15
REDUCING MORTALITY
The Hidden Losses

23 December 1999

On 12 December in Qrdjonikidzevskaya village, on the administrative boundary between Chechnya and Ingushetia, two deaths were recorded: soldiers who had died from their wounds.

As dawn broke a 20-year-old conscript, Misha Moshtyrev, military card No 8709472, died without coming round, in the intensive care unit of the district hospital. He had been brought there several hours earlier on an armoured vehicle by a group of soldiers who said they were serving with him. Early that morning Aza Tseloyeva, the doctor on duty, accompanied Misha's tormented body, which bore the marks of the surgeon's battle to save his life, to the tiny local morgue. She was astonished that no one, especially an officer, came to claim the soldier's remains.

At midday an all-male funeral procession crossed through the "Caucasus" checkpoint from Chechnya into Ingushetia. On one of the streets in Ordjonikidzevskaya the old men began to gather, as is the custom, in order to accompany and bury the body of their neighbour, 40-year-old bachelor Bagautdin, with full honours. He had died that dawn defending Grozny. He was a mercenary there and he did not hide the fact. For $1,000 a month, from early September he had fought the "feds"41 and at times had come back to visit his home, his mother and his sisters. On his short holidays in the village he squandered his pay on heroin and it was no secret that he hired himself out entirely because of his fatal addiction.

"But if that is the case, why are they burying Bagautdin with full honours? His name was cursed publicly in the mosque as a drug-addict. So the old men should not visit his family home to perform the rite." We were talking with a neighbour of the man they had just buried.

"But he redeemed all his errors."

"How?"

"By going to fight," said the neighbour, who admitted that when Bagautdin was alive he had very much disapproved of him. "But now that is all in the past. Now he has become a sacred figure ..."

Just don't imagine that Bagautdin's neighbour is also a fighter. On the contrary, his views are strongly pro-Russia. He was celebrating Constitution Day and is now going to vote for the Communists in the Duma elections: "Not because I like Zyuganov, but because it was that ideology that kept us all from fighting each other."

After these conversations I returned to the morgue, to the youthful and totally abandoned body of Private Moshtyrev. Forgotten by the army he fought for, he lay there awaiting an uncertain future. Why was Doctor Aza more upset about this than anyone else? Why did not a soul utter the same words of rapture about his sacred feat as met Bagautdin, who had until then been one of life's losers? I wondered whom the army, the government and the country as a whole intended to defeat when they showed such contemptuous indifference to what happened to their soldiers after death. Did they really think they could win against people who would never forget, no matter what the circumstances, to pay their last respects to a fallen warrior? Bagautdin's fellow Chechen fighters risked their lives to accompany his body through the checkpoint.

As we leave the morgue, Aza Tseloyeva is brief and to the point, as you'd expect from a doctor working in intensive care:

"Are you flying back to Moscow? Then go straight away, today, to the Ministry of Defence and tell them it's inconceivable to behave this way! Our attitude to death is a continuation of our attitude to life. That is a universal rule, no matter what your nationality. Why are they bringing soldiers to civilian hospitals? Why don't they collect the bodies of the dead?"

Manilov at Work

Several days later I was in Moscow at the first major international conference about the present war – "Chechnya: The Unlearned Lessons" – which was extremely well organised by the Itar-TASS news agency and the weekly Moscow News. There I managed to put Aza Tseloyeva's questions directly to the main ideologue of the present campaign in the Caucasus, First Deputy Head of the General Staff, Colonel-General Valery Manilov. He may be the namesake of Gogol's character,42 but his fantasies are not at all endearing or funny: he is behind the constant assurances in all the media about the unprecedented concern for our soldiers' survival, the minimal losses being suffered by the army and the clockwork efficiency of the medical system serving the combined forces operating from Mozdok.

Manilov, his face red after telling the latest lie about "only 400 dead", half-listened to my story: of Misha Moshtyrev's unclaimed body, of the wounded soldiers who were, for some reason, brought to a district hospital in Ingushetia, and of the chronic shortage there of medicines and equipment. Disgruntled with what he was hearing, Manilov turned to his aide: "Write that down. We'll investigate." His aide began slowly and unwillingly to draw his pen across the page, but quickly abandoned this unrewarding task. "It's a pack of lies," he retorted, and disappeared into the crowd behind his hefty boss's uniform.

What is going on here? We seem to be rolling towards some black tunnel and where it leads no one knows. The story of these two deaths in Ordjonikidzevskaya village leads me back to one of the main disputes of the present campaign in Chechnya, the level of army losses. How many are there, in reality? When they talk of 400 losses, do they mean those who died on the battlefield or does it include those who died later from their wounds? And where did they die? And to which department and category will the wily General Staff statisticians assign Misha Moshtyrev?

