Ukraine's scrappy wartime innovation

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0:36Since Russia mounted its full-scale invasion of Ukraine nearly four years ago, the losses for the country and its people have been enormous. Nearly 14 ,000 civilians have died. Fighting has led to hundreds of thousands of battlefield casualties. Russia now occupies some 20 % of Ukrainian territory. 3.7 million people are internally displaced, and nearly 7 million people have fled Ukraine because of the war. Consider this. Ukraine has suffered devastating losses because of the war with Russia, but that conflict has inspired technological advances that are leading to better weapons and better treatments for the soldiers injured in battle.

1:28From NPR, I'm Juana Summers.

1:39It's Consider This from NPR. NPR's national security correspondent Greg Myrie spent the summer reporting on the war in Ukraine. He saw the devastation of the conflict, but he also saw something else. Ukraine leveraging its resources at home to meet the moment, including in Lviv, where they are racing to make as many of their own weapons as fast as they can.

2:01Greg Myre:The emerging arms industry here is on display at an odd place, an underground parking garage beneath a gleaming new office building known as Lviv Tech City. Conference organizers chose this secure space so the event couldn't be disrupted by one of Russia's frequent airstrikes. We're a Ukrainian company. We're building drones, all different kinds of drones. Maxim Yakovlev is with the Armsmaker Freedom Group. Many Ukrainian drones are used only once, flying into a Russian target and exploding. This one on display is a high-end model. It has six propellers, carries 30 pounds of weaponry, and can be reused.

2:43So it's heavy drones, which flies and carries grenades and explosives and throws us into the target and comes back.

2:52Greg Myre:When Russia launched its full-scale invasion in 2022, Ukraine's arsenal consisted largely of aging hardware, dating back decades when Russia and Ukraine were both part of the Soviet Union. Ukraine burned through those stockpiles at a furious pace and then became dependent on U.S. and European weapons. Now, Ukraine makes many of its own. Yaroslav Ajnouk runs two tech startups. Well, I lived in Silicon Valley for six years. I went through a very classic startup journey. In California, he launched PetCube, a company that makes cameras to keep watch on pets. He brought that expertise back to Ukraine and now makes cameras for drones.

3:34Greg Myre:He says Ukraine is rapidly emerging as a Silicon Valley for the defense industry. Ukraine today is the defense value of the world. This has already happened. You sit in a cafe in Kiev and you meet one defense founder, and then 30 minutes later, another defense tech founder passes by. The energy here is just incredible. Ukraine's President Volodymyr Zelensky says the country makes at least 40 percent of its own weapons, including virtually all of its own drones. The country had no real drone industry three years ago. it's expected to make 4 million of them this year. The latest models travel hundreds of miles, striking Russian oil refineries and causing significant damage to that country's most important industry.

4:22Greg Myre:Aleksandr Mareshko is a member of Ukraine's parliament and heads the Foreign Affairs Committee. We are outnumbered. Russia has more human resources. That's why we need more sophisticated weaponry to make up for this difference, to fill this gap. Ukraine still relies on the U.S. for its most powerful weapons, such as the Patriot Air Defense System and F-16 fighter jets. President Trump has halted U.S. military aid to Ukraine, but he says the U.S. will sell American weapons to NATO countries, which can then give them to Ukraine. This is happening, though, on a limited scale so far. So Ukraine is starting to make its own heavy weaponry.

5:02Greg Myre:The current buzz centers on the Flamingo, a cruise missile that can travel 1 ,800 miles. Some skeptics think the Flamingo may be overhyped, but if it performs as advertised, Ukraine will have the ability to strike deep inside Russia with a large weapon. Again, Aleksandr Mareshko. In terms of military technologies, we are not a burden for NATO, for Europe, and for the United States. We are a very good partner, very promising partner. For now, Ukraine's arms makers are relatively small and in need of foreign investment. Yet Yaroslav Oznuk sees potential. There is a big, big financial opportunity for the investors to come here.

5:47You know, Ukraine is this wild east. It's the eastern frontier of the Western civilization.

5:52Greg Myre:Outside help is welcome, but he knows much of the work in the near term is up to Ukrainians like himself.

