When Andrei, a Ukrainian serviceman, emerged from the armoured vehicle evacuating him from the frontline in eastern Ukraine, he bore no visible injuries except a minor limp.
But the dazed and disoriented soldier was in need of urgent care after an explosion that rocked the vehicle he was travelling in, sending a violent blast wave rippling through his body.
“I’m seeing stars,” said Andrei, who declined to give his last name, gesticulating loosely in an ambulance near the front-line town of Bakhmut, controlled by Russian forces.
“And my ear,” he trailed off nervously, “it’s blocked.”
For front-line medics like Vasylyna, these are the tell-tale signs of a silent but pervasive battle wound that she says harms half of the servicemen deployed to the front.
“Concussions happen so often that they even compete to see who has had the most,” Vasylyna, a 28-year-old with the 80th assault brigade who declined to give her last name citing security concerns, told AFP.
“They think that headache medication will be enough and then get back to the front,” she said.
During nearly two years of long-range artillery duels along the sprawling front — with both sides firing off thousands of rounds a month — the war in Ukraine is a ripe battleground for concussions.
They usually result from sharp blows to the head or body that cause the brain to smack against the skull, bringing on headaches, emotional turns, confusion or tiredness.
Ukrainian officials routinely report concussions among civilians as well, particularly the elderly in shell-scarred villages near the front.
‘Time to heal’
Vasylyna, who provides care to soldiers before they are sent onwards to hospitals, said Andrei would probably return to the front before fully recovering.
“I’m constantly fighting against them. They’re kids. They refuse to get treated,” she said while packing away syringes.
“It’s very important to talk about it, to tell people that concussions are dangerous and to take time to heal.”
The injuries leave invisible scars, and the accumulation of brain lesions can have devastating long-term effects.
“It’s an insidious condition,” she said.
In the Kharkiv region further north, a Ukrainian serviceman with the call sign Prometheus echoed Vasylyna’s concerns.
“At the front you have a 90 per cent chance of suffering a concussion and going into battle with it,” said Prometheus, the leader of an assault unit.
“It happens every day,” he told AFP, watching his troops carrying out drills in a forested area.
Like his men, Prometheus said he also had suffered concussions.
‘Dropping out every day’
He said concussions could leave soldiers out of action for three to 10 days.
“We have people dropping out every day because of this, and our human resources are limited,” he said.
“The guys are disoriented. They can fall on the ground and just curl up.”
He added that head traumas also took a toll on soldiers’ motivation to fight.
“When guys have been in that critical situation, they know it’s going to happen again and worse,” he said.
It can be hard to “remotivate them to go to the front.”
But Vasylyna said that preventing concussions was “almost impossible,” noting that even ear protection offered little help.
Treatment usually lasts up to 15 days, and Vasylyna recommends rest above everything.
“Soldiers sleep badly. Their nervous systems are tense,” she said.
She also said some civilian doctors at times discharge soldiers back to the front before they are fully recovered.
“If they don’t see a serious injury, they just give a pill — and the concussions just add up.”
