As of March 22, the WHO says that Ukraine saw 62 attacks on health care in 27 days of Russian attack. This is more than two attacks per day. When there are international legal obligations to protect hospitals and other health care facilities, how has the war affected the health care in Ukraine?
With the number of attacks on health care in Ukraine increasing, the WHO has stressed that this was unacceptable.
HOW MANY HEALTH CARE DEATHS?
As per the WHO’s Surveillance System for Attacks on Health Care (SSA), the attack on health care has led to at least 15 deaths and 37 injuries, and affected access to and availability of essential health services. The WHO fears that damage to essential services like schools and hospitals will increase if fighting continues, especially in populated areas. The organisation counts more than 300 health facilities in areas with active fighting or with a significant presence of military troops. Moreover, an additional 600 facilities are located within 10 km of hostilities, leaving the health system particularly vulnerable to infrastructural damages and severe interruptions in critical services.
HALF OF ALL ATTACKS
Nearly half of all attacks on health systems worldwide this year have occurred in Ukraine. The WHO warns that thousands of children and pregnant women still living in Ukraine will be without life-saving health care if forces continue to drop bombs and shell health facilities.
WHAT ARE THE INTERNATIONAL LEGAL OBLIGATIONS?
In war, there are international legal obligations to take all necessary precautions to protect civilians and civilian objects, including schools and hospitals, which are protected under International Humanitarian Law. Parties must uphold and protect the civilian nature of schools, students, and education staff – and refrain from military-related use of educational facilities. The use of explosive weapons in populated areas should also be avoided as it risks severe harm to civilians, in particular children.
WHAT IS THE NEED?
The attacks on heath care system and health workers directly impact people’s ability to access essential health services. The world organisation mentions health care needs of pregnant women, new mothers, children and older people in Ukraine are rising even as access to services is being severely limited by the violence. The WHO states that more than 4,300 births have occurred in Ukraine since the start of war and 80,000 Ukrainian women are expected to give birth in next three months. Oxygen and medical supplies, including for the management of pregnancy complications, are running dangerously low.
The world organisation warned that the health care system in Ukraine was clearly under significant strain, and its collapse would be a catastrophe. The WHO and other UN organisations have stressed that the humanitarian partners and health care workers must be able to safely maintain and strengthen essential health service delivery. This includes immunization against COVID-19 and polio, and the supply of life-saving medicines for civilians across Ukraine as well as to refugees crossing into neighbouring countries. They also stressed the need for health services at border crossings, including rapid care and referral processes for children and pregnant women. They wanted safe deliver of emergency medical supplies – including those required for obstetric and neonatal care – to health centers, temporary facilities and underground shelters.