Kostyantynivka hospital, Donetsk Oblast, Ukraine.
War in Ukraine

Between enemy lines: The destruction of healthcare in Ukraine

International medical humanitarian organisation Doctors Without Borders (MSF) reveals the massive and widespread destruction of health facilities in Ukraine and the severe impediments to medical care under Russian military occupation.

MSF urges all warring parties to uphold international humanitarian law and their obligations to protect civilians and civilian infrastructure and to ensure unhindered access to life-saving medicines and medical supplies for people in need. 

Destroyed hospital in Lyman, Donetsk Oblast.
Destroyed hospital in Lyman, Donetsk Oblast.
Colin Delfosse

Following the escalation of the war in February 2022, Doctors Without Borders (MSF) teams assessed the medical and humanitarian needs of people in 161 towns and villages in the Donetsk and Kherson regions to provide medical assistance to those living near the frontlines. Despite requests to work on both sides of the frontline, MSF is only able to operate in areas under Ukrainian control, and our observations are limited to those areas. 

Our teams directly witnessed homes, stores, playgrounds, schools, and hospitals reduced to rubble. In some of the towns and villages where we work, the destruction was absolute. Along the 1,000 km of the frontline in Ukraine, some areas have simply been wiped off the map. Christopher Stokes, Head of Programmes for MSF in Ukraine.
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The destruction of healthcare in Ukraine

Destroyed health facilities witnessed by MSF in Ukraine retaken areas in October-December 2022.
Dora Naliesna

Hospitals are not a safe place.

By mid-2022, MSF medical workers had already witnessed attacks on healthcare infrastructure. In two separate instances, in Mikolaiv in April and in Apostolove in June, they witnessed the apparent effects of cluster munitions on hospitals, leaving medical activities suspended for several days and effectively depriving patients of access to medical care. In three other cases on 8, 11 and 15 October 2022, MSF teams also discovered the presence of anti-personnel landmines inside functioning hospitals in areas previously under Russian occupation in the regions of Kherson, Donetsk and in Izyum. 

The use of landmines is widespread in frontline areas, but to see them placed in medical facilities is shocking: a remarkable act of inhumanity. It sends a clear message to those who come in search of medicines or treatments: hospitals are not a safe place. Vincenzo Porpiglia, Project Coordinator for MSF activities in Donetsk region.

MSF medical teams have also discovered that several medical facilities located in former Russian-occupied areas in both Kherson and Donetsk regions had been looted, while medical vehicles, including ambulances, had been destroyed. Inside two of these facilities, they saw weapons and explosives.

Healthcare under occupation

Accounts from healthcare workers and patients who lived under Russian occupation indicated severe access restriction to essential medicines, treatment or medical facilities. These accounts were corroborated by MSF’s medical records following 11,000 consultations (November 2022-February 2023). MSF medical teams frequently had to treat patients for chronic conditions that went untreated for several months.

According to our patients, people were not able to access healthcare mainly due to movement restrictions, because of the massive destruction of health facilities or as a result of the unpredictable behaviour of some Russian units. Patients also reported that surviving medical facilities and pharmacies were looted and that the supply of medicines was not systematically assured by occupying forces. The interviews conducted are consistent with the medical diagnosis of many MSF patients that went untreated for months.
 

MSF teams attend to patients at the emergency of Kostyantynivka hospital at Donetsk Oblast, Ukraine.
MSF teams attend to patients at the emergency of Kostyantynivka hospital at Donetsk Oblast, Ukraine.
Colin Delfosse

MSF reminds warring parties of their obligations to protect civilians and civilian infrastructure. Hospitals and other healthcare facilities must never be targets. Warring parties must also allow the unobstructed supply of life-saving medicines, and medical supplies and provide safe and unhindered access to independent humanitarian assistance for those in need.  

MSF reminds warring parties of their obligations to protect civilians and civilian infrastructure. Hospitals and other healthcare facilities must never be targets. Warring parties must also allow the unobstructed supply of life-saving medicines and medical supplies and provide safe and unhindered access to independent humanitarian assistance for those in need.