Ukraine health care system is on the brink
Krasnohorivka, Ukraine –
Valentyna Mozgova cleans shattered glass and other debris from the empty halls of the bombed-out hospital where she started her career. Her 55-year-old laboratory technician, who lives in the basement, now works as a lone security guard.
Russian artillery fire targeted the Marinskaya Central District Hospital again in 2017 and 2021. However, numerous barrages over the past seven months have forced the hospital’s medical staff to flee, destroying key departments such as neurology and gynecology, as well as general clinics in the process. .
Mozgova chose to remain. Having worked in a hospital laboratory since she graduated from medical school in the late 1980s, she agreed to work as a hospital security guard for 10,000 hryvnia (US$250) a month. She and her husband soon joined her five other dogs and cats who had lost their homes to the bombings in the underground shelter.
Every third day, at exactly 8:00 a.m., Mozgova picks up a broom and inspects the hallway, carefully avoiding debris from the Russian Grad rocket littering the floor and fearing another explosion.
“Everything is rotting and falling apart,” she told The Associated Press. “But I’m fed up. I want to live a normal life. I want to calmly go to work and do my own work.”
A year into Russia’s war in Ukraine, hundreds of attacks on the health system have begun to take their toll. More than 700 attacks have targeted medical facilities and staff since the Russian invasion on February 24, according to data verified by five organizations operating inside Ukraine.
The World Health Organization likewise documents more than 750 attacks and 101 deaths, and Ukraine’s health minister recently said more than 1,200 facilities were directly or indirectly damaged and 173 hospitals could not be repaired. He said it was badly damaged.
A report released on Tuesday, which was previously shared with The Associated Press, said Russia had “deliberately and indiscriminately” targeted Ukraine’s health system, accusing the group of war crimes. are doing.
Attacks were most prevalent in the early days of the conflict, with a total of 278 attacks in the last four days of February and throughout March, averaging eight per day, according to the report.
The report defines attacks not only as weapons attacks, but also intimidation aimed at keeping doctors working in occupied territories, as well as cases of theft in areas the Russian military could not hold.
In the city of Kherson, residents said the retreating Russian forces had taken most of the ambulances. When they captured the city of Mariupol, Russian forces took over the city’s last functioning hospital days after Russian air strikes ravaged the maternity ward.
“Russian soldiers were on every floor. They counted the patients, they counted the employees, they made sure no one left. If the doctors left, they said they would shoot.” 2 hospital nurse Marina Gorbach told the AP in a December interview.
Like most of the staff, Gorbach was able to escape after a few days.
In Izium, explosives pierced the walls of a main hospital in March, severing wiring and forcing doctors and patients into basements.
“Before going to the basement, we covered the patient with a mattress because we thought it would protect him from debris,” said Dr. Yuri Kuznetsov, a trauma surgeon. At this point he has 3 of the 4 floors working. Water drips from the roof. But the patient already knows how much repair has been achieved.
Over the past year, AP journalists across Ukraine have witnessed firsthand the results of attacks on hospitals, ambulances and medical staff.
“They follow a pattern. It’s not the number that matters, it’s the pattern,” said Pavlo Kovtnyuk of the Ukraine Healthcare Think Tank, one of the groups collecting the data. “Because a pattern means that it is most likely a deliberate policy rather than just a coincidence or discrete event.”
Russia claims that Ukraine also attacked hospitals in occupied territories. But Kovtoniuk said there is a stark difference between the vast number of documented organized attacks and what he described as accidents occurring in the course of the war for survival.
The international organization Doctors for Human Rights has long documented Russian attacks on Syrian medical facilities and said the war in Ukraine showed the continuation of that policy. It said Russian attacks on institutions and educational facilities intensified in January.
The attack shows a strong awareness of the “cascading effects of health attacks on civilians,” said the director of Research and Investigations for Physicians for Human Rights, who contributed to the report. Christian de Vos said, “Instilling fear in the wider population is part of destabilization tactics.”
In the short term, the attacks forced many hospitals to close or severely reduce services. In Izium, liberated by Ukrainian forces last fall, about 200 of the 500 staff members have returned to work, and one of his damaged wings is up and running again after repairs. At least he said one pharmacy was also reopened so that people who ran out of medicine during his six months of service could be restocked.
Ukraine has the second highest number of HIV infections in Europe and Central Asia and one of the highest rates of drug-resistant tuberculosis. But since the invasion, the number of people receiving treatment for these diseases has dropped sharply. Thanks to a steady supply of donations, the amount of medicine is not a problem. However, the mass evacuation of Ukrainians within the country and across Europe makes it difficult to trace or trace new infections.
Andriy Klepikov runs the Alliance for Public Health, an organization that brings mobile clinics to towns near the front lines. He worries about undiagnosed tuberculosis and HIV cases, but remains optimistic about his country’s ability to overcome.
“The healthcare system is not about walls, buildings, or even equipment. It’s about people,” he said. “The Ukrainian military is known for its strength and resilience, but it is equally strong and resilient in the field of public health.”
Back in Krasnokholivka, tank shells snatched the signal of a Russian TV show about the life of a doctor Mozgova enjoyed. Both she and her husband have plans for her to be permanently reunited with her adult children in the western city of Lviv, considered one of Ukraine’s safest cities. she said no.
“They asked us to come and they have space, but what do I do? I will be a guest there. I want to be of service here,” she said.
Lori Hinnant reports from Paris. Vasilisa Stepanenko reported from her Izium. Inna Varenytsia contributed to this report from Kiev.