After-action review should also be implemented for medics, just as it is done by regular military – Viktoriia Kovach (Avicenna), head of medical unit of Third Army Corps
Viktoriia Kovach quickly corrected the Censor.NET journalist: "I’m no longer the head of the medical unit of the Third Assault Brigade, but of the Third Army Corps. I’ve been handling medical support in the Army Corps for about a month now. We are shaping the policy for delivering this medical support within the new system."
Censor.NET also wanted to discuss this new policy and the new system. But the years that 31-year-old Viktoriia, callsign Avicenna, devoted to the Third Assault Brigade during this war couldn’t be left unmentioned either. And so, navigating between the past and the present with a glance toward the future, we charted the course of our conversation. We began with the callsign of the heroine of this interview.
- Viktoriia, why Avicenna? The medical undertone is easy to read into. But why that particular Persian scholar, encyclopedist, philosopher, physician, chemist, astronomer, theologian, and poet? Do you have an affinity for science? Were you once fascinated by his Canon of Medicine?
- I did try reading the Canon, but that has nothing to do with the callsign. It came about back in 2014, when I first joined the military. Normally, a callsign isn’t something you choose for yourself – it’s given to you. And that’s what happened here: one of the servicemen decided that since I was a medic, I’d be Avicenna. Gender didn’t matter at all (smiles. – E.K.).
- Then a question that may sound playful, but is as serious as it gets. If you had the good fortune of speaking with Avicenna, and he asked: "Tell me, what are the typical injuries sustained by the soldiers of the Third Assault Brigade in the first half of 2025?" – what would you, as a professional, say to a fellow professional?
- The injuries are fairly typical for anyone positioned on the line of contact. Gunshot-fragmentation and blast injuries are the most common. Any object that breaks into small, damaging pieces, and there are plenty of those nowadays, can cause harm. Especially FPV drones. And when we’re talking about active assault operations involving close contact, we’re also looking at small arms injuries and the effects of hand grenades.
- And then Avicenna would probably ask, "What’s an FPV?"
- …Yes, and where it came from and why it has become such a problem for today’s military.
- Even people far from the front line understand that the reality of assault brigades is tied to the word "assault." And they also know that casualties during an offensive are far greater than in a defensive phase. Given that, what professional and personal qualities do you expect from your subordinates?
- Regardless of the unit, the only thing I demand is honesty. Truth allows us to create all the necessary conditions to fulfill our core mission — providing medical care to service members. We work for the benefit of service members, regardless of rank, position, or gender. In other words, our central focus in providing care is the soldier. If we are honest with ourselves, we can honestly admit mistakes, honestly say when we’re not able to do something, honestly ask for help. All of this leads to much more effective work than when we try to cover things up and pretend everything is fine, that we can manage and it’ll somehow work out. That kind of attitude leads to a much higher rate of adverse outcomes.
- What forms of dishonesty do you come across during interviews with candidates? Could you give some examples?
- Right now, we communicate with candidates. We don’t see them. Back in 2022, the situation was much better in this regard: when the brigade was being formed, we were able to conduct in-person interviews. That allowed us to pick up, at least to some extent, through both verbal and nonverbal communication, whether a person was leaning toward the truth or not. At the same time, the recruitment process itself involves reaching out to colleagues of the candidate, medics, to find out whether they actually perform certain medical procedures at their hospital (that applies to civilians, not military personnel).
- So basically a kind of proof-check.
- Exactly. And what kind of situation do we often have? A person says, "I can perform this procedure." (Because, ideally, I should be able to perform it.) But in reality, they may not be able to. And while it’s clear that no one would immediately assign a newly arrived person to insert a central venous catheter, we still begin to count on that individual as a combat-ready asset. Just because an anesthesiologist comes in and says they can do it, and that they’ve done it many times. But in practice, they haven’t.
- That’s a problem.
