In the 1990s and 2000s, post-Soviet Russia faced a permanent crisis in the North Caucasus region. Emergency measures were required from the state to eliminate the hotbed of separatism, crime, and then the terrorist threat. In those years, a turbulent situation has developed in many national republics of the Caucasus, but in order to restore constitutional legality, law and order in the Chechen Republic, the federal Center conducted two heavy military operations in 1994–1996 and 1999–2009. Historians believe that none of the ‘hot spots’ of the USSR and the post-Soviet space at the turn of the 1980s and 1990s required the state to use such large forces and means [1]. Their causes, the course of military operations, and even assessments in the Russian society of that time have repeatedly been the subject of study by domestic researchers in recent years, but such important aspects of the problem as participation of Russian military doctors in military operations in the Caucasus and their role in resolving this conflict are still relatively poorly studied by domestic researchers. This publication is intended to at least partially fill in this gap. The most important source for it is the Russian periodical press of the turn of the XX–XXI centuries, which includes both professional (Medical Newspaper) and many socio-political publications (Segodnya, Ogonyok, Arguments and Facts, Independent Military Review).

Trying to emphasize the scope of achievements of Russian military medicine in the Chechen campaigns, the authors of publications in the Medical Gazette regularly cited certain high quantitative indicators of the work of doctors. For example, in the midst of the bloody battles for Grozny in August 1996, the publication reported that a transport plane from Chechnya arrived at Volgograd airport, carrying 80 wounded servicemen who had previously received primary medical care in the hospitals of Khankala and Vladikavkaz. 23 of them, who had abdominal, chest or multiple shrapnel wounds of soft tissues, were in a serious condition, so 21 ambulance crews met the wounded at the airport. According to the newspaper correspondent Papyrin A, the flow of the wounded was slightly inferior to that observed in winter of 1995; all 485 beds in the military hospital of the Volgograd permanent post were occupied again, including 192 wounded from Chechnya [2]. Another article in the same issue of Medical Newspaper did not provide statistical data, but published photos of ITAR-TASS with the wounded in Grozny and reported their arrival first to Beslan airport (Republic of North Ossetia-Alania), and then to the North Caucasian Military District hospital in Rostov–on-Don [3].

We can find similar facts in the periodical press of the turn of the 1990s-2000s, which already narrated the events of the second Chechen campaign. Thus, the senior lecturer of the Department of military field surgery of the Military Medical Academy named after S. M. Kirov, colonel of the medical service Marchuk V recalled that when the federal troops advanced on Grozny and during the battles for the commanding heights above it in the autumn and winter of 1999, up to 70 wounded soldiers arrived at the hospital daily, and the maximum number was 156 people one day [4]. These estimates cited in an interview with the Independent Military Review (appendix to the Nezavisimaya Gazeta, one of the most authoritative and influential Russian publications of the post-Soviet period) were generally confirmed by an anonymous medical instructor of a motorized rifle company, according to whom an average of 5–6 servicemen died and 15 were injured per day at the height of the active hostilities [5]. At the same time, in 1999–2000, significant progress was observed in the work of doctors compared to the military commitment of 1994–1996: the evacuation of the wounded with the help of aviation was better organized, there were practically no problems with supply of the army with medicines, and almost all fighters were vaccinated before being sent to the Caucasus [4]. To transport the most seriously wounded to hospitals located in capitals, the federal group actively used AN-72 and Il-76 ambulance aircraft, with the intensive care unit and operating room being located on board the latter. The delivery time for such wounded soldiers from the battlefield to the hospital ward was 6 hours in average [4].

It is important that regular publications of major media about the attempts of the Russian medical community to overcome the severe consequences of active military operations in the North Caucasus in the 1990s and early 2000s were not impersonal. On the contrary, a significant role among them was played by relatively extensive materials about the most distinguished Russian military doctors who were awarded high state awards for feats in the Caucasus region. The most famous of them was the Hero of Russia, commander of the medical company of the 27th Brigade of Airborne Troops, Guard major of the medical service Belov AA, who participated in the capture of Grozny and Argun as part of the surgical medical center of the consolidated regiment in the first quarter of 1995. In the mass media of the mid-1990s, he was actually compared to front-line doctors of the Great Patriotic War era. So, in one of the notes in the Medical Gazette, published in 1996 on the eve of Victory Day, it was reported that Belov’s grandfather was also a military doctor and died at the front in 1941 [6]. It is very noteworthy that apart from Belov VA, three other heroes of the same publication were doctors awarded the Gold Star of the Hero of the Soviet Union for rescuing wounded Red Army soldiers or partisans in 1941–1945.

