Dear friends –

This one is bittersweet – the most recent Força Ukraine mission finished on 4 OCT and most of the team is back to their home of record. Dr. Nick arrived back in the US earlier today, Yuliia is home in Dnipro, Vik is on a well-earned vacation. Emily and I saw Bohdan in his hometown of Lviv over the past few days while we were there doing a quick reset and seeing my parents, who had come across from Poland. It is hard to believe that all the hard work, all the preparation, and then all the training here is behind us – for now. The end of the mission is always sad – our team is incredibly close and it always feels like the work here is critically important. That sadness though, is tempered by the incredible memories that this trip has produced and excitement for opportunities to come.

I will get a more complete report out in the next few weeks, but initially, we trained another 348 people on this mission. Geographically, we were located in Sloviansk, Kharkiv, Dnipro, and Kyiv. The training spanned the gamut of the Ukrainian healthcare system. We provided new soldiers their very first medical training – and likely the only medical training they may receive. We were incredibly lucky to work with very advanced medics from evacuation units and the emergency response system – civilians, military, and police members who are the first ones in to missile strikes in urban areas, as well as do the civilian evacuations out of the contested areas. These medics routinely risk everything to help others as this war grinds on. We ended our trip with several trainings of hospital staff and medical students – somewhat out of our typical training focus, but due to dynamics of the war, several of the units we planned on training had to cancel. These alternate trainings allowed us to provide an introduction to tactical and pre-hospital trauma medicine to already well-trained medical personnel. Given the reality in Ukraine, heath care providers are increasingly in demand, and many of these young doctors and medical students will likely end up impacted by the war. When we trained a cohort of medical students, about twenty, we asked how many of them personally knew someone in the war. Every single hand went up.

The reality in Ukraine remains grim. There were more drones and missiles launched into Ukraine in September than any other month of the war – well over 1,000. The nights were interrupted by air raids more often than not, and the team took shelter on numerous occasions. While we were in-country for just a month, this is the reality across Ukraine, not just on the front. Can you imagine trying to live this way? Under the constant harassment if not all out threat of missiles and drones striking anywhere in the country? Yet somehow, Ukraine persists – the alternative is unthinkable. In his new book, War, renowned reported Bob Woodward writes that in October 2022, the US assessed there was a 50% chance of Russia striking Ukraine with tactical nuclear weapons. As Ukraine enters its third winter, the prospects for an end of this conflict are unclear, and seemingly unlikely. There will likely be an increase in missile strikes on infrastructure to make the already harsh eastern European winters that much worse for the people of Ukraine. Russia is looking to make and solidify strategic gains in Pokrovsk, a critical town in the Donetsk Oblast.