- I mean, it’s not a total disaster. A person can be trained — that’s exactly what we’re here for: to understand what’s missing and find the appropriate training course where they can acquire the skill. What’s harder is knowing when we can apply these things in practice. How are we supposed to take it when someone says they feel fine and not tired on their third or fourth day of working non-stop?
The truth is, we’re all human and we have a limited physiological capacity. People need sleep. Especially those performing fine motor procedures where lives are at stake. They need to recover, not because they feel like it or we want them to, but because it’s essential. We had a situation during the Avdiivka campaign, when the withdrawal from the city was underway. The flow of wounded didn’t stop for an entire day. At that time, we had fewer people in the brigade than we do now, fewer doctors, medics, nurses, and drivers. And when someone not involved in the evacuation came and said, "I can take over for the driver; he needs to sleep," it was worth more than all the interviews and conversations. Because humanity prevailed. And that’s what matters most. It didn’t mean he was lazy. It didn’t mean he wasn’t brave or didn’t care about his comrades. He simply wanted to sleep and he cared enough to worry that he might make a mistake while evacuating a wounded soldier.
- That’s about responsibility.
- Yes. But also about honesty. About being able to come forward and say it. Not to feel ashamed or think there’s something wrong — that others are still working while I’m not. We are from different age groups and have different baseline health conditions. Many people joined the military already having certain health issues. So naturally, we don’t all get tired at the same rate. That’s why truth is about responsibility, and honesty, and about how consciously you act and then take responsibility for those actions.
- In an interview with a colleague from Ukrainska Pravda, you said that you need to clearly understand the motivation of your subordinates. What kind of motivation should that be? What do you consider valid motivation?
- The question is: why do you want to join the military? Some answers are classic, and others not so much. When someone says they want to join because they can’t stay in civilian life any longer, we always have to ask what exactly they mean by "can’t." General phrases like "I just want to help the army" are definitely important, but they need to have some kind of foundation. Any generalized response has to be broken down into something concrete.
- For example?
- For example: I want to help because my husband, friend, father, or someone close to me is serving. I see how they work, and I feel I could be more effective there than here — and then they explain why.
I also like this answer: I want to be useful to my country. And then I ask — so are you being harmful to your country here? This especially applies to young resident doctors who want to enlist. We used to have a policy that residents who graduated after 2023 must complete their internship before joining the military.
- What are some of the more unconventional answers to the question of why someone wants to join the military?
- We had a funny situation once when a candidate tried to set conditions during the interview. It went something like: "I’ll serve only if I get to stay in Kyiv." This was a prospective clerk-statistician. "I have one condition — I don’t work during air raid alerts. And considering how good I am, if you’re okay with my terms, then you can have me but only on my terms."
- I have a feeling you turned him down.
- In a way, yes. He told me he hadn’t been mobilized yet (and that was during the data update period at the TCR (Territorial Centre of Recruitment and Social Support)), and maybe he wouldn’t be. So I jokingly said, "Call me when you’re in the TCR bus," and forgot all about it.
- And did the story have a sequel?
- It did. About a month and a half later, I was in the Donetsk region, driving to visit colleagues from another brigade. My phone rang — unknown number. We had music playing in the car, so I put the call on speaker. He said, "Do you remember me? I’m so-and-so." I said, "Sorry, no — remind me." And he goes, "You once told me I’d call you from the TCR bus. Well, I’m in the bus…"
- And what did you do?
- Exactly what I said I would — I turned him down. You have to be consistent in everything.
- Any other examples of unconventional explanations for motivation?
- The most unconventional ones were those who tried to convince us we had to take them no matter what. For example, there was a practitioner of alternative medicine who claimed that you can’t heal the military with conventional medicine and that other methods had to be used. The interview was long — I really tried to understand what these methods were. It turned out to be hand tapping and spiritual healing; morning sun-greeting rituals on the edge of a dugout; and curing COVID. He had plenty of arguments. And this was in 2022.
- Yeah, greeting the sun near a dugout sounds like a rear-line argument.
