CNN<\/figcaption><\/div>\n<\/div>\n<\/div>\n Oleksandr said the vast majority of his patients, some 90%, have suffered multiple shrapnel injuries. Many have had amputations, and several are intubated, alive thanks to ventilators and other life-support machines. All have numbers written on their hands showing which car of the long evacuation train they need to travel on. <\/p>\n
\u201cWe are very limited in our capabilities here\u2026 If something happens, I cannot call an outside consultant,\u201d he said. <\/p>\n
\u201cThere may be minor operations, to stop bleeding. We cannot perform abdominal\u2026 and chest surgeries. We have to be very careful when selecting the patients,\u201d he added. <\/p>\n
Yevgeniy was severely wounded in a drone attack just two days before he was selected for evacuation on the ICU unit of the train. <\/p>\n
The railway hospital is an example of the kind of Ukrainian ingenuity that impressed the world in the early months of this conflict. <\/p>\n
To limit rocking, the vehicle travels at about 80 kilometers (50 miles) per hour, which is about half the speed of a regular train. It also has priority over everyone else \u2013 including any special VIP trains carrying foreign dignitaries. <\/p>\n
Even so, the ICU unit is constantly shaking. Every piece of equipment, every bed and every beeping machine needs to be anchored to the floor and the staff must take extra care when working on the patients. <\/p>\n
Ambulance trains were first used during the Crimean War in the 1850s, but they have come a long way since then. The modern Ukrainian versions come equipped with ventilators, life support machines, ultrasound scanners and portable air conditioners that help maintain stable temperatures even on the hottest days. <\/p>\n
Each carriage is a self-sustained unit powered by generators \u2013 an important safety feature given the frequent Russian attacks on Ukraine\u2019s energy infrastructure, Pertsovskyi said. <\/p>\n
But it is the little touches that make these trains truly special. <\/p>\n
Children\u2019s drawings and Ukrainian flags are on display in every car, offering some comfort to the bruised and battered passengers. The blind brackets on every window are shaped as a trident, the country\u2019s national symbol, placed deliberately in the eyeline of soldiers lying in their beds. <\/p>\n
The train provides a small window into the brutal cost of war. Experienced warriors and new recruits are traveling together, united by injury and pain. <\/p>\n
\u201cThey dropped a grenade. I was stunned. I have shrapnel in my hands, on my shoulders and on my back,\u201d he said, adding that the blast wave damaged his hearing. <\/p>\n
An electrician and a father of two, the 35-year-old was mobilized 18 months ago and was serving as an anti-tank gunner in an infantry battalion in the Donetsk region. In all that time, he has spent just 45 days away from the frontlines. <\/p>\n
\u201cMorale is high, but people are very tired,\u201d he said with a blank stare, as the train kept chugging along. <\/p>\n
\u201cAt this point you realize that everything depends not on you, but on God. Or on luck. When the bombs fall, there is not much you can do about it.\u201d <\/p>\n
It was a sobering assessment from a man with the callsign \u201cPositive.\u201d <\/p>\n
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Ukraine\u2019s President Volodymyr Zelensky has long admitted that the military is struggling to replenish its ranks, leaving exhausted soldiers without a chance to rest. <\/p>\n
At a news conference last month, Zelensky said this effort to recruit more soldiers was gathering steam. \u201cSome rotations have started. I can\u2019t call it fundamental rotations yet, to be honest. But it\u2019s a start, and that\u2019s very important,\u201d he said. <\/p>\n
Sitting just a few beds away from Oleksandr was Stanislav, who enlisted voluntarily just three months ago. He was also wounded by a drone that dropped into his trench, leaving him with a punctured lung, broken ribs and other injuries. <\/p>\n
Wearing a sports jersey and shorts, he was adamant Ukraine would win the war, despite being outnumbered and outgunned by Russia. <\/p>\n
\u201cThey use quantity, and we use quality,\u201d he said. <\/p>\n