As heavy metal music plays in the background, a doctor grabs a piece of cloth and places it atop an open wound on a medical dummy. Pressing on the cloth with both hands, he applies pressure. Later, he secures a tourniquet to the dummy’s leg.
“The data we know from the battlefield is that a significant amount of deaths are preventable with taking these steps,” Eric Goralnick, an emergency medicine physician at Brigham and Women’s Hospital in Boston, told The Washington Post.
Goralnick is the doctor shown acting out the tutorial in the short video, which provides a list of actionable steps written in Ukrainian. Another video, about 4½ minutes long, features a more detailed, step-by-step narration in Ukrainian by Nelya Melnitchouk, a Ukrainian-born oncology surgeon at Brigham and Women’s Hospital.
“Lots of civilians are dying in civilian houses and hospitals,” Melnitchouk told The Post. “I mean, that’s not what should happen.”
As Russian forces have continued their assault on Ukrainian cities, the civilian toll has swelled. A United Nations human rights office reported Monday that there have been at least 636 civilians killed and 1,125 injured since Russia began the invasion on Feb. 24, although the office said it believes the actual number is “considerably higher.”
With the death count has come vivid spectacles of violence. A video taken Friday by an Associated Press reporter shows a Russian tank repeatedly firing into an apartment building in Mariupol. Less than a week earlier, videos showed Russian troops firing on civilians in a Kyiv suburb.
At least nine medical facilities have been hit by Russian attacks, according to a Post analysis. That included a Russian airstrike last Wednesday on a Mariupol maternity hospital, where 17 people were injured and at least three people were killed, according to city officials there. A pregnant woman and her baby died in the aftermath, the Associated Press reported.
Melnitchouk came to the United States from Ukraine when she was 18, and she still has family there. Before the war started, she worked with an organization to share information with Ukrainian doctors and patients on how to treat cancer. When the war began, she said, Ukrainian doctors started calling her about trauma care, so she brainstormed ways to help from the United States.
Melnitchouk contacted Goralnick, who had been working with an educational campaign called Stop the Bleed, which is administered by the American College of Surgeons’ Committee on Trauma and provides tutorials on how ordinary people can temporarily control bleeding wounds.
The videos for Ukrainians were posted to YouTube on March 4. The longer tutorial has so far received more than 4,000 views, while the shorter one has more than 700.
Goralnick, whose father’s parents were Ukrainian, explained that the method taught in the videos was developed in the early 1990s by a Navy physician named Frank Butler who examined casualties in the Vietnam War.
He found “there were a significant amount of preventable deaths on the battlefield, mostly from uncontrolled bleeding,” Goralnick said, adding that another analysis found similar results in the early days of the wars in Iraq and Afghanistan.
Nonmedical personnel in the military were thus trained on how to recognize uncontrolled bleeding and intervene, Goralnick said.
The civilian training focuses on three steps, which Goralnick demonstrates in the videos aimed at Ukrainians. The first involves calling emergency responders so the injured person can eventually receive help from medical professionals. The second involves looking for significant bleeding. If a person is bleeding heavily, the third step is to control the bleeding by applying pressure to the wound using a cloth or tourniquet until help arrives.
One image from the war stuck with Melnitchouk as she made the tutorials: a video of a woman who had lost her leg early in the conflict. Melnitchouk read that the woman died and worried that her death might have been preventable.
“She obviously could have died from something else, too,” Melnitchouk said. “But the most likely cause is that she bled to death.”
The tutorials were, in part, a response to Melnitchouk wanting to take action amid her feelings of helplessness.
“Even if one life is saved with this video,” she said, “it’s totally worth it.”
War in Ukraine: What you need to know
The latest: Russian President Vladimir Putin announced a “partial mobilization” of troops in an address to the nation on Sept. 21, framing the move as an attempt to defend Russian sovereignty against a West that seeks to use Ukraine as a tool to “divide and destroy Russia.” Follow our live updates here.
The fight: A successful Ukrainian counteroffensive has forced a major Russian retreat in the northeastern Kharkiv region in recent days, as troops fled cities and villages they had occupied since the early days of the war and abandoned large amounts of military equipment.
Annexation referendums: Staged referendums, which would be illegal under international law, are set to take place from Sept. 23 to 27 in the breakaway Luhansk and Donetsk regions of eastern Ukraine, according to Russian news agencies. Another staged referendum will be held by the Moscow-appointed administration in Kherson starting Friday.
Photos: Washington Post photographers have been on the ground from the beginning of the war — here’s some of their most powerful work.