- Exactly. That came when he’d run out of other arguments — the sun ritual by the dugout. The sad part is, he’s probably serving somewhere now and "connecting people to the sun." And most likely healing them the same way.
- The other day, you spoke at Arseniy Yatsenyuk’s Security Forum, where you received an ovation. I saw how, after that speech, you were approached by numerous military personnel, diplomats, and journalists...
- What else have these past days involved for the head of the medical service of the 3rd Assault Brigade? I assume logistics and supply issues were at least part of it. Could you list the kinds of tasks you’ve dealt with — at least the ones you’re able to talk about?
- As of now, I’m no longer with the Third Assault Brigade, but with the Third Army Corps. For about a month now, I’ve been working on medical support within the Army Corps. We’re shaping the policy for delivering that support under the new system. We’re planning how it should be done, given that we don’t have any centralized action algorithms from the state. We’re trying to figure out how to make it most effective for the end user — the service member. It has to be understandable for all participants in the system, for the medical services of the brigades and currently for some individual battalions as well. And for those who need to quickly receive operational information.
- So is it accurate to say that the state didn’t provide you with a roadmap, and now you’re reinventing the wheel?
- Who knows if it’s a wheel or something else. But my assumption is that we’re now building a new system that will be refined and scaled over time. And it’s good that we’re getting there based on data, not just our own assumptions.
- Or based on foreign experience, which often doesn’t work in this war.
- Foreigners are very standardized. That has its pros and cons. We’re more democratic — sometimes too much so. Democracy in choosing your position and similar things is great. But in most cases, clear military subordination and rules are essential. And that’s where the foreign military medical and medical management style becomes really helpful.
Often, we’re taught to build teams using a business-like approach. But that doesn’t work in the military. You can’t guarantee hiring or discharge — it all depends on factors like whether the commander releases someone or not, whether a mobilization order has been issued, and whether discharge is even possible. It’s a bit of a funny situation. We’re limited by the human capital and material resources we have. Yes, we aim to improve that human capital. We try to find the most effective person for a specific position. But the conditions under which this search and implementation happen are quite different.
- So, at the lower level, there’s more room for initiative?
- Yes, but it has to be justified. Command and control is impossible without standardization. Initiative is only effective when backed by concrete figures, data, and understanding—not just "because I feel like it." When it’s purely based on impulse, it doesn’t work. There has to be some foundation. That’s why foreign experience is an advantage. But applying foreign practices to our circumstances also comes with its own nuances—wars fought on foreign soil, relatively short-term missions, uninterrupted supply chains, and air cover.
- What other fundamental changes does the transition from brigade to corps bring to your service?
- First of all, some corps either already have or are planning to establish medical battalions. That means an additional medical component within the corps structure. Most likely, the corps with such battalions will also create extra hubs with reserves of material supplies—at least, that would be the logical approach.
- Won’t this lead to overlapping functions?
- I’m afraid it will.
- I think it all depends on the leadership. This kind of overlap can be used in a positive way.
– In our current situation, the problem of functional overlap can be addressed by redistributing responsibilities—or by reallocating human resources.
Coming back to the operational framework: corps that lack dedicated medical structures will most likely face difficulties in building up reserves. And without reserves, we won’t get very far.
- What kind of calls have you been getting from subordinates these days? What issues are they asking you to resolve?
- Finding armored medical transport. It’s a regular thing—like morning coffee, we’re constantly looking for armored medevac vehicles. We talk to Ukrainian manufacturers and try to source something abroad. It’s incredibly difficult to do this in 2025.
The second issue is calculating the equipment needed for wounded personnel and for a diagnostic center. We’re talking about a truly large amount of funding here. The estimates are based on data from previous years. We use the medical service of the Third Assault Brigade as a benchmark—back when we had a clear understanding of how many people sought medical care, what conditions they had, and the volume of diagnostic procedures.
