The Kharkiv region became a strategic target during Russia’s full-scale invasion of Ukraine. Russian forces continue to shell the civilian infrastructure of the region, including its medical facilities.
The vast majority of Russian attacks are the result of systematic indiscriminate shelling of civilian infrastructure, completely disregarding basic principles of international humanitarian law. This means that Russian troops deliberately targeted civilian infrastructure without distinguishing between civilian and military objectives.
Russian soldiers systematically and brutally destroy Ukraine’s healthcare system. Among all other civilian objects, medical facilities have a special status. The Geneva Conventions explicitly prohibit causing harm to them under any circumstances, except when medical facilities lose their humanitarian function and operate as military objectives.
Ukrainian Healthcare Center (UHC) experts have investigated the events that took place in Kharkiv and the region from February 24, 2022, to March 2023. They have gathered evidence of attacks, analyzed the damages, and collected testimonies from healthcare workers who were subjected to multiple shelling incidents.
Nearly 20% of the medical infrastructure in Kharkiv has been damaged. In total, as a result of 83 attacks in the Kharkiv region, 42 facilities suffered damage, and 7 of them were completely destroyed.
The losses from the war cannot be measured solely by the destruction of hospital buildings. According to the local Department of Health, from the beginning of the full-scale invasion until the end of February 2023, 106 medical workers were killed in Kharkiv.
What are the specific features and consequences of the attacks on medical facilities in Kharkiv, carried out by Russian occupying forces?
75% of the attacks on medical facilities in the Kharkiv region were carried out by Russians in the first 3 months of the full-scale invasion
During the initial three months of the full-scale invasion (from February 24 to May 13, 2022), Russian troops focused on capturing Kharkiv and bombarding cities in the Kharkiv region, such as Izium, Dergachi, and others. The proximity of Russian military positions to the region allowed them to use various short-range weapons for shelling, including artillery, multiple rocket launch systems (MLRS), tanks, and mortars. During this time, Russians conducted six attacks on the medical infrastructure using aviation.
According to the reports from the Mayor of Kharkiv as of March 30, 2022, a total of 1,531 objects were damaged in the city, including 292 residential buildings, 70 schools, 54 kindergartens, 16 hospitals, and 239 administrative buildings.
The first attack on Kharkiv Regional Children’s Clinical Hospital No. 1 took place as early as February 25, 2022. The hospital’s territory was shelled with mortars and cluster munitions. At the time of the attack, there were approximately 150 children inside the hospital. The most significant damage occurred on April 7, 2022, when Russian military used MLRS Uragan One of the rockets hit between four buildings of the medical facility.
“It came from the Russian side, well, from Tsurkuny, approximately. I’m not a military person. And the second time, when Ruska Lozova was liberated, they said there was some platform there. They brought in the Uragan MLRS and just started firing — today they would shoot like this [he gestures in one direction – ed.], tomorrow like that [ gestures in another direction – ed.]. And periodically, they would also fire through the hospital. There were no military personnel [Ukrainian – ed.] here. There were children. The hospital was shelled four times: three times with children inside and once with staff, without children,” Savvo Oleksiiov, Acting Chief Doctor of Kharkiv Regional Children’s Clinical Hospital No. 1, provided information about the direction of the shelling with an interview with the UHC team.
Deliberate terror by Russians
After failures on the battlefield, the Russian army began systematically terrorizing the civilian population and deliberately destroying the city’s infrastructure. It actively shelled the Kharkiv region with long-range artillery, rockets, and S-300 anti-aircraft missile systems.
Kharkiv Regional Traumatology Hospital was targeted by Russian shelling four times since the start of the full-scale invasion. The first attack occurred on March 12, 2022, using mortars. The fourth attack took place on June 26, 2022, utilizing MLRS Uragan, which caused significant damage to the hospital.
“Russians knew perfectly what they were shelling. There were plenty of informants who would report and tell them, so they knew what they were doing. If it was a mortar operator, it was loud, for sure. They probably intended to create panic, to make us scatter and run. It was designed to provoke panic. But nonetheless, they failed; we stood our ground,” hospital representatives recount.
Systematic attacks have severely impacted access to medical assistance in the Kharkiv region
Russia continued its rocket terror campaign on the territory of Kharkiv throughout the autumn and winter of 2023. A new threat emerged with shelling from the territory of Belgorod, where the Russian army deployed S-300 anti-aircraft missile systems. The most intense shelling with this type of weapon occurred in February 2023. During this period, hospitals in Kupiansk and Vovchansk were affected, being targeted 6 and 4 times, respectively, by Russian attacks.
In the Kharkiv region, the most destructive consequences were seen in the attacks on medical facilities in smaller towns, where the healthcare infrastructure is represented by a few or even just one medical institution. The cities of Izium, Kupiansk, Dergachi, Zolochiv, and smaller settlements were affected. In these regions, the only places providing medical services were damaged or completely destroyed by Russian shelling.
The Central City Hospital of Pishchanska Bohomater in Izium serves as a prominent example, illustrating how Russian екщщзі intentionally and indiscriminately targeted Ukraine’s healthcare system as part of their broader attack on its civilian population and infrastructure. As a result of the invasion, the hospital was damaged and shelled at least three times. It has not fully resumed its operations as it suffered significant damage, according to the report published in March 2023.
“It hit the main building — it was blown apart, and it also hit the fourth floor. So, overall, we lost our operating rooms and the intensive care unit. And we understood that, suddenly, we wouldn’t be able to do anything. We knew that there would be a large influx of wounded patients — and what then?” Bogdan Berezhnyi, a surgeon and medical director of the hospital, shared with the UHC team the attacks he and the medical staff had to endure.
Medical facilities remain under attack despite their special protection
Russian soldiers continue to shell medical facilities in the Kharkiv region with varying intensity. In addition, after the full-scale invasion, other crimes against healthcare have been documented. These include the seizure of medical institutions for military purposes, looting, killings, deliberate damage to buildings and equipment, as well as threats to medical personnel.
Some hospitals targeted by Russians were marked with internationally recognized symbols of medical facilities, which grant them special protection under international humanitarian law. The shelling of these hospitals indicates that Russian forces likely knew about their protected status but still engaged in potentially criminal actions.
Russian senior officials and the military continue to destroy medical facilities and other civilian infrastructure, kill civilians, and launch devastating attacks on populated areas.
On May 24, 2023, the World Health Organization Assembly adopted a resolution condemning Russia’s aggression against Ukraine, including attacks on healthcare facilities.
Since the beginning of the full-scale invasion by the Russian Federation, the team of the Ukrainian Healthcare Center (UHC) has been documenting and collecting evidence of Russian military attacks on healthcare facilities in Ukraine. During this time, the center prepared 5 analytical documents, including reports on attacks on medical infrastructure in Mariupol and the Kharkiv region, and also created a map of attacks on healthcare facilities in Ukraine.
As of June 29, 2023, UHC experts have recorded 85 attacks on medical infrastructure in the Kharkiv region and 335 attacks throughout Ukraine since the start of the full-scale invasion.
UHC continues to document Russian war crimes against the Ukrainian healthcare system and cooperate with Physicians for Human Rights, EyeWitness to Atrocities, Insecurity Insight, Media Initiative for Human Rights, Open Society Justice Initiative, and prosecutors to ensure that all those responsible are held accountable.
Originally posted by Alina Blahodur on LB. ua. Translated and edited by the UaPosition – Ukrainian news and analytics website