The discovery of civilian bodies on the streets of Butcha, Ukraine, has heightened tensions in the conflict in Eastern Europe and increased accusations by Kiev and its Western allies of war crimes committed by Russian forces. Another front that may open up against Vladimir Putin in this regard is reports of attacks on medical facilities.
Last week, the UN’s High Commissioner for Human Rights, Chilean Michelle Bachelet, warned of military actions in Ukraine directed against these sites – what international courts classify as war crimes. Days earlier, the director of Emergencies of the World Health Organization (WHO), Michael Ryan, also warned: the entity “has never seen, globally, this rate of attacks on health institutions”.
According to WHO data, until this Wednesday (6) there were 91 offensives against medical facilities in Ukrainian cities since the beginning of the war, on February 24. The actions led to at least 73 deaths and 46 injuries.
One of the most symbolic episodes took place in the second week of March, when Russian troops were accused of bombing a maternity hospital in Mariupol – a city in the southeast under siege and which is classified as a humanitarian catastrophe. The episode caused, according to Ukrainian authorities, the death of a pregnant woman and her baby, as well as injuries to 17 other women and children.
Russia has said since the beginning of its military operation that it does not target civilians. Regarding the bodies in Butcha, Moscow says the images are fakes and that its forces were not involved in the killings and torture. Regarding the action in the maternity ward, the allegation was that the place had been without patients for days and had been occupied by Ukrainian soldiers.
The Geneva Convention, which brings together international human rights treaties, maintains that civilian hospitals “cannot be attacked under any circumstances and must always be respected and protected by the parties to the conflict”. The Red Cross notes, however, that this safeguard ceases to apply if “the medical facility is placed close to a legitimate military target” or becomes a depot for arms and ammunition.
To carry out surveys of these actions, local authorities and the United Nations rely on organizations and professionals within Ukraine. One of them is Pavlo Kovtoniuk, deputy health minister between 2016 and 2019 and co-founder of a think tank linked to the sector in Kiev. THE sheet he explained that he gathers data based on reports from professionals from hospitals and clinics.
Now a refugee in Lviv, in the west, Kovtoniuk leads a team of 15 people and a network of volunteers spread across the country. “These people are physically close to the places attacked. We ask them for contact details of victims or witnesses and then we gather evidence of what happened, usually with photos or recordings.”
So far, his organization, the Ukrainian Health Center (UHC), has reported damage to at least 77 medical facilities — most of the attacks targeting ambulances. The survey still indicates nine health professionals dead. “In the universe of 2,500 hospitals in Ukraine, 77 seems a small number, but the places affected are concentrated in very specific regions, where the situation is really bad”, he says.
In addition to the punctual difference between them, the figures from the WHO and the UHC differ from those presented by the Ukrainian government, which speaks of more than 200 attacks. The discrepancy is, according to Kovtoniuk, due to the methodology of the local Ministry of Health, which considers offensives that have caused some damage to the functioning of the institutions, such as an interruption of energy supply.
Regardless of the exact amount, authorities and organizations warn of the impact on the health system. In a statement on the 16th, Michael Ryan said that the crisis is reaching a point where medical care in Ukraine “is on the edge of a precipice”.
“How can we send professionals when many facilities where they will work will be attacked and bombed?” he asked. On the eighth day of the war, Kiev reported that 500 foreign medical professionals had registered to help victims of the conflict.
Kovtoniuk ponders that, although there are places completely destroyed, such as Mariupol, it is not possible to say that the country’s health system is collapsing. As he points out, more than half of the attacks are concentrated in the Kiev, Kharkiv and Lugansk regions, which, in a way, indicates that other regions manage to keep operating, despite the adversities.
“The healthcare system is under strain and in some places it’s destroyed, but looking at the country as a whole that doesn’t happen.” He also states that, so far, the reports he has access point out that patients in continuous non-war treatments — such as those with mental disorders — have been able to obtain the appropriate medication.
On at least one thing Kovtoniuk and Ryan agree: the symbolic impact of the attacks. “It’s not just about the destruction of buildings, it’s about the destruction of hope. [Essas instalações] they give people reasons to live, knowing the fact that their family members will be treated if they become ill or injured. This is the most basic of human rights,” the WHO director said in his statement.
