Bomb attack on a hospital was the latest act in Russia’s war against the Ukrainian health care system

The bombing of Ukraine’s largest children’s hospital in Kyiv on July 8 has sparked a wave of global condemnation. US President Joe Biden called the attack a “horrific reminder of Russia’s brutality.” Others noted that this latest airstrike was not an isolated incident. “Once again, Russia has deliberately targeted residential areas and health infrastructure,” commented the French UN representative.

Since the start of the large-scale Russian invasion almost two and a half years ago, the Kremlin has been repeatedly accused of deliberately targeting Ukrainian health facilities. On the first anniversary of the invasion CNN reported that “almost one in ten” Ukrainian hospitals had been damaged by Russian military action. The frequency of such incidents is underscored by the fact that Kyiv’s Okhmatdyt Children’s Hospital was one of three different Ukrainian medical facilities hit by Russian missiles on July 8.

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The Russian military has killed a large number of Ukrainian health workers over the past two and a half years. At least six Ukrainian medics died in Monday’s bombings, joining hundreds of their health-care colleagues killed since the invasion began. Russia’s military actions have also caused billions of dollars in damage to Ukrainian health facilities, in many cases making it impossible to continue providing vital medical care, resulting in significant additional human costs.

The campaign against Ukraine’s health infrastructure is far from exceptional and appears to be consistent with Russian military doctrine. Similar patterns of attacks on clinics and hospitals have been noted during Russian military campaigns in Syria, Georgia, Chechnya, and elsewhere. Unless Russia can be held accountable for the attacks on health infrastructure, this potentially opens the door for other countries to use similar military tactics in future conflicts.

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Under international humanitarian law, health facilities and medical personnel in conflict zones enjoy special and enhanced protection. Despite this status, Russia is accused of systematically attacking medical facilities throughout Ukraine. These attacks have been documented by the “Attacks on Healthcare in Ukraine” project, run by a coalition of Ukrainian and international civil society organizations.

In addition to direct military attacks on health infrastructure, this civil society initiative’s research has also identified a clear pattern of Russian behavior in the occupied territories of restricting access to basic health services. In all regions of Ukraine currently under Kremlin control, the occupying authorities reportedly deny medical care unless Ukrainians accept Russian citizenship and otherwise cooperate.

It is also important to recognize the indirect impact of the Russian invasion on Ukraine’s healthcare system. The war unleashed by Vladimir Putin in February 2022 has created a number of long-term challenges, including unprecedented demographic changes and a dramatic rise in mental illness. The impact of Russian aggression on healthcare extends beyond Ukraine’s borders, including the strain on foreign healthcare systems from millions of Ukrainian refugees fleeing the war.

Prosecuting Russia for war crimes related to the attacks on Ukraine’s health infrastructure is likely to be an extremely challenging and time-consuming process. Potential obstacles include slow justice systems, difficulties in identifying those responsible for the targeted attacks, and problems in establishing clear links between the perpetrators and the crime. Collecting evidence that meets international law enforcement standards during ongoing hostilities is also a complex task.

To break the cycle of impunity, the international community must prioritise the investigation and prosecution of those who target health infrastructure and medical personnel. This process should involve international and national legal systems, as well as relevant United Nations investigative bodies.

Russia is clearly targeting Ukraine’s healthcare system, using the provision of medical services as a weapon in a campaign aimed at breaking Ukrainian resistance and strengthening Moscow’s control over the country’s occupied territories. If these crimes are not held accountable, Russia’s actions will set a dangerous precedent that will lead to similar crimes in other conflict zones.

Olha Fokaf is a health specialist and currently works as a consultant for the World Bank in Kyiv.

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The views expressed in UkraineAlert are solely those of the authors and do not necessarily reflect the views of the Atlantic Council, its staff, or its supporters.

The Eurasia Centers The mission is to strengthen transatlantic cooperation to promote stability, democratic values ​​and prosperity in Eurasia, from Eastern Europe and Turkey in the west to the Caucasus, Russia and Central Asia in the east.

Image: Rescue workers work at the Ohmatdyt Children’s Hospital, which was damaged during a Russian missile attack in the wake of Russia’s aggression on Ukraine, in Kyiv, Ukraine July 8, 2024. REUTERS/Gleb Garanich