The Army’s Landstuhl Regional Medical Center has quietly started admitting soldiers who were wounded in Ukraine combat – most of them American volunteers, reveals ‘The New York Times’.

A group of Ukrainian Army soldiers pierced by Russian grenades and mortar shells arrived at a hospital recently in need of surgery. It would have been a familiar scene from the bloody war grinding on in Ukraine, except for two crucial differences: Most of the wounded soldiers were American, and so was the hospital — the U.S. Army’s flagship medical center in Germany.

The Army has quietly started to treat wounded Americans and other fighters evacuated from Ukraine at its Landstuhl Regional Medical Center. Though the number so far is small — currently 14 — it marks a notable new step in the United States’ deepening involvement in the conflict.

When the war erupted in 2022, hundreds of Americans — many of them military veterans — rushed to help defend Ukraine. Nineteen months later, perhaps a few hundred are still there, volunteering for local militias or serving under contract with the Ukrainian national army.

An unknown number of them have been shot, hit by artillery, blown up by mines or otherwise injured in combat. About 20 have been killed. Most of the wounded have had to rely on a patchwork of Ukrainian hospitals and Western charities for help. Now, though, the Pentagon has stepped in to offer some of them the same care it gives to American active-duty troops.

The hospital at Landstuhl is authorized to do so under a Defense Department policy, which began last summer, that allows the hospital to treat up to 18 wounded members of the Ukrainian forces at a time, the Pentagon confirmed in a statement. The fact that most of the Ukrainian troops at Landstuhl are Americans illustrates how the war has progressed in unexpected ways.

The Biden administration vowed at the start of the war that it would not put American troops on the ground in Ukraine, and it warned Americans not to get involved. Now it finds itself treating those it told to stay away.

Asked about the development by The New York Times, a Defense Department official who is regularly briefed on Ukraine-Russia matters expressed surprise, and said that leaders at the Pentagon were unaware that Landstuhl was regularly treating wounded American volunteers, but added that the leaders were not concerned about it.

The 65-bed facility, a Level II trauma center, is the largest American military hospital outside the United States, and served for years as a way station for thousands of wounded American troops evacuated from conflicts in Iraq or Afghanistan. After those wars wound down, Landstuhl’s beds and expertise often went unused.

The patients now at Landstuhl are mostly from the United States, but also from Canada, Britain, New Zealand and Ukraine. Several of them said in phone interviews from their beds that they were receiving excellent care.

“We’re blessed to be here,” said an American veteran who underwent surgery this month to remove shrapnel from an arm and both legs. The veteran, who previously served in the U.S. Air Force, asked not to be identified because he feared reprisal by Russia.

He and others from a company of English-speaking fighters were hit during an assault on a village near the Russian-held city of Donetsk. More than two dozen soldiers were wounded, and two were killed. Over the next few days, the wounded were moved among Ukrainian evacuation points and hospitals, first near the front lines and then in Kyiv, the capital. The fighters who were interviewed said Ukraine’s hospitals were under tremendous strain.

“Man, we are so thankful” to be at the hospital, said another American veteran, who was hit by shrapnel in his legs, arm and neck. He, too, asked not to be named. “I was wounded in Ukraine three weeks before they told me it would be a month before I got surgery. In Germany, they did it in two days.”

Mr. Sanchez, the spokesman for Landstuhl, said the hospital was prepared to treat more wounded, and “remains postured and ready to support U.S. Armed Forces, NATO member countries and other allies and partners as directed.”

But the arrangement is not without risks. Russia has repeatedly warned that any increase in U.S. involvement could spark a broader war. It would not take a particularly creative Russian propagandist to portray the American volunteers, wielding American weapons and being treated at an American Army hospital, as de facto U.S. troops on the ground.

Sen. J.D. Vance (R-OH) and House Republicans urged President Joe Biden’s Pentagon to stop escalating a “dangerous” war with Russia, as the “same idiots” pushed the Iraq war.

Vance and Reps. Chip Roy (R-TX) and Matt Gaetz (R-FL) sent a letter to Defense Secretary Lloyd Austin as influential media outlets such as Foreign Affairs have called to lift the restriction on the number of American government personnel allowed in Ukraine and across its defense apparatus.

“The idea that we’re going to send in offensive equipment and have planes and tanks and trains going in with American pilots and American crews — just understand, don’t kid yourself, no matter what y’all say, that’s called World War III,” Vance said.

‘Foreign Affairs’ explained: “Sending advisers would increase the number of Ukrainian soldiers who receive top-of-the-line training. It would enhance Washington’s understanding of Kyiv’s material needs, allowing U.S. policymakers to fine-tune the aid they already provide and offer psychological assurance to Ukraine. Positioning U.S. advisers inside Ukraine would let Washington better champion crucial defense reforms that could pave Ukraine’s path toward NATO and EU membership. Advisers would give the United States an added layer of oversight, as well, ensuring that aid is both optimized and employed responsibly. And, critically, deploying advisers would deliver these results at a reasonable cost.”

Sen. Vance, Roy, and Gaetz cautioned that any military adviser mission risks severe escalation with a nuclear-armed Russia. They wrote:

“A military adviser mission to Ukraine would run a significant escalatory risk with Russia. It would mean placing additional “boots on the ground” in the midst of a direct and bloody conflict with Russia. Harm to our personnel under such a mission would be a tragedy, and could easily trigger Article IV consultations or even an Article V collective security declaration by our NATO Allies under the Washington Treaty. A military adviser mission would be one more step towards a dangerous, unnecessary war between the United States and Russia.”

“We write to ask whether the U.S. government plans now, or in the future, to deploy an adviser mission to Ukraine, either U.S. direct-hire personnel or contractors, whether under foreign affairs, military, or intelligence authorities,” the conservatives continued. “We request a response by October 3, 2023.”