The service has looked to the eastern European country, as well as Finland, to plug a shortfall in numbers blamed on a shortage of newly-qualified paramedics and a higher-than-expected number of current medics quitting.
Unions said cancelled in-house training was also to blame.
The first cohort of 10 new recruits were hired in January and were deployed across the north west last month, NWAS documents revealed.
A further 13 were recruited in March, while another 19 were due to be offered jobs, papers showed.
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A spokesman said: “There is currently a national shortage of qualified paramedics with many ambulance trusts across the country undertaking recruitment campaigns and looking to recruit from abroad to fill vacancies.”
NWAS had expected a paramedic turnover of around 7.5 per cent from March last year until the end of February, but it was actually 8.4 per cent, statistics showed.
Around 30 of 213 leavers completed an exit interview and said rota patterns, issues around transfers, management support, and opportunities elsewhere had triggered their resignations, NWAS papers found.
But NWAS said job satisfaction was improving and not considered to be a major contribution to the increase in paramedics quitting.
Instead, opportunities elsewhere have been blamed, as well as hopefuls now needing a university education rather than in-house training.
Director of organisational development, Lisa Ward, said in a report: “There is a shortage of newly-qualified paramedics with insufficient throughput from universities to meet demand.
“This is combined with a market for graduates and qualified staff becoming increasingly competitive, with some services starting to offer incentives to encourage applicants and other parts of the health sector actively recruiting paramedics.”
As well as recruiting from abroad, NWAS is also training emergency medical technicians (EMTs) who work alongside paramedics, up to the required level, and has launched an advertising campaign.
Last year, more than 180 paramedics were hired or trained, with 95 more expected to start work in the next three months, the service said.
NWAS’s plans were first revealed last year, when Bob Parkinson, branch secretary of Unite at NWAS, said: “We are now in a situation where we are scouring the planet for paramedics and we have a workforce who want to be trained for the role.”
Mr Parkinson said the decision to allow EMTs to train came ‘too little, too late’.
And Steve Rice, GMP branch secretary, said moving away from in-house training to recruiting graduates was a mistake.
“The real issue, the real crux of this is we used to be trained internally. I went from being an ambulance man to a technician to paramedic.”
NWAS said that decision was made nationally in the best interests of patients.