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President Volodymyr Zelenskyy called for urgent operational changes in Ukraine’s army as he sacked the commander of the medical forces following months of criticism from combat medics about the poor quality of supplies for the country’s soldiers.

The call was followed by an unannounced visit to Kyiv by US defence secretary Lloyd Austin on Monday. Austin reassured Ukrainian leaders of Washington’s continued support as they head into what is likely to be a difficult winter military campaign against Russian forces.

Announcing the leadership change during his evening address on Sunday, Zelenskyy said Major General Tetiana Ostashchenko’s dismissal and the need for a change within the military’s medical forces was “obvious”.

“This has been repeatedly discussed in society, in particular in the community of our combat medics — a fundamentally new level of medical support for our military is needed,” the president said.

Military medics told the Financial Times in October that poor quality supplies and lack of medical training were costing soldiers’ lives on the frontline, as Ukraine presses ahead with its sputtering counteroffensive meant to wrest back territory and deter increased Russian attacks in the country’s east. Cheap tourniquets, many made in China, have flooded Ukraine and made their way into soldiers’ first-aid kits, medics said.

While Ukraine does not disclose its casualty figures, the US estimates that about 130,000 Ukrainian soldiers have been injured and about 70,000 killed since President Vladimir Putin launched Russia’s full-scale invasion in February 2022. Russia’s military is believed to have lost roughly 120,000 troops, with another 280,000 wounded, according to US estimates.

Washington is Ukraine’s largest political and military backer, having provided more than $74bn of military assistance, humanitarian aid and financial support.

President Joe Biden has pledged to back Ukraine in its fight against Russia’s invading forces “for as long as it takes”. But he faces challenges in Congress, where some Republican lawmakers oppose continued aid for Ukraine or want to place conditions on the assistance.

Kyiv’s latest military shake-up came after Zelenskyy met newly appointed defence minister Rustem Umerov to discuss Ukraine’s military priorities, which would include prioritising high-quality tourniquets, better training, digitisation and clearer communication in line with Nato standards.

“There is simply no place for such problems as subpar tourniquets,” Umerov wrote in a statement on Facebook after his meeting with the president.

“There will not be much time to wait for results,” Zelenskyy said. “Changes need to be made quickly.”

Ostashchenko was replaced by Major General Anatoly Kazmirchuk, who heads Kyiv’s main military clinic. While Ostashchenko’s dismissal was largely met with approval from Ukrainian military medics, some questioned the appointment of Kazmirchuk, who they argued comes from the same rank and file.

Kazmirchuk’s appointment, combat medic Rina Reznik wrote on the social media platform X, was “not a productive decision”.

“I wanted a charismatic leader as the commander of the medical forces,” she said. “But I hope the new commander will at least be careful in his decisions and actions and will rely on the [military medical] community.”

Ostashchenko’s removal came after media reports last week that she and two other military leaders could be fired. Independent news outlet Ukrainska Pravda reported that Umerov might decide to replace her, as well as Oleksandr Tarnavsky, the general leading Ukraine’s struggling southern counteroffensive, and Serhiy Naiev, a lieutenant-general and commander of the joint forces.

Umerov was tapped by Zelenskyy to lead and reform the defence ministry in September. His appointment followed a corruption scandal within the ministry over allegations that it was paying inflated prices for food and military jackets for the country’s soldiers. 

Umerov did not respond to a request for comment about personnel changes on Monday. He has not spoken publicly about replacing Tarnavsky and Naiev. 

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