According to WHO data, more Ukrainians could die in attacks on medical facilities in 2024

A Russian missile attack on Ukraine’s largest children’s hospital on Monday highlighted the growing number of deadly attacks on medical facilities, vehicles and workers in the country this year. It adds to World Health Organization data suggesting that more Ukrainians could be on track to be killed in such attacks this year than last.

Prior to the attack on Ohmatdyt Children’s Hospital in Kyiv, WHO documented 18 deaths and 81 injuries from more than 175 attacks on healthcare infrastructure in Ukraine for the first half of 2024. The organization also recorded 44 attacks on medical vehicles during that period.

In all of 2023, the organization counted 22 deaths and 117 injuries from 350 such attacks, and 45 more specifically on medical vehicles such as ambulances. Other organizations have estimated the number of victims even higher.

In Monday's attack, at least one doctor and another adult were killed at a hospital, and at least 10 others, including seven children, were injured in a Russian-led strike across the country. In total, the strike killed at least 38 people, including 27 in Kiev, Ukraine's capital, local officials said.

Attacks on civilian hospitals are prohibited by Article 18 of the Geneva Convention, ratified by United Nations member states after World War II. And Article 20 of the convention states that health workers must be protected by all parties to a conflict.

Experts say Russia has repeatedly attacked Ukrainian healthcare infrastructure, in a campaign that some say amounts to war crimes.

In a statement on social media Monday, the Russian Defense Ministry denied intentionally hitting civilian targets in Ukraine. Video of the strike taken by a Kiev resident and verified by The New York Times showed a missile moving downward at high speed before hitting the hospital.

Christian De Vos, an attorney and director of research and investigations at Physicians for Human Rights in New York, said the world has yet to see a case before an international court where the primary focus of the case was an attack on health care infrastructure.

Experts said the Russian attack targeted the most vulnerable people and strained a Ukrainian healthcare system already stretched to its limits.

“Under international humanitarian law, hospitals and medical facilities are protected precisely because civilians are seeking treatment,” Mr. De Vos said. “These are sites that are meant to ensure the protection of the civilian population and spare them from the horrors of war.”

WHO defines an attack on health infrastructure as any act or threat of violence that interferes with the availability, access, or delivery of health services. Its data includes both confirmed and probable attacks, which the organization defines as attacks with a witness account. or two confirmed secondary accounts to a WHO partner.

Experts say attacks on hospitals and health workers in conflicts around the world are on the rise, and in Ukraine, the increase comes as no surprise to some emergency workers.

“We have to constantly review where we are working and withdraw from areas that are becoming impossible,” said Christopher Stokes, emergency coordinator for Doctors Without Borders in Ukraine. The war there has been going on for more than two years.

Earlier this year, the organization tried to set up an emergency room in the Kherson region, but the hospital kept coming under shelling, Mr. Stokes said. After the sixth attack, he said, the decision was made to abandon the effort.

Some hospitals are trying to take precautions, experts said, covering windows with sandbags and moving patients and operating rooms to lower floors. The upper floors are considered too risky because of strikes.

“These hospitals are not sanctuaries where anyone can feel safe, especially patients,” Mr. Stokes said.

Uliana Poltavets, emergency response coordinator for Physicians for Human Rights, documents attacks on health care infrastructure and said she heard the explosion during the strike Monday morning in Kiev. She said it was part of “a pattern of violence” that has been repeated in Ukraine since the war began in February 2022.

“The full-scale invasion began with an attack on a maternity home in Mariupol,” he said. “After three years of war, children are apparently being targeted.”

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