Ukrainian Meat Grinder - As Russian forces poured across Ukraine's borders, Palich knew pain, suffering and injury would follow in the war that followed, and his training as a paramedic would be necessary.
"I couldn't sit on the sidelines, so I went to the front as a volunteer," says Palich, the warrior name of the 35-year-old medic working near the front line in the eastern Ukrainian city of Bakhmut.
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Day after day, he and his team circled the front, picking up the wounded and rushing them to the main hospital in Bakhmut, just a few kilometers from the contact line.
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"It's always scary," he told AFP during a recent trip transporting a wounded soldier suffering from a brain injury and a broken leg from Bakhmut to a nearby medical center in the town of Chasiv Yar.
Once famous for its vineyards and cavernous salt mines, Bakhmut has been called a "meat grinder" because of the brutal trench warfare, artillery duels and frontal assaults that have defined the battle for the city over the past six months.
On the Russian side, mercenaries, prison soldiers and newly mobilized soldiers are believed to make up the fighting forces that have launched the waves of attacks on Bakhmut.
Ukrainian forces are largely located in and around the city, including mud-soaked trenches that bisect tight stretches of land battered by relentless shelling.
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"We can compare the fighting to World War II, as (both sides) use standard methods of conducting combat operations without any special technological means," said Sergiy Zgurets, a military analyst at Defense Express Media & Consulting Company.
Yevgeny Prigozhin, the founder of the Russian mercenary group Wagner, which is helping in the fight, said his forces were focusing their efforts primarily on destroying the Ukrainian military.
"The Ukrainian army is well prepared and is offering good resistance," the Kremlin-linked businessman said in a recent statement released by his company, Concord.
"Our task is not Bakhmut itself, but the destruction of the Ukrainian army and the reduction of its combat potential, which has an extremely positive effect on other areas, that's why this operation was called the "Bakhmut Meat Mill".
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Nine months after the conflict began, frontline medics have become hardened battle veterans, for many a marked departure from their previous lives.
Before the war, Malish was a transport driver - just a 'regular' job, which he left to join an ambulance team after the invasion in February.
"I pray to God that things will slow down in the coming days. I wish we didn't have jobs like this at all," says the ambulance driver as he waits outside Bahmut's main hospital.
The facility is the first stop for many of the wounded at the front. The explosion of artillery, mortars and Grad rockets, along with the rumble of nearby tanks, echo through the streets surrounding the hospital as ambulances deliver patients to waiting doctors.
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Blood-stained stretchers lined the walls, where at least two black body bags could be seen when AFP visited.
"The hardest thing for any doctor is when 300 [injured patients] turn into 200 [deaths]," Maryana, a 30-year-old anesthetist, told AFP during a shift break, using Soviet-era military code words.
"Our morale is high, but physically it can be difficult when we have many injured in a shift.
In recent days, a number of young doctors have arrived in Bakhmut after being moved from the southern front near Kherson, where a Ukrainian counter-offensive managed to liberate the city.
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For many, the fighting in Bakhmut is some of the worst they have ever seen. "Before coming here, we worked in the Kherson region. It was difficult, but not that difficult," says an ambulance driver with the call sign Octan.
After the liberation of Kherson, the epicenter of the war shifted strongly to the Eastern Donbas region, where Bakhmut is located.
The smaller front line and greater density of forces paved the way for fierce fighting in the open steppes of Donbass, in the pine forests and on the outskirts of cities like Bakhmut.
Posts on pro-Kremlin social media swirled with speculation about the continued Russian advance around the city, along with ultimatums aimed at Ukrainian units at risk of encirclement.
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"Even if Russian forces were indeed able to take control of the settlements south of Bakhmut, these gains do not threaten critical lines" of supply to the city used by Ukraine, the Institute for the Study of War said in an assessment released this week.
Maintaining the line is likely to be costly, putting additional pressure on medical teams on the ground.
But for Palich and other first responders, the gruesome nature of the job gives them a chance to push forward.
"If this saves even one life of a soldier who will later join the ranks, then my work has not been in vain," he says.
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"I couldn't sit on the sidelines, so I went to the front as a volunteer," says Palich, the warrior name of the 35-year-old medic working near the front line in the eastern Ukrainian city of Bakhmut.
Day after day, he and his team circled the front, picking up the wounded and rushing them to the main hospital in Bakhmut, just a few kilometers from the contact line.
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"It's always scary," he told AFP during a recent trip transporting a wounded soldier suffering from a brain injury and a broken leg from Bakhmut to a nearby medical center in the town of Chasiv Yar.
Once famous for its vineyards and cavernous salt mines, Bakhmut has been called a "meat grinder" because of the brutal trench warfare, artillery duels and frontal assaults that have defined the battle for the city over the past six months.
On the Russian side, mercenaries, prison soldiers and newly mobilized soldiers are believed to make up the fighting forces that have launched the waves of attacks on Bakhmut.
Ukrainian forces are largely located in and around the city, including mud-soaked trenches that bisect tight stretches of land battered by relentless shelling.
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"We can compare the fighting to World War II, as (both sides) use standard methods of conducting combat operations without any special technological means," said Sergiy Zgurets, a military analyst at Defense Express Media & Consulting Company.
Yevgeny Prigozhin, the founder of the Russian mercenary group Wagner, which is helping in the fight, said his forces were focusing their efforts primarily on destroying the Ukrainian military.
"The Ukrainian army is well prepared and is offering good resistance," the Kremlin-linked businessman said in a recent statement released by his company, Concord.
"Our task is not Bakhmut itself, but the destruction of the Ukrainian army and the reduction of its combat potential, which has an extremely positive effect on other areas, that's why this operation was called the "Bakhmut Meat Mill".
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Nine months after the conflict began, frontline medics have become hardened battle veterans, for many a marked departure from their previous lives.
The explosion of artillery, mortars and Grad rockets along with the rumble of nearby tanks echo through the streets ANATOLY STEPANOV AFP
Before the war, Malish was a transport driver - just a "regular" job that he left to join an ambulance crew after the invasion in February.
"I pray to God that things will slow down in the coming days. I wish we didn't have jobs like this at all," says the ambulance driver as he waits outside Bahmut's main hospital.
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The explosion of artillery, mortars and Grad rockets, along with the rumble of nearby tanks, echo through the streets surrounding the hospital as ambulances deliver patients to waiting doctors.
Blood-stained stretchers lined the walls, where at least two black body bags could be seen when AFP visited.
"The hardest thing for any doctor is when 300 (injured patients) turn into 200 (deaths)," Maryana, a 30-year-old anesthesiologist, told AFP during a shift break, using Soviet-era military code words. .
Our morale is high, but physically it can be difficult when we have many injured in a shift", she adds.
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In recent days, a number of young doctors have arrived in Bakhmut after being moved from the southern front near Kherson, where a Ukrainian counter-offensive managed to liberate the city.
"Before coming here, we worked in the Kherson region. It was difficult, but not that difficult," says an ambulance driver with the call sign Octan.
After the liberation of Kherson, the epicenter of the war shifted strongly to the Eastern Donbas region, where Bakhmut is located.
The smaller front line and higher force density paved the way for fierce fighting across the Donbass
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