Ukraine: Krovospas, or the Factory of Survival

For almost four years now, around a hundred volunteers have been performing a minor miracle: producing enough hemostatic dressings to equip, at cost price, a large proportion of the million soldiers defending Ukraine. The gauze, soaked in a chemical coagulant, is used to stop severe bleeding. It is one of the essential items in a military first aid kit. The author met with Ihor Tsouroupa, one of the inventors of the technology used to produce these pads and the initiator of this amazing project.

– “Could you give me a quote?”

– “No, we don’t give quotes. We don’t sell our products: we give them in exchange for a donation, but I can tell you how many compresses you could get for the amount of your donation.”

– “Ah. What about the invoice?”

– “We don’t issue invoices, as we don’t sell anything. But our partner association, Anomaly, to which the money will be transferred, can send you a receipt confirming your donation.”

Sigh. Sitting at his computer, a volunteer tasked with ordering several hundred packs of hemostatic gauze for Ukrainian army units wonders if this story is not taking a turn that is a little too complicated.

The price of Krovospas compresses is unbeatable, and the military rescuers he has contacted have all assured him of the product’s reliability, but this contact on Facebook and these unusual procedures make him somewhat suspicious. He finally takes the plunge. Less than a week later, a box full of compresses, along with a proper receipt, is waiting for him at his local post office in Kyiv.

A saving legal loophole

These confusing subtleties can be explained quite simply. Krovospas, as our skeptical volunteer eventually understood, is neither a company nor an association; it is simply the name given to the compresses produced exclusively for the Ukrainian army by around 100 Ukrainian volunteers—the vast majority of whom are women—on a non-profit basis.

”What we do falls into a gray area of Ukrainian law,” explains Ihor Tsuroupa, a chemist by training, who coordinates the intriguing production. Due to the bombings, production is spread across different sites. It is at one of these sites, somewhere in the Kyiv Oblast, that we meet the 30-year-old lover of electronic music, formerly a synthetic chemistry engineer in the healthcare industry.

The lack of legal status for this initiative, Tsuroupa says, explains the ridiculously low cost of Krovospas compresses, as their production is not subject to the strict standards that govern the healthcare industry. The compresses are also delivered at cost price, for a pittance, more than ten times lower than the prices charged by Western suppliers, mainly American and British, who supply NATO armies.

Lives saved, amputations avoided

As a result, demand from the military and civilian volunteers who help them equip themselves is constant. Krovospas volunteers work seven days a week, and more than 3 million packs of compresses have already been produced and distributed since production began in 2022.

“I think 60% or more of [Ukrainian] military personnel are equipped with our compresses. We have saved thousands of lives,” explains our interviewee, without exaggeration, between sips of tea. Lives, ”but also limbs,” he adds gravely; because in cases of massive hemorrhage, hemostatic gauze is also used in the replacement phase of the tourniquet, which is applied as a first aid measure to a seriously injured limb, with a bandage. Without this operation, the affected limb, deprived of blood flow, must be amputated within a few hours.

An industry of mutual aid

The figures are impressive, and even more so when you consider that the financing of this production owes nothing to orders from the Ukrainian government. “They can’t place orders with us because we don’t have any official status,” Tsuroupa points out, while the hissing sound of a vacuum packaging machine can be heard behind a thin partition wall. Thus, equipping soldiers with Krovospas compresses has only been possible thanks to a show of solidarity. The fact that the production of compresses is carried out entirely on a voluntary basis is perhaps the most obvious sign of this, but that’s not all.

“The local administration allows us to use these premises for a symbolic hryvnia [$0.024]; a local company gives us the packaging cardboard; a dairy processing plant gives us milk every week and ice cream in the summer; volunteers and charitable funds provide us with sterile clothing [worn by the workers, editor’s note],” says Tsuroupa, before adding that the machines that could not be “purchased in China” were built free of charge by engineers he knows. The chemicals are purchased at cost from accommodating wholesalers.

Voluntary responsiveness…

The system, which might seem precarious because it depends on goodwill that can sometimes fluctuate, nevertheless has the advantage of guaranteeing rapid supply to soldiers, as it bypasses the legendary administrative red tape of the Ukrainian army.

“If a soldier comes to us asking for bandages,” says Tsuroupa, “he will receive them the same day or the next day”; and if he is unable to come in person, the bandages will be sent to him by mail within a week. It is then up to the recipient to send photos or videos proving that the order has been distributed to his comrades. This is one of the only conditions that must be met if he wants to place a new order, and it takes no more than a few days to do so.

…against state shortcomings

Conversely, “within the military hierarchy, communication is poor. If soldiers request supplies in accordance with legal procedures, they will have to wait six months before they get them,” says Tsuroupa, echoing a sentiment of weariness shared by many Ukrainian soldiers. In addition, he says that in early 2022, at the time of the Ukrainian army’s ramp-up (which grew from about 200,000 to nearly 800,000 men in a few months), stocks of first aid medical supplies were not available, creating a situation of severe shortage, including hemostatic gauze. In such a context, the flexibility of the Krovospas volunteers was, as one might expect, greatly appreciated by the military and their supporters.