6:05Greg Myrie continues his reporting from a hospital in central Ukraine near the front lines. It is so old, it treated wounded soldiers during the Crimean War in the 1850s. Yet, Metchnikov Hospital plays a critical role in the current Russia-Ukraine war, where traumatic brain injuries are all too common. With some help from U.S. doctors, Ukraine's neurosurgeons are conducting state-of-the-art operations with cutting-edge technology.

6:31Greg Myre:Metchnikov Hospital is just 60 miles from the front line of the Russia-Ukraine war. When Ukrainian troops suffer serious head injuries, and many do, this is where they need to come as fast as possible. The Medical Hospital, our rules, we need to start surgery in the first two hours after admission. Just two hours after admission, much faster than most places. And that's Andrei Sirko, the head of neurology, who handles the most complex cases. He's carried out 2 ,000 operations since Russia first attacked in 2014. The huge number of casualties and the severity of the wounds forced Dr. Sirko and his team to develop new ways of rapidly handling brain injuries, most now caused by Russian drone strikes.

7:21We implemented a new strategy named comprehensive surgery.

7:27Greg Myre:Traditionally, a soldier with multiple brain injuries might endure several separate operations over many days. This could involve drilling a hole in the skull to relieve pressure from brain swelling, removing shattered skull fragments, and delicate repair work on damaged blood vessels. At Menschnikov, all this may be done in a single surgery.

7:52Greg Myre:However, the hospital's proximity to the front line also carries risk. This shattered glass inside the hospital is the immediate aftermath of a Russian missile strike last October. Dr. Sirko's 27-year-old son, Dr. Bodan Sirko, is also a neurosurgeon. He was operating on a patient at the time. It was big bomb and it was like whistling of air I never feel before. When you open your eyes, I think, okay, maybe I'm dead. The blast shattered windows and shrouded the operating theater in dust and debris. Everything is like gray. My nerves was like fall down. And they say, okay, you just, everything is okay.

8:39I finished this operation.

8:41Greg Myre:This hospital in the central city of Dnipro was established in 1798. It proudly boasts one building, still in use, that treated Russian soldiers in the Crimean War, which ended with Russia's defeat in 1856. At the time, the region was part of the Russian Empire. Walking the crowded halls today is to travel through a time capsule from the Soviet Union. The main colors are dull gray and drab brown. Chairs are scarce and worn bare. The elevator groans as it strains to reach the next floor. Then you peek inside an operating room. What I was amazed is that they had so much more capability than what we had in Iraq and Afghanistan.

9:24Greg Myre:Dr. Rocco Armanda is a neurosurgeon and a retired U.S. Army colonel who spent more than a decade serving in the Middle East and at Walter Reed National Military Medical Center. He operated on hundreds of U.S. troops with traumatic brain injuries, learning and pioneering new techniques over the course of the U.S. wars. He describes Metchnikov Hospital this way. It's like if you had transported Walter Reed within an hour of the front line. They're so close to the battlefield and doing amazing, heroic work. But just for comparison, two days in Ukraine is equivalent to the worst month that we had in Iraq.

10:07Greg Myre:Dr. Armanda, now at Georgetown University Hospital, has traveled here three times in the past two years. He hauls supplies to the hospital and assists on operations. He's also helped it acquire multi-million dollar equipment. He's most impressed by what Ukrainian surgeons learned long distance from Americans and from their own war experience at home. They took it one step further. They took devices that we would use, let's say, to treat a civilian aneurysm emergency, and they applied it to wartime injuries. In short, I was teaching them some things, but I think I was doing a lot more learning than teaching.

10:46Greg Myre:In his cramped office, Dr. Andre Sirko opens a plastic bag with shrapnel he's removed from the brains of patients. He pours the contents on his desk. Different patients. One patient's a bullet. Another is a metallic splinter, A green piece of metal is the size of a credit card. That patient, Dr. Sirko says, is doing reasonably well. Then he displays a tiny pellet the size of a pea. This patient died, he explains. War is random. Outside his office, the hallway is now filled with patients. He has six more surgeries planned for the week. That was NPR's Greg Myrie in Dnepro, Ukraine.

11:40This episode was produced by David West and Matt Ozug. It was edited by Andrew Sussman. Our executive producer is Sammy Yenigan.

11:52It's Consider This from NPR. I'm Juana Summers.

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