To Help Ukraine, Send More First Aid

The Biden Administration has committed to support Ukraine against Russian invaders, providing significant weapons, surveillance, and intelligence while avoiding committing troops. U.S. support for Ukraine is constrained by two key factors: the need to avoid antagonizing Russia into expanding the war and Congressional opposition. One strategy to lend aid within the confines of these constraints is to supply additional medical aid to Ukraine’s armed forces.

What Does Medical Aid Look Like?

Military medicine is comprised of four main components: preventive medicine, including immunizations and sanitation, battlefield medicine, such as stemming blood loss and performing damage control surgery, evacuation, and, personal protective equipment (PPE). In recent conflicts from Colombia to Syria, the U.S. and NATO allies have provided aid such as individual first aid kits (IFAKs), PPE, and direct medical training and assistance from U.S. military personnel. While some medical supplies have been included as part of aid to Ukraine, the overall emphasis has been on lethal aid rather than life-saving aid.

Why Military Medicine?

Military medicine is an often-overlooked force multiplier, in part because its effects are often less visible than a rocket system or air defense battery. Armed forces with better military medicine can bring more people to the fight, increasing their odds of winning a war. Military medicine also carries benefits at the unit level. The fewer troops that are out for illness and injury, the greater unit cohesion. This factor has been shown to correlate with military effectiveness. Additionally, when individual soldiers know that they will be cared for should they sustain an injury, soldiers demonstrate higher levels of morale.

Military Medicine in Ukraine

Military medicine is especially important in the Russia-Ukraine war for two reasons. First, the Ukrainians are fighting at a distinct population disadvantage. Especially if the U.S. and its allies want to avoid their own boots on the ground, it is crucial to provide care for Ukrainian troops. And second, numerous reports suggest low morale amongst Russian forces. Better medicine will not only help sustain morale amongst Ukrainians, but it may also serve as an inducement for defection amongst disaffected Russian troops.

Additionally, the benefits of military medicine typically spill over into civilian populations. Medical aid, in other words, can serve humanitarian as well as military purposes. It’s also worth noting that medical aid is less obtrusive and controversial than the use of weapons systems, such as the HIMARS rocket launcher or authorization for allies to train Ukrainian pilots in US-made F-16 aircraft.

Policy Recommendations

While Western aid packages to Ukraine have included some medical aid, it is not enough. Ukrainian forces require continued training on the Tactical Combat Casualty Care guidelines developed by the U.S. military during the Afghanistan and Iraq wars. Based on analyses showing that 87% of deaths amongst U.S. forces in Afghanistan and Iraq occurred before injured troops reached a medical facility, Tactical Combat Casualty Care’s focus is prehospital care. In addition to further medical training there are also physical needs such as replacement ambulances, supplies to manage blood transfusions, and modern tourniquets among other needs. Some elements of medical aid may require limited in-country presence of NATO member country forces, given the logistical challenges of transporting Ukrainian forces across even nearby borders for training. 

Unfortunately, there are bureaucratic barriers to providing additional medical aid to the Ukrainian military. Ukraine has not requested medical aid due to concerns that non-lethal aid could replace lethal aid, which is Ukraine’s priority. Because of this, the U.S./NATO have not been proactive in offering medical aid, instead responding strictly to what has been requested. 

Although Ukraine has not requested this type of aid, military medicine is both cost-effective and significantly less politically controversial than other components of the U.S. aid package to Ukraine’s military. U.S. military medical aid can capitalize on the remarkable medical advances made and knowledge gained in the recent wars in Afghanistan and Iraq. It is in the U.S.’ interest to provide military medical aid to Ukraine, even if unasked.