A year and a half after the entry of federal troops into the rebellious republic and the beginning of large-scale hostilities, in an interview with the correspondent of the Medical Newspaper, reserve Colonel R. Chekmarev, Belov laconically recalled that during the storming of the Chechen capital at the beginning of the 1994–1996 campaign, ‘days and nights were mixed for us.

And the wounded kept coming’ [7]. Then he together with his colleagues rescued hundreds of wounded Russian soldiers [6]. On the contrary, the capture by federal forces of the third largest city of Chechnya, Argun, on March 23, took the lives of 5 soldiers of a combined airborne regiment, and very few wounded were received at the medical center [7]. It should be noted that the above information about the losses of the federal group completely coincided not only with the official estimates of the army command, but also with those of the metropolitan journalists who were very critical about the military solution of the Chechen crisis [1].

In the same interview, Guards Major Belov emphasized the high professionalism and personal courage of his colleagues. Pugachev V, Lukonin V, Kirh A. Noskov R, Germanov V, Chaplygin A and Barinov B [7]. With reference to unnamed Russian soldiers, they were also provided a specific example of his work in the war zone. In winter of 1995, in Grozny, senior lieutenant of the medical service Leonenko E. came under fire from militants, barely got out of a burning armored personnel carrier, but fell into a sewer well and almost died, as Chechen separatists threw a hand grenade there. The seriously wounded medical officer was able to reach the place where the Russian troops were located only three days later. Leonenko was given primary care at the medical center and sent to the hospital, where he was diagnosed with ‘contusion, multiple shrapnel wounds, and thermal burns [7]’. His further fate was unknown to Belov VA.

Russian doctors had to act in no less difficult circumstances during the second campaign in Chechnya. Comparing the two operations in the North Caucasus, military surgeon, Hero of Russia, Lieutenant Colonel of the medical service Milyutin IA considered the events of 1999–2000 to be a more difficult test due to frequent movements across the territory of the rebellious republic [4]. During the fighting in the Novolak district of Dagestan in September 1999, enemy snipers and mortars tracked the movement of medical workers and fired heavily at them. To avoid death or injury, it was necessary to use armored vehicles, which blocked the visibility of snipers and helped to pull wounded Russian servicemen from the battlefield [4]. According to the memoirs of the head of the surgical department of Vishnevsky A. Central Military Clinical Hospital, Lieutenant Colonel of the Medical Service Filippov AV, transfer to another location occurred about 1–2 times a week. Each time, the military field hospital was deployed from scratch, in the bleak steppe, with no electricity, water supply and communications around. According to the military doctor, his colleagues ‘were mid leg deep in the mud’, worked and lived in tents measuring 30 by 10 meters [8].

The main author of another large essay published on the pages of the Medical Newspaper in summer of 1996 was the head of the microsurgery department of the 3rd Central Clinical Military Hospital named after Vishnevsky A (the city of Krasnogorsk, Moscow region), Lieutenant Colonel of the Medical Service Kuzin VV. According to the author of the publication, journalist Golovenko A, the mentioned surgeon annually performed up to 200 complex operations, which resulted in recovery of even hopeless wounded. It is noteworthy that Golovenko himself was a witness to one of them. It lasted about 8 hours. He later told readers about the fate of some military personnel who became patients of the Krasnogorsk hospital. For example, the 18-year-old sergeant of the Russian army Semakin A, almost lost his right arm after being hit by a burst of a large-caliber machine gun in a battle with terrorists from S. Raduyev’s gang in the Dagestan Pervomaiskoye village (January 1996). However, the military doctor Kuzin cut out the fibula from the shin and fixed it to the shoulder, which saved the fighter’s limb. A veteran of the Afghan war and some hot spots in Transcaucasian countries, the foreman of the reconnaissance company Emelyanov Yu had ‘his stomach… full of fragments’ during the storming of Grozny in winter of 1995, as a result of a close shell explosion. However, the doctor cut out a thin muscle from the thigh and carefully applied a ‘patch’ to the stomach. Moreover, Kuzin was even able to transplant Yemelyanov’s finger from his foot to his hand. The case of common soldier Kolomnin I was also mentioned in the article. He almost lost his right leg below the knee as a result of the explosion of his BMP on a radio-controlled land mine near Argun. The soldier also avoided amputation due to the highest professionalism of Kuzin, who transplanted a fibula with a muscle from the left leg to the soldier’s right leg [9].

