One of the most tragic consequences of dissolution of the Soviet Union in 1991 included the further aggravation of inter-ethnic relations and growth of national and religious radicalism in the young CIS countries. As a result, the notorious protests escalated into a full-scale war with 63 to 98 thousand recent Soviet citizens being its victims, according to American political scientist and economist Trizman D [1]. The bloodiest wars occurred in Nagorny Karabakh, Tajikistan and Abkhazia, while conflicts in South Ossetia and Transnistria accounted for less deaths. In this case, the victims of numerous conflicts in the Russian North Caucasus in the 1990s and 2000s are not taken into account. Despite the difficult socio-economic situation in the early and mid-1990s, Russia could not stay away from the conflicts in the republics of the former USSR, but publicly expressed its willingness to take responsibility for their settlement. Thus, on February 28, 1993, the country’s first president, Boris Yeltsin, declared that “all responsible international organizations, including the United Nations, should supply Russia with special powers as a guarantor of peace and stability in the territory of the former Soviet Union” [2]. It should also be noted that the causes, course and consequences of military conflicts in the post-Soviet space, taken both individually and collectively, have repeatedly been the subject of study of domestic and foreign authors, but all these researchers have almost not paid attention to the role of physicians in resolving and overcoming tragic consequences of these wars. This article is intended to fill the existing gap, at least partially, mainly based on the works published in the early 1990s by Meditsinskaya Gazeta, the independent international periodical.

According to it, the activities of medical workers in flashpoints of the former USSR were extremely dangerous. Thus, in spring of 1992, the metropolitan Meditsinskaya Gazeta reported that unknown criminals had shot at an ambulance on the Tashly–Grigoriopol highway in Transnistria. As a result of this raid, a midwife was killed, a driver and two passengers were injured; they later underwent surgery and survived [3]. It was specifically noted in the publication that the criminals saw who they were shooting at [3]. This crime was obviously not the only one even during the relatively short armed conflict in Transnistria. In Meditsinskaya Gazeta of 1992, a murder of a nurse in the city of Bendery by an unknown sniper was mentioned [4], whereas a special correspondent of the publication Panyushin R witnessed how Pridnestrovian guards shot an ambulance from Chisinau that had refused to stop. Luckily, there were no casualties, but the driver was slightly injured [5]. In turn, a bus carrying doctors and nurses from the Dushanbe Hospital was attacked by a grenade launcher during the 1992–1997 civil war in Tajikistan. One of the workers was seriously injured and subsequently died [6]. In an interview with Meditsinskaya Gazeta, soldiers of the Khorog border detachment informed about attacks of vehicles with Red Cross symbols from Afghan territory, which was a gross violation of international law, or firing at doctors and paramedics by Tajik opposition fighters directly on the battlefield [7].

Vivid front-line reports from such places of major military conflicts in the post-Soviet space as Transnistria or Tajikistan amounted to a relatively small but factually significant percentage of publications in Meditsinskaya Gazeta. The report was commonly published shortly after the end of large-scale hostilities when a fragile ceasefire between the warring parties was established. The first report about the situation in Tiraspol and Bendery a month after Moldova’s unsuccessful attempt to resolve the dispute in Transnistria in a military way was published in the periodical in summer of 1992. According to the special correspondent Panyushin RY, the capital of the unrecognized PMR (Pridnestrovian Moldavian Republic) was a “quiet, flourishing city”, where only numerous armed fighters, evening curfew, night blackout, “the distant rumble of artillery fire” and new wounded who daily arrived at the military and republican hospitals (medical city) in Tiraspol from Bender, Rybnitsa, Grigoriopol or Dubossary reminded of the recent war [5].

Direct eyewitnesses recalled that the military hospital and medical city were operating in a disaster mode on the night of June 20, 1992, when Bendery were stormed by Moldovan forces. Over 20 people with gunshot or shrapnel wounds, burns and contusions obtained almost at the same time were admitted to the military hospital only [5]. Hospital director, lieutenant colonel of medical service Moskovchuk BF also claimed that due to a shortage of dressing and suture materials, as well as places to accommodate all the wounded, surgical teams “did not leave the operating rooms for days”, resting no more than 2–3 hours a day [5]. In those days, doctors placed stretchers with the wounded on the floor. A similar situation was observed in the medical city as its numerous employees who had left the place for a weekend later found themselves behind the front line and had to get to Tiraspol through Ukraine. The correspondent briefly noted that Bendery assault split the doctors of the republican hospital, as some of them chose to leave the city and abandon their duties. Panyushin RY refused to mention their names for ethical reasons [5].

