A blinding flash, and his legs were lying on the ground. Unattached

Warning: this blog contains images readers may find distressing

What better than to phone mum at the end of another long and trying day at work?

After clocking off at the heating company he works for, Yuri Koryagin was already on the phone as he walked the familiar route out, through the front entrance and into the street near Horlivka.

Then a white blinding flash. Then stunned deafness for a few moments. He recalls he then looked around. He noticed he was on the floor and his legs were lying on the ground. Unattached to him.

The next thing that happened was someone approached, looked at him, bent down, stole his mobile phone and legged it.

But the call to mum ended up saving his life. Hearing the bang and living with months of shelling, she called the ambulance, knowing just where he was.

By the time the paramedics came, some other of Yuri’s compatriots had decided there is more to first aid than thieving: they’d applied rudimentary tourniquets and by some miracle he did not bleed out.

But now he lies on the battered old bed inside the grim Hospital 2 in Horlivka, the constant rumbling of the battle for Debaltseve ever present in the distance 10 miles east.

Yuri Koryagin saw a flash, leaving work whilst phoning his mum. Both legs amputated after shell burst. pic.twitter.com/isg7n5HIrs

— alex thomson (@alextomo) February 17, 2015

As is the pain. Real pain and phantom pain- the torment of amputees – and no effective drugs to deal with it.

Dr. Michael Roesch, an NHS surgeon in secondment to Médecins Sans Frontières‎, patiently spells out the right drug to Yuri’s sister.

Read more: bodies, shells and snow in the ruins of Donetsk airport

She has no idea where she might buy it: “I’m sorry, I have only been here a week or two. I really just don’t know.”

The quietly spoken Austrian had been doing hip replacements in the calm, comforting, in fact luxurious conditions of a UK NHS hospital in Shepton Mallet, Somerset, until volunteering to come to eastern Ukraine.

“We have been completely overwhelmed here. The hospital simply isn’t equipped for this level of trauma surgery. We had 65 cases here on Friday and several amputees.”

Michael Roesch of #MSF is volunteering at the #Ukraine frontline hospital-says shocked by all the shell fire injuries pic.twitter.com/JdELcAfH5w

— Stuart Webb (@Worldwidewebb1) February 17, 2015

For patients like Sergei – a wounded rebel fighter -the prognosis may be typically deceptive. With two broken femurs after his armoured vehicle was shelled, he has survived the immediate trauma.

But high-velocity battlefield trauma injury is as much about sepsis as it is about surgery. The wounds are violent in terms of initial force but almost inevitably highly contaminated as well. The effects of that may not show up for weeks or even months and could well prove fatal down the line.

Read more: death rains down on Ukraine as the clock ticks down to midnightr

There is little, if any, aftercare here. Half the medical staff at the hospital have fled. The other half are depressed or exhausted or both, and have been paid once on the past six months.

On the upper floors, six operating theatres lie idle. Just one in the basement is in use – considered not safe but safer from the apparently indiscriminate shelling by Ukrainian forces.

A school has been hit. The cathedral has been hit. The children’s clinic has been hit. And Yuri has been hit.

Military targets? Any of them? Well, of course, rebels could have been using them as cover for firing positions.

But the fact is, we know enough from random shells falling across towns and cities witnessed by independent observers to know that indiscriminate shelling of civilian areas and hitting shops, schools, hospitals and buses is the central hallmark of this war’s often random violence – and both sides bear heavy responsibility for those constantly committing these war crimes.

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