The central mass media promptly reported that doctors of some provincial military medical institutions also achieved notable professional results during the first Chechen campaign of 1994–1996. So, only 3 wounded servicemen died in the surgical department of the Volgograd Military Hospital during the capture of Grozny in winter of 1995, although two planes with wounded arrived daily from the Chechen capital to Volgograd airport, and ‘soldiers, officers arrived directly with equipment, and machine guns, in burnt, dirty pea jackets’ [10]. After the escalation of the situation in Grozny in spring of 1996, 90 more wounded and sick Russian servicemen were taken to the same hospital. The heroic work of doctors has not been ignored by the state and society. For successful professional activity, doctors Bryzgunov A, Asimov A, as well as the operating nurses Vasilyeva I and Sharai S were awarded government awards, and the lead surgeon Goncharov A even described own experience in his report at a meeting of the regional society of surgeons [10].

The example of the Volgograd Military Hospital was not the only one cited in the major media in those years. For example, in another issue of the Medical Gazette it was mentioned that the head of the department of traumatology of Inpatient military hospital No. 358 of the Volga Military District (the city of Samara) Colonel of the Medical Service Fedoseev MM, who served in Afghanistan in the 1980s, developed and implemented several operations into daily practice. They included plastic ligaments of a traumatically damaged knee joint and a dielectric insert into the Ilizarov apparatus, which reduced the time of fusion of limb fractures by more than a month. Moreover, as stated by a journalist of the Medical Gazette, no single case of death among wounded servicemen had been recorded in the department of traumatology of the Samara Hospital by summer of 1996 [11]. Meanwhile, during the first Chechen campaign, 1,900 wounded soldiers passed through the Samara hospital, with 120 of them staying in the intensive care unit [12].

Russian military doctors tried to save not only physical, but also mental health of their patients. In a large article in the Medical Newspaper, the famous military journalist Colonel Karpov BV mentioned the participant of the Great Patriotic War of 1941–1945, Candidate of medical sciences, psychotherapist Perevalov IP from the sanatorium of the Ministry of Internal Affairs in Kislovodsk (Stavropol Territory). During a year and a half of active hostilities in Chechnya, he and his colleagues provided a full 24-day course of treatment to more than 400 wounded officers and soldiers of the Airborne Forces, whereas other 100 soldiers obtained treatment within the 12-day program [13]. To do this, doctors at the resort had narzan baths, physical therapy, hydro, acupuncture and aromatherapy courses. They also attended a phytobar, a sauna and a swimming pool. However, as the author of the publication noted, the main indicator of highly effective treatment in Russia sanatorium were excerpts from letters of the vacationing Russian military themselves. N., a soldier of the Ministry of Internal Affairs of the Russian Federation, who had previously served in the ‘hot spots’ of Transcaucasia, expressed gratitude to Perevalov for having ‘become different’ after treatment in the sanatorium, that is, he felt the urgent need to continue life. In turn, Colonel V., a veteran of the war in Afghanistan, wrote that after Perevalov’s rehabilitation, he ‘returned to normal human life’ and stopped alcohol abuse. It should be noted that the medical experience gained during the military operations in the North Caucasus was analyzed long before the formal end of this armed conflict. Thus, rehabilitation departments were created in sanatoriums and rest homes of the Ministry of Internal Affairs of Russia, and freelance military medical commissions were established directly in military units to refer front–line soldiers to rest, treatment and rehabilitation in a sanatorium. With the support of officers of the Military Medical Directorate of the Government Apparatus Perevalov IP was preparing a memo for participants of military conflicts [13].

Russian doctors provided assistance not only to wounded or sick servicemen and representatives of other law enforcement agencies, but also to the civilians of the Chechen Republic. In the above-mentioned interview with the Guards Major Belov VA it was claimed that residents of Grozny, especially the elderly, women and children, repeatedly became his patients. They were either receiving the necessary medicines or emergency assistance from army doctors for free. The military doctor recalled that in winter and early spring of 1995, he and his colleagues often gave their own combat rations to ‘people who were starving, huddled in basements and tumble-down houses’ [7]. His point of view was shared by Prokofieva N, the correspondent of the ‘Ogonek’ magazine that was popular in the late Soviet and post-Soviet years, who repeatedly visited Chechnya at the height of hostilities. In her opinion, largely thanks to the efforts of Russian military doctors in the republic during the war years, it was possible to prevent a repeat of the cholera outbreak; the fight against polio, plague, diphtheria, anthrax, dysentery and hepatitis was successful. Thanks to the efforts of the Deputy Chairman of the State Committee for Sanitary and Epidemiological Supervision Onishchenko GG, the restoration of the sanitary and epidemiological service destroyed during the years of the separatist regime began in Chechnya [14].