The supply problems affecting the Ukrainian army have been known for a long time. “Since 2014 [Editor’s note: and the outbreak of the first Donbas war], the issue of military medicine has been delegated to volunteers. Because volunteers do a pretty good job of it, and the government says, ‘That’s fine, no need to intervene,’” explains Tsuroupa, somewhat disheartened. It is a de facto situation, he continues, which is not the result of any official decision but can be explained by a lack of resources on the part of the Ukrainian state and, at times, a lack of competence on the part of the military hierarchy.

The Donbas War and the cost of survival

Despite some hesitation in his use of English, Tsuroupa’s presentation on military medicine flows smoothly and is well structured, as if he had held the talk for the hundredth time. This is because it was the shortcomings of the Ukrainian state that, in 2014, prompted him to embark on what would later become the Krovospas adventure.

At that time, Tsuroupa was far from imagining that he would one day devote himself to production management. He was pursuing a doctorate in physical chemistry at the National Academy of Sciences of Ukraine in Kyiv when one of his neighbors and friends was mobilized in the first Donbas war. “I bought him a military first aid kit with my last savings,” he recalls. “It was very expensive—$100-200—and the most expensive item in the kit was the hemostatic gauze,” he adds. At the time, only brands imported from the United States or the United Kingdom seemed to offer reliable solutions.

It was a bitter realization because, as a doctoral student, Tsuroupa was earning “less than a street sweeper” and could not even afford “normal food.” But for the scientist, with the help of a few colleagues, this problem quickly turned into a scientific equation to be solved.

From rocket fuel to hemostatic agents

“My doctoral work, carried out in conjunction with the Ukrainian space construction office, focused on materials that react to rocket fuel,” he explains, drawing a parallel that, at first glance, escapes the average person. He continues: “One of these materials, used to detect fuel leaks in rocket engines, resembles gauze impregnated with a component. This changes color when it comes into contact with fuel, making it possible to detect leaks […]. We had the [impregnation] technology and we thought we could use it to impregnate gauze with hemostatic agents.”

It was a promising idea, as it was enough to convince four chemistry PhD students and three medicine PhD students to embark on a voluntary research project, without any funding, which they would work on outside their official working hours. “We used our own blood in the lab” to carry out the initial tests, Tsuroupa explains, adding that he was working “12 to 15 hours a day”  to complete the project. His research supervisor, a senior researcher, was responsible for carrying out the safety checks required for the product’s development.

“We developed the chemical formula in six to nine months, but then it took us a year or a year and a half to draft the patent and carry out the preclinical and clinical trials,” Tsuroupa recalls, while the two volunteers busy sealing the gauze bags laugh heartily in a cheerful discussion. With the chemical formula and impregnation technology finally perfected, Ihor Tsuroupa and his colleagues entrusted production to a large Ukrainian healthcare company, thereby helping to provide their country with valuable industrial capacity.

From volunteer researcher to voluntary manufacturer

The story could have ended there, had the managers of the company concerned not decided, Tsuroupa says, never to pay the license fee owed to the seven researchers for the use of their invention. So, when the large-scale invasion began, the chemist, who was in high demand, quickly decided to embark on the adventure, abandoning his professional activity and the manufacture of Molotov cocktails, to which he had devoted himself during the early days of the conflict.

In the urgency of the situation, obtaining the various production licenses, a long and costly process, was out of the question. Launching production was then “a matter of life and death,” Tsuroupa recalls, “and thanks to this decision, we were able to supply the military at a critical moment: by March 2, we already had a stock of ready-to-use compresses.” During the first month of activity, the volunteers managed to produce tens of thousands of compresses, despite difficulties sourcing materials. In the chaos of the first days of the invasion, contacting suppliers was a real challenge, he recalls.

“We found contact details for the owners or managers of warehouses, but people were hiding in their homes, terrified. Sometimes we would call a taxi driver, who would go to these people’s homes just to pick up the keys to the warehouse and then bring us the components,” Tsuroupa explains, suddenly animated by these memories. While sourcing raw materials proved complex, he emphasizes that the help of volunteer workers was never lacking.

Regularization and threats

Tsuroupa is now working to regularize the production of Krovospas compresses by founding a company that is fully compliant with Ukrainian law, despite the physical threats he receives by phone or on the street and the online harassment campaigns he attributes to his future domestic competitors. “I don’t think about all that. I do my job […] and when, at night, people listen to the Shaheds approaching [Editor’s note: Iranian kamikaze drones sent to the country’s cities by the Russian army], I sleep soundly and don’t go down to the shelters,” he concludes with a smile.