According to this publication in Meditsinskaya Gazeta, there was a real full-scale war in Transnistria in summer of 1992. Only in the first two days, the hospital morgue received over 150 bodies of those killed during the fierce battles for Bendery, though it was designed for 5 places only. How to preserve the corpses in summer heat was a pressing issue. The correspondent of Meditsinskaya Gazeta later wrote that they “covered the entire courtyard of the pathology department as a terrifying carpet.” However, the head of the Republican healthcare department Semko A managed to find 3 refrigerators and solve the issue [5]. Attacks of unknown snipers were taken as another specific problem typical of wartime. A bullet of one of them hit the operating room of a military hospital in Tiraspol when surgeons were working, which later forced the staff to use night blackout [5].

The city of Bendery, which in summer of 1992 became the epicenter of the military confrontation between the armies of the Republic of Moldova and the unrecognized PMR, was severely destructed. The correspondent of Meditsinskaya Gazeta Panyushin RY, who got to the place with journalists from the USA, Canada, the Netherlands and Czechoslovakia, told readers and subscribers in close detail that the new building of the local maternity hospital, which was considered one of the best in the USSR, was destructed. During the city bombardment, a unique operating room with imported equipment was destroyed, an autoclave was burned, and a safe with documents of employees and an ultrasound machine by Toshiba were saved with great difficulty [5]. During the cease-fire that happened later doctors still traveled daily to the ruins of the maternity hospital in order to rescue the remaining medicines, tools and survived equipment. To do that, they needed regular consent from both sides of the Transnistrian conflict, both Cossacks and Moldovan policemen [5].

It is stated in the publication of Panyushin R that shortly after the end of the active phase of the confrontation the PMR was in a terrible condition from the point of view of sanitation and hygiene. Vice-President of the self-proclaimed Republic Karaman AM, who was a neuropathologist and traumatologist in the recent past, had an interview with a journalist from Meditsinskaya Gazeta where he described the consequences of the armed confrontation with Moldova as “simply catastrophic, comparable only to the first post-war years” for the USSR. They included not only 150,000 refugees from Transnistria, but also destruction of sewers, gas pipelines, sewage systems in Bendery and Dubossary, a sharp deterioration in water quality in the Dniester and, as a result, a ban on its use by the authorities [5]. The boarding school for psychochronics on the Kosice bridgehead faced a very tragic situation in those days. With the outbreak of hostilities, the supply of drinking water was stopped and the patients had to drink water from a fire reservoir. Due to that, 69 outbreaks of typhoid fever were reported here in summer of 1992 [5].

Taking into account all of the above, it is not surprising that special correspondent Panyushin RY asked rhetorical questions whether doctors could understand the “original criminality of any war” and scale of the tragedy of civilians in conflict zones [5]. He actually asked Russians to help the affected region in his article. His call was heard, and soon some paragraphs of Meditsinskaya Gazeta briefly informed the public about the serious humanitarian assistance provided to the civilian population of Transnistria by Russia, which was experiencing an acute socio-economic and political crisis in that historical period. The publication mentioned the facts in summer 1992 when the active hostilities in the region were ceased. In particular, the newspaper reported that a truck with 100,000 meters of gauze and medicines was sent from the citizens of St. Petersburg to Transnistria. The initiator was the infamous St. Petersburg businessman and politician, Chairman of Garant Joint Stock Company Baskin IM. A center collecting medical aid for the flashpoint was set up near Gostiny Dvor on Nevsky Prospekt, in the historical center of the Northern capital, and despite serious economic difficulties, a queue of citizens willing to help Transnistria, which suffered from military operations, was never-ending [8].

During these months, Moscow was active as well. In an interview with ITAR-TASS state news agency, head of the Medical Support Department of the Russian Red Cross Rescue Service Kashlev A announced arrival of a car with 350 kg of medicines and dressings totaling 80 thousand rubles from the closed city Arzamas-16 (now Sarov, Nizhny Novgorod region) to the capital. They were purchased by public organizations using the funds from city enterprises or voluntary donations from citizens [9]. Medical and preventive institutions in Moscow sent medicines and bandages to the city headquarters of the Red Cross as well. The most significant contribution was made by St. Vladimir’s Hospital (formerly City Clinical Hospital No. 2 named after Rusakov IV). Moreover, since the Transnistrian hospitals were overcrowded with the wounded and sick after the battles for Bendery, the Main Medical Directorate of Moscow formed medical detachments to work in the self-proclaimed republic for three months despite a shortage of medical personnel and working in almost front-line conditions. According to the correspondent of Meditsinskaya Gazeta, the main motivating factor in this case included a triple salary, the funds for which were personally allocated from the capital’s budget by the Mayor of Moscow Luzhkov M. (1936–2019). As the publication states, there were a lot of volunteers [4].

