Sergey and Lena Koznienko, a soldier and a nurse, began dating in Ukraine a year ago. They wed in April. In July, Sergey was injured when his military truck hit a mine. Now he is recuperating in a military hospital near the front lines. (Michael Birnbaum/The Washington Post)

The nurse and the police officer started dating a year ago in a different Ukraine. They could not imagine the tumult that would upend their nation, or their sudden marriage before he was deployed to an uncertain conflict in the east. And never in their dreams did they expect that she would wind up caring for him at a military hospital for wounded soldiers.

The four-month-old strife in Ukraine is taking a mounting toll on those fighting in it, with losses on both sides intensifying in recent weeks as Kiev’s forces press in on rebel strongholds. But the Ukrainian government’s gains have come at a steep price — on a recent day at the biggest military hospital near the fighting, four ambulances with mournful sirens pulled into the gates in a 10-
minute span.

The violence is putting pressure on Ukrainian President Petro Poroshenko to bring the war to a quick conclusion. Anger is building about poorly equipped soldiers who at times have been ordered into fights with the odds stacked against them. Some soldiers say they had no bulletproof vests. Others have only light weapons to use against artillery.

Since the fighting began, more than 500 soldiers have died, Ukrainian military officials say. Rebels do not consistently announce their death toll, but reporters in rebel-held Donetsk have witnessed large-scale burials of dozens of rebel fighters.

Poroshenko, who met with Russian President Vladi­mir Putin in Minsk on Tuesday, said beforehand that a “constant military threat will hang over Ukraine” for the foreseeable future.”

A nurse tends to a wounded Ukrainian soldier in a hospital in the southern Ukrainian city of Mariupol. (Alexander Khudoteply/Agence France-Presse via Getty Images)

In a nationally televised speech, he said, “Over the last six months, a new Ukrainian army has been born in heavy and exhausting fighting.”

Sergey Koznienko, 28, met Lena, a 23-year-old nurse, a year ago when she was taking care of his best friend after an operation in the central Ukrainian city of Sumy, where they live. Months of tumult — first the pro-European protests in Kiev, where Sergey was deployed as a police officer, then the sudden ouster of the Kremlin-backed president, Viktor Yanukovych, then the flaring insurgency in the east — drew them closer.

And when Sergey knew he would soon be called up for the front, they had a quick town-hall marriage in April. They were saving the church wedding for September. When he left for the east, Lena packed a first-aid kit for him because the Ukrainian army didn’t issue it.

The wedding plans went out the window in July. Sergey and the friend who had introduced him to Lena were dispatched on a reconnaissance mission to a town from which rebels had retreated only hours previously. Their superiors had not given them maps, Sergey said, and they had little idea where they were going.

“We asked locals whether there were any separatists, and they said two hours ago they were driving around here with guns,” he said.

Then their truck hit a mine. Both of Sergey’s legs were grievously wounded. His buddy was sitting next to him.

“In the past, whenever I had questions and I couldn’t reach Sergey, I would call his friend,” Lena said. “But when I called this time, someone answered and said, ‘Don't call this number any more. He’s dead.’ And that’s when I panicked.”

She ran to the headquarters of the Sumy police — his old employer — where she asked what had happened. They told her the news, and she dropped everything to head eastward toward the front. By the time she left, Sergey had already had one emergency operation at a battlefield hospital and was heading toward Kharkiv. That’s where they were reunited.

Seven operations later, Sergey’s right leg, fractured in four places, is slowly healing. He has stitches on his brow from a shrapnel wound. Doctors tell him he may not be able to walk for a year. For weeks, Lena wouldn’t let him watch the news because his mood would become too dark.

The weight of combat is beginning to take a toll on soldiers, Sergey said.

“Soldiers’ morale is fine, but it’s hard when you know how much support the other side has,” he said, referring to accusations from Kiev and its Western allies, denied by the Kremlin, that Russia is supporting the rebels with heavy weaponry and fighters and that it has even started intervening under its own flag.

Nor do the patchwork groups of pro-Kiev forces always communicate or coordinate with each other, he said. The Ukrainian military has its own protocols and plans — but volunteer militias have joined the fighting, many with plenty of passion but limited training.

Amid the chaos, some soldiers are deeply angry about the demands being made of them. They blame two decades of neglect and corruption that they say left the military struggling to defend the country against an insurgency that has Russia’s support. Others say that both civilian and military leaders in Kiev are making unreasonable demands of their fighters. In some western Ukrainian cities, protests against mobilization are starting to grow.

“Taking over cities is very easy, but afterward, that’s when the rockets start” from the opposite side, said Yuri Vergun, a welder from the north-central city of Chernihiv who had not driven a tank for 20 years until he was called up from the reserves this year. Last week, he suffered a leg injury from shrapnel in a rocket attack near Luhansk, where some of the heaviest fighting has been taking place, and on a recent afternoon he was hobbling with wooden crutches around the well-kept but modest grounds of the military hospital.

“We need help, but there’s very little of it. There aren’t so many soldiers left,” he said. “It makes a difference if you send 20 to fight, instead of 100.”

Several times this month alone, Ukrainian soldiers have found themselves surrounded by hostile forces in circumstances that advocates have described as heroic and critics have blamed on poor planning by military superiors.

In early August, more than 400 soldiers were forced onto Russian soil after their supply lines were cut and they ran out of food and other basic supplies. (No one, including Russian officials, accused them of being part of an invasion force, in contrast to the reception given Russian soldiers caught in Ukraine this week.) Last week, in the key railroad hub of Ilyovaisk, near Donetsk, one volunteer militia was repeatedly cut off from other pro-government forces amid fierce fighting.

The conflict is driving a steady stream of casualties into hospitals. The Kharkiv military hospital averages 30 new wounded soldiers every day, officials there say. When the hostilities started in April, Western officials estimated that just 6,000 of Ukraine’s then-130,000 armed forces personnel were combat-ready. That number has risen with time and experience, those officials say.

Now, Sergey and Lena have pushed their church ceremony back a year — to encourage Sergey to work on his recovery, in hopes that he will be able to walk down the aisle.

“We’ve been saying that it’s a fast life. So many bad things have happened so quickly,” Lena said. But, she said, at least they’re together in the hospital. “It’s lucky, in a way.”