Russia's missile attack on Ukraine's largest children's hospital on Monday highlighted a rise in deadly attacks on medical facilities, vehicles and personnel in the country this year, adding to World Health Organization data suggesting more Ukrainians may lose their lives in such attacks this year than last.
Prior to the attack on Omaddit Pediatric Hospital in Kyiv, WHO recorded more than 175 attacks on Ukraine's medical infrastructure, killing 18 people and wounding 81, in the first half of 2024. The organization also recorded 44 attacks on medical vehicles in the same period.
The group counts 350 such attacks in 2023 alone, killing 22 people and wounding 117, with 45 specifically targeting medical vehicles such as ambulances. Other groups put the death toll much higher.
Monday's attack killed at least one doctor and one adult at the hospital and wounded at least 10 others, including seven children, as Russian forces bombarded the country. At least 38 people were killed in the bombings, 27 of them in the Ukrainian capital, Kiev, local authorities said.
Attacks on civilian hospitals are prohibited by Article 18 of the Geneva Conventions, ratified by UN member states after World War II, and Article 20 of the convention states that medical personnel must be protected by all warring parties.
Experts say Russia has repeatedly attacked Ukraine's medical infrastructure in attacks that some say amount to war crimes.
The Russian Defense Ministry denied in a statement on social media on Monday that it had deliberately attacked Ukrainian civilians. Video of the attack taken by a Kiev resident and reviewed by The New York Times showed the missile descending at high speed before hitting the hospital.
Christian de Vos, a lawyer and director of research and studies at Physicians for Human Rights in New York, said the world has yet to see a prosecution at an international tribunal that has focused primarily on attacks on medical infrastructure.
Experts said the Russian attacks targeted the most vulnerable and put further strain on Ukraine's already stretched health care system.
“Under international humanitarian law, hospitals and medical facilities are protected precisely because civilians are seeking treatment,” de Vos said. “These facilities are designed to protect civilians and relieve them from the horrors of war.”
The WHO defines attacks on health infrastructure as violent acts or threats that prevent the use, access or delivery of health services. Its data includes both confirmed attacks and potential attacks, which the organization defines as attacks with a single witness. Or two secondary accounts confirmed to WHO partners.
Experts say attacks on hospitals and medical workers have increased in conflicts around the world, and in Ukraine the increase came as no big surprise to some emergency workers.
“We have to constantly reassess where we are operating and withdraw from areas where it is no longer viable,” said Christopher Stokes, emergency coordinator for Doctors Without Borders in Ukraine. The war in Ukraine has been going on for more than two years.
Stokes said the group tried to set up an emergency department in the Kherson region earlier this year, but the hospital kept coming under bombardment, and by the sixth attack the decision was made to abandon the effort.
Experts say some hospitals are trying to take precautions such as sandbagging windows and moving patients and operating rooms to lower floors, where higher floors are deemed too risky from strikes.
“These hospitals are not sanctuaries, especially for patients, where they feel safe,” Stokes said.
Uliana Poltavets, emergency response coordinator for Physicians for Human Rights, who has been documenting attacks on medical infrastructure, said she heard explosions from the attack in Kyiv on Monday morning. She said it was part of a “pattern of violence” that has been repeated in Ukraine since February 2022, when the war began.
“The real invasion started with an attack on a maternity hospital in Mariupol,” she said. “Three years into the war, it seems like children are being targeted.”
