“It’s do or die”: Ukraine’s battlefield evacuation system is on the brink of collapse

Time is running out to save the vital NGO evacuating wounded Ukrainian soldiers from the frontlines.

It all began with one ambulance and an army of volunteers. Soon after Vladimir Putin launched Russia’s brutal invasion of Ukraine on 24 February 2022, an NGO called MOAS snapped into action. The organisation’s founder, Christopher Catrambone, went to Ukraine and mobilised a team of heroic doctors, paramedics and drivers with a single purpose: to evacuate Ukraine’s critically injured soldiers fighting on the frontlines of the country’s war with Russia.

Fast forward more than two years later and MOAS has grown to become a vital part of the Ukrainian army’s casualty evacuation (“casevac”) operations. Today, the NGO presides over a fleet of 50 state-of-the-art ambulances and a team of 150 full-time medics, while its courageous casevac operations have saved the lives of at least 62,000 Ukrainian soldiers – and counting.

In the most difficult of conditions, MOAS has consistently provided these wounded troops, many of whom have sustained life-threatening injuries, with vital emergency medical attention. In the process, it has become an indispensable part of Ukraine’s war effort, stepping in to offer lifesaving support for military personnel that the country’s cash-strapped government is unable to provide.

Every week, MOAS’s brave staff carry out 500-700 casevac operations, risking their own lives to extract severely wounded soldiers from some of the most dangerous battlefields of the war and take them to safety. This has enabled thousands of young men and women to recover from their injuries and continue defending their country, either by returning to the battlefield or serving in supporting roles behind the lines.

Now, however, MOAS itself faces an existential threat. After relying on generous private donors to fund its vital work for nearly three years, the NGO has exhausted its funds. Without emergency funding, the group will be unable to pay its staff and will have to close down its operations. If new funds are not forthcoming, MOAS will have to suspend its work at the end of the year.

MOAS says that it “is now in urgent talks with all its donors in North America and Europe to keep the lifesaving operation on the road.”

The organisation has also approached the British government for help. “We’re in talks with the UK government which we desperately hope will bear fruit,” says Christopher Catrambone, the founder of MOAS, who has been based in Kyiv since the start of Russia’s full-scale invasion.

The NGO is asking for $6 million (£4.7 million) to keep its operations afloat for the next 6 months. It says that $1 million (£785,000) – roughly the cost of one Storm Shadow missile – is enough to cover its monthly costs.

When asked why the British government – and taxpayers – should provide a financial lifeline to MOAS’s Ukrainian operation in its hour of need, Catrambone told Reaction: “The UK has been an extraordinarily generous supporter of Ukraine since the full-scale war started. Both the British government and the British public together understand the importance of standing up to the worst aggression in Europe since the Second World War.”

Catrambone continued: “Due to the unique circumstances of this devastating war, MOAS has become the Ukrainian army’s main critical casevac provider – meaning we evacuate the most severely wounded soldiers, day in, day out – and after three years of support from wealthy donors, we have now run out of money.”

“That’s why we are appealing to the British government for urgent support. $6 million will keep the life-saving operation going for another six months. Without that money, I’m sorry to say it, but many more Ukrainian soldiers will die.”

The financial difficulties faced by MOAS come at a challenging time for Ukraine and its war effort in general. The incoming Trump administration is expected to scale down United States military and financial support for Kyiv after it takes over the reins of government on 20 January, and analysts are sceptical that European nations will succeed in filling the funding gap.

A recent report by the Kiel Institute has warned that, from the start of next year, Ukraine could face a significant shortfall in aid. It notes that humanitarian aid from NATO countries in particular remains low, at around €0.2 billion in July 2024 and less than €0.1 billion in August.

In this context, the continued functioning of Ukraine’s casevac system will be of vital importance.

Catrambone said: “The facts are simple. If we have to stop our operation, huge numbers of Ukrainian soldiers will die. In the words of a Ukrainian general, it will be a complete catastrophe. They’re overstretched and cannot do what we do. Nor can any other NGO in Ukraine. That’s why today we are launching this urgent appeal for support. It’s our last throw of the dice, it’s do or die.”

With the winter setting in on the battlefield and Russia redoubling its efforts to grind Ukrainian forces into submission, casualty evacuations are as important to Ukraine’s war effort as ever. If MOAS cannot secure the new donations required to continue its lifesaving operations, the cost on the ground in Ukraine will be grave.

Time is running out to save Ukraine’s casualty evacuation system.