The following year, Meditsinskaya Gazeta continued to cover the professional activities of Russian doctors during conflicts in the post-Soviet space and published a long report from the Republic of Tajikistan (RT), engulfed in the bloody civil war. The special correspondent Smirnov F arrived in the flashpoint of the former Soviet Central Asia in February 1993 as part of a group of journalists from Russia, the USA, Japan, China, Germany and other countries. The trip was initiated personally by the Chairman of the Supreme Council of the Republic Rakhmonov ESh President of the Republic from 1994 till today, he also changed his name into Rahmon E starting from 2007). Thus, the later publication of Meditsinskaya Gazeta included clear signs of confrontation between Dushanbe and forces of the United Tajik Opposition (UTO), and a number of assessments of the difficult events in the republic were political and, therefore, one-sided [10].

For example, correspondent Smirnov claimed that most of the republic’s indigenous population blames the leaders of the Islamic opposition for the outbreak of the civil war in Tajikistan, as they “sowed the seeds of hatred in people’s hearts producing poisonous sprouts” [10]. According to the journalist, who referred to local intelligence services, Tajik opposition used the long-standing mutual distrust of residents in various regions of the republic and set them on each other. They tried to create the so-called Islamic hospitals. To do that, they forced out of medical institutions those leaders and doctors who did not share their religious and political beliefs or belonged to ethnic minorities of the republic. For example, 23 Tajik doctors from the state farm named after the XXV Party Congress of the Kurgan-Tyubinsk region started a strike that lasted about three weeks and ended with dismissal of the local chief physician, an experienced Uzbek specialist [10]. In the autumn of 1992, armed opposition members kidnapped the chief physician of a district polyclinics in the same region, and at the time of the publication of the article his fate was still unknown [10].

The journalist of Meditsinskaya Gazeta believed that the actions of the Islamic opposition destructed the economy. For example, Turkmenistan state farm, that was established in the semi-desert during the Soviet period and appeared to be one of the largest state farms in the republic of those times, was destroyed: out of more than 10,000 employees, only a few remained, almost all residential buildings were destroyed, and the cotton crops of 1992 was never harvested. The state farm was turned into a base of opposition formations, which blocked roads in the area, carried out numerous brutal reprisals against those who were objectionable and committed other illegal acts. References to transformation of the former House of Culture of the state farm into a concentration camp, and the bath into a torture chamber, killing prisoners with steam containing a high concentration of chlorine, and shooting dozens of civilians in water treatment facilities of the former state farm could have resulted in direct associations with the actions of the Nazis in the Soviet Union during the Great Patriotic War of 1941–1945.[10]. The journalist asked a rhetorical question whether it was possible to forget and forgive such crimes, and also reminded of the fate of Sharipov S, the ambulance driver from the Kulyab district center. A representative of a rather peaceful profession had to enter military service in the detachments of the governmental National Front and become an armored personnel carrier driver because he did not want his children to go through the same events again.

Smirnov F believed that outbreak of infections in Tajikistan could be another purely medical consequence of the civil war here. An outbreak of heliopropic hepatitis was recorded at the end of 1992 In some parts of the south Khatlon region. Up to 5 thousand cases of this disease were registered here with over 700 people being its victims [10]. According to the special correspondent of Meditsinskaya Gazeta, the reason was an acute shortage of food in the south of Tajikistan due to the prolonged blockade by the Islamists. Local farmers could harvest wheat later than usual. That’s why the grain was poisoned by heliotrope, a poisonous weed. Many collective and state farms in the south of the country were affected. Bread made from unrefined wheat led to the outbreak of the disease. It should be noted that all the patients accused the opposition of poisoning the grain. According to Smirnov, the disease was extremely difficult and painful for the patients as their liver function was disturbed resulting in accumulation of a large amount of fluid in the abdominal cavity and extensive balloon-like stomach swelling [10].

