P05 Experiences and challenges of military medical care in Ukraine – interview study of frontline medical personnel

This study examines the experiences and challenges of Ukrainian military medical personnel during the ongoing war, offering insight into frontline trauma care, medical organization, and civil-military cooperation. Drawing from in-depth interviews with 12 Ukrainian study participants - ranging from combat medics to brigade commanders -conducted in Sweden, the research explores perspectives shaped by rank, responsibilities, and direct engagement with battlefield medical operations. Using thematic content analysis of transcribed interviews, notes, and supporting visuals, the study identifies recurring themes tied to Ukraine’s military medical doctrine, including decision-making structures, triage systems, training gaps, logistical constraints, and psychological strain. Combat medics emphasized the importance of clear triage protocols and the need for improved first-aid training among soldiers. Medical commanders highlighted the complex decision-making required for casualty evacuation, influenced by distance, injury severity, and available medical expertise. Senior officers described systemic challenges in organizing care under crisis conditions, particularly the integration of military and civilian medical infrastructures. Informants also noted significant material shortages, especially in specialized equipment, as well as critical documentation and communication issues that hindered coordination. The psychological impact on personnel emerged as a major concern, particularly due to frequent casualties and sustained operational stress. Several informants underscored local leadership deficiencies, especially among officers lacking medical training, which impeded timely and effective medical responses. Despite these obstacles, the adaptive use of medical professionals, innovative logistical solutions, and support networks contributed positively to care delivery and system development. Based on these findings, the study offers a set of pragmatic recommendations for strengthening medical preparedness. These include developing rapid response systems for mass casualty incidents, improving the integration between military and civilian healthcare services, enhancing trauma training and protocols, leveraging technology for resource tracking and communication, expanding mental health support services, involving local communities in emergency planning, and improving supply chain resilience through contingency stockpiling. In conclusion, the interviews provide a rare and detailed look into the Ukrainian military medical response under wartime conditions. The study underscores the critical need for intersectoral coordination, flexible logistics, and human-centred leadership in trauma care. These insights not only contribute to understanding conflict medicine but also offer valuable lessons for other countries in the same geopolitical sphere of interest that are aiming to bolster their own emergency medical readiness in the face of potential conflict with Russia.