ARTYOMOVSK, Ukraine – An ashen-faced man in a loose-fitting military uniform shuffles past a blood-soaked stretcher propped against the wall. Slowly stirring a cup of tea, he watches Ukrainian military officials announce the day’s casualties – one killed and 20 wounded.
“Don’t believe what they tell you,” he says, checking the door is closed before continuing.
“There are many, many more. At least 280 were injured in just one day last week and 30 or 40 killed. There were many more killed this week, Debaltseve and Konstantinovka are the worst cities now. I take 18 wounded to Kharkiv myself every day.”
The man, who didn’t want to be named, is a medic in Ukraine’s overstretched, under-resourced army. Clearly traumatized, he speaks quietly and hesitantly, barely audible over the low rumble of artillery fire from the outskirts of town.
His words confirm Ukraine’s worst-kept secret - that the Ukrainian army is drastically understating its casualties. But only now is the scale of that understatement starting to become clear.
On Jan. 22, the director of Kostiantynivka hospital told Organization for Security and Cooperation in Europe monitors that in the last two weeks that the number of soldiers admitted has “increased dramatically, with figures comparable to those in August and September 2014.”
Between Aug. 10 and Sept. 3, when Russian troops first entered Ukraine in support of a beleaguered rebel force on the brink of defeat, the Kyiv Post estimates at least 200 servicemen were killed.
Many of the recent casualties are coming from areas around the besieged town of Debaltseve, a strategic rail junction between Donetsk and Luhansk oblasts, where thousands of Ukrainian soldiers are struggling to prevent being surrounded and cut off from Ukrainian lines.
The town’s defenders – and its civilian population - have faced an incessant artillery bombardment from three sides since Russian-backed rebels launched a massive offensive all along the front line last week.
With the imminent threat of encirclement, speculation is rife that Ukrainian forces are planning a withdrawal from the isolated position.
But the soldiers themselves remain defiant.
Marian, a 25 year-old infantryman from the 128st Brigade, had shrapnel rip into his ribs and through his shoulder when he was hit by a rocket outside his checkpoint at Chernukhino, just outside Debaltseve.
“I don’t know when it will finish. But in Debaltseve, our soldiers will stay until the end,” he says firmly as he sits in a crowded, crumbling hospital ward with his wounded comrades. “Reinforcements are coming, everything is fine,” he adds.
Their stand has already come at a bloody price. One soldier has a deep scar on his head where shrapnel had torn into his skull, the other heavily bandaged legs from the blast of a rocket-propelled grenade.
Despite heavy casualties, the army itself appears to have minimal resources to deal with wounded soldiers. Civilian hospitals, already ill-equipped and in desperate need of repair, now not only have to deal with vast numbers of wounded non-combatants, but also provide emergency care for soldiers.
“Usually our hospital can provide services for 23,000 people, but now it has to provide services for about 100,000 people,” Olga Vladimirovna, the surgical director of Kurakhove hospital, told the Kyiv Post.
“We only provide first aid, stabilize the critically wounded and treat shock, then they are transported to Dnipropetrovsk hospital or the military hospital in Zaporozhye.
“Even so, we had to put more beds in each room - where there were four beds now there are six, where there were two, now four.”
Kurakhove hospital takes wounded from around Donetsk, the scene of some of the heaviest fighting on the front. Yet they have to treat military personnel without any additional assistance from the government.
“Our pharmaceuticals fund didn’t become bigger,” Olga Vladimirovna says.
“We get most of our medicine from volunteers, charities, even Privat Group. Our hospital is not a military hospital, it’s a hospital for citizens of our district, but in a time of war we have to help everyone.”
The situation at Artyomovsk central hospital, where the wounded from Debaltseve are brought, is much the same.
“There is so much work I didn’t even sit down today,” says surgeon Dmitriy Bondar, after his last patient is wheeled away on an antique trolley, down a dark corridor with faded, peeling walls.
“There are many soldiers every day. There are many wounded. Always, but in the last three to five days there are so many more. I’m treating between 10 and 15 people every day from Troitskoe, Debaltseve, Popasnoe, and Dzerginsk. We get no more medication from government, only from volunteers.”
Bondar is not as optimistic about the battle for Debaltseve as his patient Marian and his comrades, having seen too many young men just like them leave his care in boxes.
“The situation is bad in Debaltseve, it’s bad everywhere. Yes, the soldiers are still standing at their positions ready to fight. But we don’t see any help coming for them.”
Kyiv Post editor Maxim Tucker can be reached at firstname.lastname@example.org or via Twitter @MaxRTucker
Editor’s Note: This article has been produced with support from www.mymedia.org.ua, financially supported by the Ministry of Foreign Affairs of Denmark, and implemented by a joint venture between NIRAS and BBC Media Action. Content is independent of the financial donor.