The third, and most important, is finding people—both civilians and military personnel—who are willing to join the team and work. It’s particularly difficult with civilian medical workers. The reservation system has taken its toll...
- When asked about their main needs and what fundraising should focus on, medics—both those handling evacuation and those at stabilization points—respond in unison: vehicle repairs. What’s the situation on your end?
- It’s the same story. The fund for vehicle repairs constantly needs topping up.
- And usually it’s either the guys and girls chipping in from their own pockets, or donations?
- Yes, both donations and personal contributions. Credit where it’s due: some businesses are helping. There are service stations that offer us discounts or even cover certain repairs themselves. But the number of such stations is gradually decreasing.
We try to get the vehicles back in working order as quickly as possible, because we know no one’s going anywhere unless the transport is repaired.
- Could you describe the structure of the medical service under your command? As I understand it, it includes the med company itself, as well as the medical units of battalions that were formerly part of a brigade, now a corps.
- At this stage, the structure of the medical service — or the medical support system — within the corps consists of the following components: a medical department within the corps headquarters; a medical battalion (which, in our case, is currently being formed); medical companies within brigades, separate regiments, and separate battalions that fall under the corps structure; and medical posts within individual battalions.
- Will these separate micro-medical companies be under your command?
- The chain of command for specialized services — and specialists in general — in the army is dual. In any company, a servicemember primarily reports to their direct commander. But when it comes to medical support, they are also subordinated along the medical chain — to the chief of the medical department of the army corps. So, in practice, the medical department defines the medical policy for brigades, regiments, and battalions. We do not influence administrative processes. On the other hand, our role is clearly not focused on reporting. We’re responsible for proposing the mechanism through which the internal medical ecosystem within the corps will function — explaining how feedback loops will work and jointly analyzing, together with subordinate commanders and medics, the problems that will need to be adjusted in the future at the corps level.
- You mentioned that the number of personnel under your command will increase in the corps structure. Roughly how many people are we talking about?
- I hope many. We’re talking hundreds. And these must be professionals who are ready to work as a team.
- What percentage of them will be directly involved in treatment, and how many will handle technical support?
- Ideally, I’d like it to be 50% focused on the medical side and 50% on support, unit operations, analytics, paperwork, medical logistics, and similar tasks. But that’s just my vision. Reality will show.
- Spoken like someone who worked at Dobrobut. Everything to keep the "customer" satisfied.
- It’s less about satisfaction, and more about confidence — confidence that when needed, they’ll get all the help required. But without unhealthy fanaticism.
- When you visit outpatient facilities within your structure, what do you always pay attention to?
- Let’s say visit, not inspect. I might check expiration dates on the medications sitting on the shelves.
- Like people who’ve just finished renovating their apartment and instinctively check the wallpaper when visiting someone else’s place?
- Exactly. Or whether the ultrasound probe has been properly wiped down.
- How is the staffing of your medical service going? Do you still need anesthesiologists, general surgeons, nurses — like you did a year and a half ago? Or has the picture changed?
- In addition to them, we now also need internists. And yes, we still need a psychiatrist.
- So you’re also doing a bit of headhunting?
- I’ve been doing that since I first took the position… Especially when it comes to psychiatry. Over the past three years, we’ve had quite a few candidates. Unfortunately, not a single one ended up joining the military. There were two main reasons. First, many of them advocated for aggressive treatment methods aimed more at suppressing symptoms than actually treating the condition. And second, they preferred to serve closer to central Ukraine — a comfort we simply couldn’t offer.
- Do you ever borrow good ideas from the medical services of other brigades? Is there some kind of experience exchange, like roundtables? Or is it more informal?
- I used to work in postgraduate medical education. One of the most effective methods there is the peer-to-peer format. Honestly, we do talk to other brigades — from those stationed along the flanks to units holding the line in other regions.
- And what’s your impression?
