Since February 24, 2022, violence against the Ukrainian healthcare system has become a characteristic feature of Russia's illegal behavior. This was discussed in the report of the Ukrainian Health Center (UHC), presented on February 21, "
One of the most high-profile incidents occurred just two weeks after the start of a full-scale invasion, when Russian aircraft bombed a maternity hospital and a children's hospital in Mariupol.. The photo of a pregnant woman being carried out of the hospital on a stretcher, who later died with her baby, was one of the first clear evidence of Russia's brutal, indiscriminate way of waging its illegal war..
In the first weeks of a full-scale Russian invasion, there were constant, daily attacks on Ukraine's healthcare system.. Attacks were especially intense in February and March; during the first two weeks of the invasion, an average of four to five hospitals and clinics were attacked daily. Attacks continued throughout the year, with a total of 235 attacks on medical facilities in March and an average of 47 attacks per month from April to December 2022.
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In the period from February 24 to December 31, 2022, the research team recorded a total of 707 attacks on the Ukrainian healthcare system.
Documented:.
292 attacks that damaged or destroyed 218 hospitals and clinics. Many medical facilities have been repeatedly attacked.
65 attacks on ambulances.
181 attacks on other healthcare infrastructure (e.g. pharmacies, blood centers, dental clinics, research centers, etc.).
86 attacks on medical workers, including 62 medical workers killed and 52 injured. Many others have been threatened, imprisoned, taken hostage and forced to work under Russian occupation.
About nine percent of Ukrainian hospitals were directly damaged by shelling, with the most damage inflicted in the eastern regions of Kharkiv, Donetsk, Lugansk and Kherson..
In some cities, almost all medical facilities were affected in one way or another.. Nearly 8 out of 10 medical aid points damaged or destroyed in Mariupol and southern Donetsk region.
In Makarovsky municipality, where three medical facilities and 30 pharmacies were damaged or destroyed, the scale of the attacks severely disrupted medical services and infrastructure in the area.
In 10 regions, 48 \u200b\u200bhospitals were hit multiple times, highlighting not only the indiscriminate nature of the attacks, but also the possibility that they were deliberate. For example, the Severodonetsk city multidisciplinary hospital in the Luhansk region was hit 10 times between March and May 2022. One hospital in the Kharkiv region was hit five times, the other four times.
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Many hospitals had internationally recognized symbols of their status as medical centers, which were clearly visible from the air.. The general hospital in Bashtanka, which was badly damaged during the April attack, was marked with a red cross painted on a white canvas placed on the roof.
The 707 total also includes a number of additional incidents that meet the WHO definition of health hazards, including robberies, denial of access to medical care, disruption of access to utilities (water and electricity), and serious health impacts on patients, such as having to take them out.
All of these attacks caused widespread and costly damage.. As of August 2022, according to the World Bank, the government of Ukraine and the European Commission, the direct damage to Ukraine's healthcare sector was estimated at US$1.4 billion. This represents a monetary value of the destroyed and damaged health infrastructure included in the damage cadastre compiled by the Ministry of Health of Ukraine.
However, it is likely that the actual level of damage is higher, given the incomplete reports of damaged facilities located in areas temporarily not controlled by the government of Ukraine and other private sector facilities..
Estimated further damage from attacks on health exceeds US$6 billion, including the removal of garbage and demolition of destroyed medical facilities, loss of income from private providers, losses from funding institutions that did not function fully during the war, and additional losses incurred as a result of the deterioration.
According to the WHO, the European Union Delegation to Ukraine, the United States Agency for International Development (USAID) Mission in Ukraine and the World Bank, Ukraine's total health sector needs are estimated at US$15.1 billion (nearly three times the annual public health spending).. This amount includes the cost of building new infrastructure using a “better back” approach and immediate restoration of partially damaged facilities.. This also includes a significant expansion of rehabilitation and mental health services in Ukraine, which will need to be scaled up to deal with the aftermath of the war..
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Report "
The report consists of three parts. The first shows the total number of documented attacks on medical facilities and healthcare workers from February 24 to December 31, 2022, based on a dataset and interactive map developed collectively from public and confidential information during the year. It also examines the early impact of these devastating attacks on Ukraine's health care system and their historical roots in other conflicts in which Russian troops have been involved - in Chechnya, Georgia, Syria..
The second part presents 10 detailed case studies that illustrate the types of attacks carried out on hospitals, healthcare workers and medical transport in Ukraine.
The third and final section sets out the legal framework for understanding how these attacks can qualify as war crimes and crimes against humanity under international law.. All these crimes require further investigation..
The release of the report is accompanied by the launch (in English and Ukrainian) of an interactive online map with documented attacks on Ukrainian healthcare. The map and dataset will be continuously updated in the future.