Tajik authorities had to send patients to local hospitals, outpatient clinics, schools, kindergartens and hotels, whereas the most serious patients were referred to the Republican Institute of Gastroenterology or medical institutions in the city of Dushanbe. Minister of Health of the Republic Akhmedov A and leading gastroenterologists went to the affected regions on a regular basis to provide aid to local doctors. In that difficult situation, assistance to Tajikistan was provided by the near and far abroad countries, and representatives of the International Red Cross and Red Crescent. Thus, doctors from neighboring Uzbekistan equipped a mobile hospital with 50 beds in regions with an epidemic outbreak [10]. The help of the main ally, Russia, was also important to fight the disease as well. In February 1993, the Minister of Defense of the Russian Federation, Hero of the Soviet Union, General of the Army Grachev PS (1948–2012), personally visited Tajikistan, after which units and subunits of the Russian army stationed in Tajikistan donated up to 8 tons of medicines to the population of areas affected by heliotropic hepatitis [10]. The head of the military hospital in Dushanbe Gafarov A later delivered humanitarian aid to the Parkhar regional hospital and personally allocated 5,000 rubles for the needs of the residents. His subordinates followed the example [10]. Joint efforts helped them to achieve a positive result in the fight against a serious illness.

A significant part of the mentioned newspaper report from the flashpoint was devoted to a story about functioning of the Republican Clinical Hospital named after Dyakov AM (Dushanbe) at war time. By the beginning of February 1993, up to 80 patients with heliotropic hepatitis were found in the hospital with children being about half of them [10]. The journalist of Meditsinskaya Gazeta referred to the relevant reviews of the patients and provided good references about the work of the hospital staff as the doctors of the named medical institution were able to provide truly qualified assistance to the sick. Treatment included strict bed rest, a diet rich in proteins and carbohydrates, vitamin therapy, hepatoprotectors, diuretics, detoxification, and, if necessary, hormonal drugs. The civil war left its trace as in addition to patients with heliotropic hepatitis, 30–40 patients in the hospital had gunshot wounds as victims of recent night clashes [10]. Smirnov stressed that the situation was even worse in November-December 1992. All medical institutions in Dushanbe were overcrowded with the wounded, and the ambulance service in the city was almost paralyzed due to the lack of gasoline and the doctors’ fear of armed gangs [10]. In an interview with Meditsinskaya Gazeta, the therapist of the republican hospital Tiloev A reported a widespread occurrence of diseases such as pneumonia, bronchitis, peptic ulcer, protein starvation and influenza. He said that the reasons were the recent heavy fighting in Dushanbe and, as a result, the presence of numerous refugees, decreased immunity among citizens due to severe stress, shortage of food and medicines and antibiotics, in particular. Tiloev stated directly that “only humanitarian aid is saving us so far” [10], including aid from Russia.

The press of those times paid significant attention to high qualification and professional success of Russian doctors in the flashpoints of the post-Soviet space. For example, a report by Meditsinskaya Gazeta from Tajikistan provided details on the activities of a military doctor, Captain Krysenko O. He was a graduate of the Military Medical Faculty of Tomsk Medical University, served in the amphibious assault maneuver group (AAMG) of the Russian border troops deployed in the mountainous republic and was awarded medals “For bravery”, “For service in Tajikistan” and “For distinction in military service” of the first degree for his two-year service. The military service of Krysenko O. in Central Asia was extremely difficult. According to correspondent of Meditsinskaya Gazeta Papyrin AL, that person and other fighters of AAMG were surrounded by Tajik opposition fighters. In the highlands, even a common military campaign of border guards in full combat gear often led to the need to provide first aid due to sprains, hematomas, or acute gastroenterocolitis. Doctor Krysenko succeeded in that as well [6].

An episode of the medical officer’s military activity was mentioned in Meditsinskaya Gazeta. The events on the Tajik-Afghan border were referred to as a “warfare”, which was “not only armed and open, but also mine and terrorist”. The publication had to prove the thesis [6]. During a military operation in the Yazgulem gorge in September 1994, Krysenko accompanied the AAG, which found an enemy refuge in a cave near the ruins of Safi Sang border village. The main forces of the Tajik and Afghan Islamists retreated, Russian military got abandoned equipment and ammunition as a trophy, and one wounded militant was detained. However, a land mine explosion killed 6 border guards, and seriously injured 3 more of them [11]. Lieutenant Yefremov who obtained “very skillfully and competently provided first aid” from military doctor Krysenko was among the wounded. The doctor “treated and bandaged multiple wounds on the left side of his face, neck, limbs, and chest.” The wounded officer was subsequently taken to the hospital of the Russian border troops in Dushanbe by helicopter, where military surgeons from the Central Hospital in Golitsyn saved his life [6].

The medical specialists who served as part of the Group of the Federal Border Service in Tajikistan in the 1990s actually agitated for the presence of Russia in the flashpoint of the former Soviet Central Asia. According to correspondent of Meditsinskaya Gazeta Papyrin AL, staff of the first district hospital of the Russian border guards in Dushanbe provided assistance to the injured and sick soldiers of the Tajik army regardless of where they came from [12]. It should be noted that it was not a simple thing to do. A local civil war of 1992– 1997 was largely a clan warfare, and most of the border troop personnel included local residents due to its chronic shortage. Unlike the local islamists, Russian military doctors tried to help absolutely all patients, sometimes even the UTO, the enemy.