There is hardly anyone who continues to believe that the number of killed and wounded soldiers corresponds to the official figures. How, though, can we catch the military officials red-handed and prove that they're lying? In present conditions, the opportunity only surfaces by chance. Only those journalists in special favour with the high command, who have been carefully vetted for any "unnecessary talk", continue to be admitted to the field hospitals. Therefore only a strictly controlled amount of information reaches the media, and only that which shows the military in a favourable light and conforms to the principles announced by the General Staff ("a war with very low losses"). It is only the chance occurrence, such as the incident I encountered at the Sunzhensk district hospital, that enables us to prove how successful the military have become at concealing their own losses.

A Night's Work

"What did you say? He was ex-what . . .?"

"Exat. In other words, departed from us . . ."

At the entrance to the emergency department of the Sunzhensk district hospital the gloomy local medical assistant is trying to explain what happened the previous night. Only later do I realise that he is describing Misha Moshtyrev.

"To begin with, at nine in the evening, they brought a soldier on an armoured vehicle with blood gushing from the open femoral artery. The lads with him said they had come from Bamut and had been driving for three hours. Why had they dragged him so far? Where were the army doctors? Why had no one qualified travelled with such a seriously wounded soldier? It was strange . . ."

The story is continued by Igor Listov, the anaesthetist: "The boy was in a very poor way. There was little chance of pulling him through. He was almost in his death throes when they arrived. Fifteen minutes later he was clinically dead, but we managed to get his heart going again. Then the operation began."

The surgeon on duty, realising that he would have difficulty coping on his own, got in touch with doctors from the mobile hospital of the "Medical Catastrophe" organisation. Since the arrival in Ingushetia of several hundred thousand refugees this unit has been in operation not far from the Sunzhensk hospital and aims to provide skilled first aid.

"We began to operate, although we realised that the soldier had lost five of his six litres of blood," says Victor Popov, head of a team of doctors from Yekaterinburg who is now working with the Emergency Relief hospital. It was Popov who tried to save Moshtyrev's life. "We extracted a very large calibre bullet – incidentally no one came to collect it and the military prosecutors showed no interest in it. We gave the lad a so-called artificial artery because the bullet had torn away about five centimetres of the artery. Just at that moment, as chance would have it, there was a power cut, quite a usual occurrence in Ingushetia. The artificial respirator stopped working and we had to pump air in by hand."

"Was that what finally killed him?"

"It's hard to say," the surgeon replies. "At least we did everything to ensure that he left the operating table alive. We battled as only we know how. He died just before dawn. We were then already operating on the next soldier."

"So there's a constant flow of bodies coming here, like a field hospital?"

"Judge for yourself. Over the last 48 hours we have received three soldiers," Popov continued. "The one with the torn artery died. Another wounded private was operated on by Igor Piven, our traumatologist, and survived, though only by a miracle. He has lost half his brain. Only one of them stands a good chance. I think he's called Artyom. Incidentally, we don't bother with names here, there's no time for that, we must operate. Artyom should live. We extracted bullets that had pierced his intestines in four places. He was haemorrhaging severely. Now he's in intensive care, recovering."

Doctor Popov insists on calling the soldier Artyom. Several minutes later, however, we find out that he is called Ramil Abdurakhmanov, a 19-year-old from Kazan. For the present he talks very badly. His speech becomes garbled, but his eyes are calm: he knows that he has survived. Aza Tseloyeva, who is in charge of the intensive care unit, allows me to sit and chat to him.

Ramil has extraordinary tales to tell. To begin with, he is serving with Unit 73745 of the railway's armed detachment. What are they doing here? Their unit is located on the boundary between Chechnya and Ingushetia at the Sleptsovskaya (Ordjonikidzevskaya) oil storage plant. They are serving at the "Caucasus" checkpoint, taking the place of the Migration Service men. Ramil and the others filled in special forms agreeing to their "enforced relocation". In the evenings they are brought back to the plant. That fateful evening Ramil was about to enter the compound when someone tried to push him into a white Zhiguli car, an attempted kidnap. He fought them off as best he could, and when he shouted was rewarded by a stream of bullets at point-blank range from the window of the retreating vehicle.