A similar point of view about the relationship between doctors and Chechen civilians was shortly expressed before the end of hostilities in 1996 by director of Protection All-Russian Center for Disaster Medicine, Major General of the Medical Service, Goncharov SF. According to him, there was a ‘very good atmosphere, a friendly atmosphere’ around the hospital in the village of Staraya Sunzha in the suburbs of Grozny in 1994–1996, because the local population ‘helped the doctors very well’. For the residents of Chechnya, the very existence of a medical facility was something like a barometer. They regularly asked the doctors if the hospital would leave and whether they need to leave the settlement as well. At that time, the team of the Zashchita Hospital included 23 highly qualified specialists such as neurosurgeons, traumatologists, pediatric surgeons, anesthesiologists from leading clinics in Moscow [15]. The importance of their assistance to civilians could not be overestimated. During the battles for Grozny in August 1996, over 370 people turned to them for help, including 117 wounded [15]. As Professor Goncharov reported, his subordinates provided support to numerous women who received penetrating wounds to the thoracic, abdominal and cranial cavities, and the vast majority of patients were rescued and later evacuated to hospitals in Vladikavkaz, Mozdok and the Znamenskoye district center. Russian doctors failed to save only two seriously injured people [15].

Another important event directly participated by Russian doctors during the military operations in the North Caucasus was the ‘Frontline Children of Chechnya’ charitable social and medical program, launched in 1995 by the Russian Children’s Fund (RDF). Its main goal was to organize the rehabilitation and treatment of disabled children in the new ‘hot spot’ of the post-Soviet space. In more than a year, up to 250 Chechen children were sent to medical institutions in the neighboring national republics of the North Caucasus (Ingushetia, Dagestan, North Ossetia-Alania), and another 22 children were sent to hospitals in Moscow. Obviously, these indicators were a drop in the bucket as only in the first weeks of March 1996 and only in Grozny, the RDF staff identified more than 70 more children and adolescents who could not be cured in Chechnya and had to be urgently taken to special clinics in large cities of the country for rehabilitation. Personal accounts in rubles and foreign currency were opened for each child affected by the military activities, and later the RDF asked public and private organizations, commercial structures, banks and ordinary citizens of the country to organize assistance to seriously injured children [16].

It is also very important that the standard of living of most Russian military doctors in those years was quite low: in the mid-1990s, 20 out of 35 employees of the Volgograd Hospital mentioned above did not have their own housing, their lack for new surgical equipment was acute [10]. In the midst of the second Chechen campaign, doctors from St. Petersburg also recognized the fact that they did not have expensive anti-shock suits or vacuum stretchers, which were common abroad [4]. At the same time, it should be noted that, despite the difficult socio-economic situation and permanent political instability in Russia of those years, the same Volgograd hospital as a whole was not deprived of attention and care of the authorities and community. He was assisted by the city and regional administrations, which allocated two cars and transport for the delivery of wounded soldiers from the plane to the hospital, as well as the local community. Many industrial enterprises in Volgograd supplied the medical institution with their own products, and ordinary citizens regularly visited wounded soldiers, brought them fruits or showed respect for them in other ways [10].

The results of the activities of Russian doctors in the North Caucasus at the turn of the XX–XXI centuries can be summed up using the following phrases about surgeons from St. Petersburg: ‘these people can disassemble and reassemble a person’ or ‘we are fighting for every centimeter of a limb’ [4]. These words are confirmed by official statistics, according to which the mortality rate in medical institutions steadily decreased during the largest military campaigns of the 20th century. Thus, it was 5.5%, 4%, 1.2% and 1% during the Great Patriotic War, the war in Afghanistan, and both Chechen campaigns, respectively [4]. As we can see, it was the fighting that became the most successful for our country in terms of saving human lives. It was Russian doctors who contributed to the restoration of the health care system of the rebellious republic and, in general, provided a high example of humanism and compassion for people. It was not by chance that the hospitals of various central ministries and departments were called ‘islands of mercy’. Largely because of their selfless work and courage, Russia managed to achieve a settlement of the Chechen crisis and, closer to the end of the second decade of the 21st century, establish calm, constitutional order and legality in the North Caucasus.