier. My team of British instructors again, they are top class. I’ve urgent care paramedics, a lot of very experienced combat medics and a smattering of paramedics. They could absolutely deliver the course themselves, but having that extra scope and that extra thought process from the Dutch and the Icelandic’s, that helps us to deliver a really strong course. Diversity is key.
Q: The Dutch and Icelandic’s have brought an extra dimension to the course, have the Ukrainians also brought with them lessons for the instructors?
I don’t see us as instructors if I’m quite honest, we are mentors because mentorship is a two-way thing and through the mentorship of the Ukrainians, we are learning from them. Yes, we are teaching them, but we are learning from them.
They are fighting a World War Two type conflict, with huge casualty rates, a really contested battle space, where they just don’t have the freedom to operate as medics because they are actively targeted. So, we are learning from them.
It’s very important that we learn those lessons and actually take them forward, in case God forbid, that we end up in a conflict like that because these are harsh lessons that are sorely won.
Q: As your first cohort of Ukrainian medics complete this training course and head back to the frontlines what is your message to them?
We wish them well, and I look forward to the day they have liberated Ukraine, and I can visit Ukraine and have a beer with them.