- We all have something to learn from one another. The problem is that some of us don’t fully realize that what we’re doing — and the conditions we’re doing it under — is actually an achievement. The second issue is that sometimes it’s hard to talk openly about either a success or a failure.
- Why’s that?
- Because while after-action review is becoming more or less accepted in the conventional military, in medicine, when you talk about a mistake, it can come across as if you’re incompetent or that you’re trying to shift blame for a botched procedure onto another doctor. So we’ve still got a long way to go in terms of adopting the after-action review format in military medicine. But there’s a lot we can learn from other brigades.
- That’s exactly what I mean. It needs to be preceded by information gathering.
- Absolutely. A lot of important things can be clarified with just a phone call. I’ve had cases where heads of medical services would call me and ask, "How do I explain to the brigade commander that this simply won’t work? You don’t use this, do you?" – "We don’t." – "How did you explain that to your brigade commander? Maybe I can use the same approach here?"
- What about contact with foreign colleagues? We increasingly hear that our personnel rarely learn anything new during overseas training courses or only very little. More often, it’s the foreign instructors asking Ukrainian counterparts about their experience in what is now the most modern war in the world. Is it the same with medics?
- Yes and no. There are definitely things we can learn from them. A protocol is about simplification—and about saving lives.
- Yes, and it also removes doubt in many situations: if you’re unsure, follow the protocol.
- And it creates a safety framework—you feel confident that you’re doing everything right. It’s about knowing your next step. If I’ve done the previous three steps correctly, then I’ll do the fourth one correctly too, because I remember what the protocol says.
As for medics: military medicine isn’t just about providing care. We can teach our foreign partners about logistics, about maintaining scattered supply depots, about preserving equipment and how all of that can be lost in an instant after a single missile strike. On the other hand, it’s them who teach us about structure and consistency. I’ve worked with the Germans, for example. A colleague of mine once said: they’re so precise that if you try to soften a sharp angle, you just end up cutting yourself on it. We call it "praktisch, quadratisch, gut."
- That definition should be remembered — it really fits Western protocols.
- We tried doing medical planning with the Germans during a military exercise. Honestly, I have a fairly positive view of their military medical support system. Yes, I understand they’re still a non-warring country. But their command structure is clear and logical.
As for the clinical component, we’ve already reached the point where we’re the ones teaching. Foreign personnel would like to be allowed to treat our wounded as early as possible. But they don’t know how to handle large numbers of casualties, because they simply don’t have that kind of experience.
They also had ideas about whether it might be possible to transport a wounded soldier directly from the East to a European country by train for treatment there. But the earlier the patient comes into contact with a specialist, the higher the chances of recovery and return to duty—or, depending on the severity of the injury, to civilian life.
As for combat medics and tactical medicine: based on all the feedback we’ve received, our personnel learn very little that’s new in those trainings. Especially when service members with at least some frontline experience go abroad for courses.
- Medics from any unit that has been deployed on the front line for an extended period eventually experience burnout. How can that be addressed? There are well-known methods: taking leave, spending time with friends, getting some decent rest during another team’s shift. What else would you add?
- Work schedule (as strange as that may sound in a military context). Second—that same honesty. Always having the option to say, "I’m exhausted, I need a break." Third—leave. The ability to take time off between shifts. Communication about the fact that their spouses or loved ones can come visit them in a front-line region.
I don’t know—maybe some specialists would disagree with me—but for certain people who’ve reached a certain level of fatigue, knowing that they can go on a training course, change the scenery, and avoid stagnation is extremely important. I think one of the components of burnout is the feeling that you're no longer growing professionally. Training is one way to address that. When specialists have the opportunity to improve their qualifications in any narrower field.
- And internal motivation—when, in addition to state or departmental awards, you create your own internal hierarchy of recognition within certain areas (That’s how it worked for us).
- And how do you "fix your own roof," so to speak? There’s always an Avicenna looking after others. But who looks after Avicenna?