Even the Tajikistan and Afghan frontier intruders obtained qualified medical assistance. One such patient, an Afghan who received a gunshot wound while trying to cross the Panj River, was found by Meditsinskaya Gazeta journalist at the medical center of the Khorog border detachment [7]. Meanwhile, the enemy failed to display similar noble qualities. In those years, the service of military doctors in Tajikistan was far from being safe. According to Konev D, who was the head of the Department of Traumatology surgery at the military hospital in Dushanbe, Russian doctors were once surrounded by the UTO militants during a mandatory monthly business trip to the Panj border river. Meanwhile, Konev’s friend, a doctor at the Central District Hospital, was killed by local armed opposition members “because he helped everyone,” and not just supporters of the official government of the republic [12]. It should also be noted that in spring of 1995, the UTO militants seized a truck with seriously wounded soldiers during full-scale hostilities at the Dashti-Yazgulem border post. Then they beat and almost shot Abdullobekov M, a Tajik surgeon at the Khorog hospital, accusing him of betrayal. The doctor could avoid death only because one of the militants, whose wife had been previously successfully operated by Abdullobekov, stood up for him [7].

Covering the armed conflicts in the post-Soviet space in the 1990s, Meditsinskaya Gazeta focused on a number of aspects. Firstly, the publication preferred to appeal not to the state interests of Russia, but to general humanistic issues. It differed from the public statements of politicians. Thus, describing the incident with shooting of a convoy of Ossetian refugees on the Zarskaya road by Georgian militants on May 20, 1992, the newspaper noted that “… shots fired on the Georgian Military Road are shots at us” [13]. The editorial board of Meditsinskaya Gazeta later emphasized that it provided financial and organizational assistance to Golub L, an engineer from Tiraspol, whose sick son required to purchase a medicine at Moscow pharmacies. The reasons of the journalists were extremely simple and humane: “We  all lived peacefully and amicably so far. We had enough freedom and territory’. At the end of the note, the woman and her son were wished to survive the Transnistrian crisis [14]. Having returned from Tajikistan, journalist Smirnov F also asked Russian readers to display compassion for the residents of this republic and other CIS flashpoints who got into trouble [10].

Secondly, the aim of the newspaper was to become a  tribune inviting all doctors of the post-Soviet space to take active action and join forces in the anti-war struggle. In particular, a telegram entitled “Pain breaks our hearts” signed by the Minister of Health of Uzbekistan Karimov Sh and other famous Uzbek doctors was published on the first page of the May Day issue of Meditsinskaya Gazeta in 1992. They asked medical professionals from the CIS countries to help politicians settle conflicts in Nagorny Karabakh, South Ossetia and other regions of the former USSR. The signatories demanded “to stop the slaughter and solve problems in a civilized and peaceful way,” for which they proposed “to gather in one of the republics, discuss the situation and act as one against violence and slaughter” [15].

Following the outbreak of violence in the Prigorodny district of North Ossetia [16] six months later, the Minister of Health of Kabardino-Balkaria Berov ML called for the creation of a movement of doctors against ethnic hostility [17]. The editorial board of Meditsinskaya Gazeta fully supported his call, stating that the goal of the medical profession is “not to start, but to extinguish the resulting fire flames” [17]. The same idea was mentioned by special correspondent in Nalchik Bliev Yu [18]. To confirm their words, photographs of Kosints A, correspondent of ITAR-TASS agency, taken on November 8 of 1992, were published in the newspaper issue of November 20, 1992. The photos captured the military everyday life of North Caucasus with dozens of corpses of the Ingush residents in the square of the Progorodny district in Nazran, a temporary capital of Ingushetia. Dinner for refugees at the field kitchen of the Russian military unit in Vladikavkaz was displayed there as well. A  few months later, the organizing committee of Doctors against Violence, Interethnic Conflicts and Civil Wars International Movement published an appeal in Meditsinskaya Gazeta on March 24, 1993 to the presidents, parliaments, and governments of all post-Soviet countries, especially the Russian Federation, to “find a way to harmony and nonviolent resolution of contradictions” [19]. The organization confirmed its peaceful intentions during the war campaign of 1994–1996 in Chechnya [20]. Thus, a peaceful and humanistic attitude was clearly expressed in the publications of Meditsinskaya Gazeta devoted to the armed conflicts of the post-Soviet space of the 1990s. The publication presented doctors as true peacemakers who were able to stop violence between former compatriots.