An attempt to kidnap a soldier, who was severely wounded in the process. This is a much too serious offence to be passed over without the attention of the military prosecutor. Especially since Ramil displayed considerable bravery. Well, that's the conclusion any normal person would reach. Alas, when I was back in Moscow I discovered that Abdurakhmanov, born 1980, conscripted in June 1998, was everywhere listed not as a wounded soldier, but as a deserter ("having voluntarily left his unit" is the phrase). The formal justification is that he had not entered the compound of the plant at the moment of the attempted kidnap. The officers used this to quickly disassociate themselves from yet another "loss of manpower", and to transfer the incident to quite a different category for which they would not find themselves held responsible.

Indeed, who among the high-ranking military officials will bother to get his hands dirty and discover that there was, in strict terms, no "unit" located at the oil storage plant? It worries no one that they had absolutely no right to force conscript soldiers to sleep where there were no defensive posts. Nor that it is plainly indecent to conceal the mistakes officers have made behind the supposedly improper behaviour of Ramil.

Incidentally, the other soldiers in Unit 73745 say that Ramil is one of the best, and fought the bandits to the last of his strength (he was unarmed), and did not let them capture him although he was severely wounded. That's what our ordinary soldiers are like, although they are unbearably young. And that's what their officers are like. Their main worry is submitting the kind of report their superiors expect.

Ramil looks down at his hands, which appear black against the hospital sheet, and explains why they're so dirty: "You remember there was rain and slush yesterday. I crawled through the mud to the fence to hide myself. I thought the Zhiguli was coming back to get me."

"When did help come from the oil plant?"

"I don't remember."

The officers made good use of this circumstance. I should add that the doctors who operated on the three soldiers – Misha Moshtyrev, Ramil and Andrei Batrakov (the lad with the head wound) – take not the slightest interest in how they were wounded. That is entirely in accordance with the Hippocratic oath. Still, they're very surprised that there are more and more soldiers in this war who are "by chance brought to the wrong place", and who are transported not to military hospitals but to ordinary civilian medical centres. Doesn't this contradict Manilov's statements about the General Staff's efforts to keep losses to a minimum?

Doctors are firm and decisive people only when they are operating. The rest of the time they are gentle and thoughtful. Therefore, it is up to me to take their thoughts to their logical conclusion: soldiers are deliberately being denied the protection of military medical aid.

Just consider the Sunzhensk district hospital. It is certainly one of the best in Ingushetia. However, it has very limited facilities and resources. It was built to meet the needs of this peaceful town and the surrounding villages, not to fulfil military purposes. It doesn't have staff with a narrow specialisation in field surgery. Neither does it have its own generator. The electricity is constantly going off and an operation is often successful only because a patient was lucky not to be treated during one of the frequent power cuts.

Myths and Reality

These "chance admissions" do not square at all with the talk about the Ministry of Defence's smooth-running system of medical treatment.

Had the case of the wounded soldier from Bamut been included in official reports, it would raise many other questions. Bamut is one of those villages that has been "liberated" for a long while. There are no more Chechen fighters there, if one believes the General Staff. Ramil's story suggests the opposite. Perhaps we are again the victims of shameless deception by the authorities. If we admit this is a lie, then the whole encouraging picture of the planned and steady advance of the Russian forces begins to fall to pieces.

The superior officers must conceal the fact that the war continues in Bamut. That's the only reason why wounded soldiers were dragged three (!) hours on an armoured vehicle – not by helicopter! – along poor roads, during which the soldier with a severed artery lost his chance to live. It also means that there are no military doctors or, at least, medical assistants in Bamut who can assess the severity of someone's wounds. Otherwise they would certainly have warned his superior officers that Private Moshtyrev would not survive the journey. And why Ordjonikidzevskaya? There is another small hospital with an operating room at Galashki in the foothills of the mountains. Don't these people have local maps?

There are too many questions and too few answers. But we are waiting for Ivan Chizh, the head of the armed forces' chief military-medical department, to give us his answer. If he keeps silent, then we shall take it as an acknowledgement that our suppositions are correct.

To be frank, like the doctors, we don't have much chance of making ourselves heard. All we can do is wait, though these delays are shaming and offensive. We know that wounded soldiers are steadily being sent out of Chechnya and not to the hospitals that are especially equipped to treat them. They go instead to Ingushetia, because it helps the Russian authorities look better and increases their popularity rating.

The ordinary soldiers, as before, remain no better than dirt beneath the officer's boot. No one regards them as "sacred", like Bagautdin. Though the TV constantly tries to persuade us it is so: it shows us leading government officials, press spokesmen, and the army's professional political advisers – like Manilov, who will not rest until he can equal the achievements of Movladi Udugov,43 the man who brainwashed so many during the first Chechen war.

We're fighting in Chechnya the only way we know how. And the things we're best at are lies and cynicism. It is by shortening the lists in this way that we have successfully created "a war with very low losses".

INGUSHETIA