- Viktoriia Kovach. Look, this is how I see it: I don’t know how to save lives—but I do know how to do something else. So I do what I can. Each of us has a role. Saying "I’m tired" doesn’t make the list of problems or issues any shorter.
- But you do know that you’re tired. Your staff can come up to you and say, "Boss, I need a break." But who do you go to?
- My commander.
- Has that ever happened?
- Yes. Sometimes I need a day to reset. More than that is a luxury. Even one day—it’s not nothing. A single day can change a lot.
- One more question. Tell me this—do you think it’s normal when service members, whose lives were saved or who were helped significantly during initial evacuation or at a stabilization point, or further along the evacuation chain, DON`T try to find the girl from the medevac team who bandaged them and talked them through their fear? Or the surgeon who performed the operation and gave them confidence in their recovery? Why doesn’t that happen? Or am I just being overly idealistic and missing something?
- It’s normal. It might be a form of psychological distancing from circumstances that caused a great deal of pain, mentally and emotionally. A person tries not to revisit or reflect on that chapter. Any contact with one of the links in that chain brings them back to those traumatic moments.
- I understand now. No wonder those who fought in World War II didn’t like talking or even thinking about it.
- We’re coming back to the idea that this is one of the mechanisms for avoiding re-experiencing trauma. We’re not particularly good at processing our own traumatic experiences. There’s still a shortage of psychologists in the country. And not everyone is willing to seek them out. A man in uniform from one of the brigades recently approached me and said, "I remember you—we met near Moschun. I looked a bit worse back then, but you said something to me." I said, "Me? Where exactly?" "Well, I was brought in by so-and-so… You treated me and then transferred me to another vehicle to be taken to Kyiv. I remember how people were addressing you.
- Did he remember it correctly? Didn’t mix anything up?
- He got it right. Though he thought I was from a different unit—there were a lot of them operating around Kyiv at the time. He said, "I remember you." Four years have passed. We started talking, and he told me he’d tried not to think about those events at all… It was just by chance that he ran into me.
- You spoke at the Kyiv Security Forum, where politicians, journalists, and diplomats were listening. How interested are you in politics yourself? Do you at least keep up through news feeds, or is there simply no time?
- We can’t afford not to be interested in politics. All of us live in a bubble. Just yesterday, by the way, I was joking about this, regarding new statements coming out of the United States. It would be fun to watch with popcorn, if only it weren’t about you, your life, your loved ones, and your country. It could’ve been a fascinating global story about shifting approaches to diplomacy. But it is about you—so you can’t isolate yourself... Projects that are shutting down abroad are sending part of their equipment to Ukraine. I can’t ignore this process or isolate myself from it. Any public statements about mobilization affect recruitment in the medical field. Every decision made in Ukraine has an impact on how people enlist or even how they ask questions. Lately, candidates have started asking me: what happens if there’s a ceasefire? Will we be dismissed if we mobilize now? So any narrative that enters the public information space directly affects our work. We may shield ourselves from the news overload, but we’re not insulated from the consequences of those news stories. That’s why I follow politics: to understand what to expect from the person I’ll be talking to next or from a subordinate. I need to have an answer for that person.
- If a ceasefire happens and most of the military personnel are demobilized, will Viktoriia (Avicenna) Kovach return to civilian life? And if so, where to?
- Where to? We’re never going back to the life we had before. A ceasefire is a temporary measure. We need to prepare for the next phase. We need to prepare military medicine for it. We need to prepare a unified medical space for it.
I have no desire to go abroad. I want to live here. And if I want to live here, I need to do everything I can to make life here comfortable.
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Censor.NET thanks the team of the Kyiv Security Forum titled "UA: LET’S UNITE AGAIN TO DEFEAT THE GLOBAL AGGRESSOR", organized by the Arseniy Yatsenyuk Foundation "Open Ukraine," for their assistance in preparing this interview.
Yevhen Kuzmenko, Censor.NET
Photo from the archive of Viktoriia Kovach
