WHO records more than 1000 attacks on health care in Ukraine over the past 15 months of full-scale war

Kyiv, 30 May 2023

WHO has verified more than 1000 attacks on health care in Ukraine since the invasion by the Russian Federation in February last year - the highest number WHO has ever recorded in any humanitarian emergency. This grim milestone yet again highlights the difficult and dangerous circumstances in which the country's health system operates, and the challenges of providing both routine and emergency health-care services. Attacks hinder access to health care for tens of thousands of people, increasing the risks of illness and death.

The 1004 WHO-verified attacks over the past 15 months of full-scale war have claimed at least 101 lives, including of health workers and patients, and injured many more. They have impacted health providers, supplies, facilities and transport, including ambulances.

WHO defines an attack on health care as "any act of verbal or physical violence, obstruction or threat of violence that interferes with the availability, access and delivery of curative and/or preventive health services during emergencies". This can range from violence with heavy weapons to psychosocial threats and intimidation that affect access to health care for those in need.

"These attacks threaten the safety and well-being of health workers and undermine care for people living close to conflict areas," said Dr Jarno Habicht, WHO Representative in Ukraine. "Attacks on health care are a violation of international humanitarian law. They deprive people of the care they need and have wide-ranging, long-term consequences."

Such attacks rob entire communities of essential health services that are needed to save lives, leading to increased illness and death and deterioration of health systems in the longer term. The psychological effect on patients scared to seek health care, and on health workers unable to provide care in safe and protected environments, are also significant, and will impact the health of the population for long periods of time.

WHO continues to advocate for safe access for the delivery of health-care services, free from violence, threat or fear. This is critical to putting people in need at the centre of the collective humanitarian response.

"The fact that the health system in Ukraine continues to operate amid such circumstances is a testament to the heroic dedication of health-care workers," continued Dr Habicht. "Despite the challenges posed first by the COVID-19 pandemic and now well over a year of war, Ukraine's health-care workers remain amazingly strong, brave and patient, day after day, saving lives and providing care to those in need. We stand in solidarity with them and all those working to ensure that everyone in Ukraine has access to the health care they need."

WHO has been monitoring and responding to health needs in the regions most affected by fighting in the east and south of the country. According to the Health Resources and Services Availability Monitoring System (HeRAMS), health facilities in the most affected areas, including Kherson, Kharkiv, Zaporizhzhia and Donetsk, have reported facing difficulties due to lack of security and to structural damage. However, a high percentage of health facilities in these regions are functional and accessible, even though they continue to operate only partially due to damage.

"Even as we continue to verify attacks on health care as this relentless war grinds on, we also note that attacks on other civilian infrastructure, especially in the past 6 months, are indirectly impacting the capacity of the health system overall," explained Dr Habicht. "WHO has so far reached almost 9 million people with support nationwide since 24 February last year. We are stepping up efforts, along with the United Nations and other partners, to access more areas, including regained parts of Ukraine where health needs are among the most acute."

According to WHO data, significant challenges have been reported in providing specialized services, such as chemotherapy and mammography, due to a lack of staff and medical equipment. Some regions also face difficulties in providing high-skilled childbirth services.

Although primary health-care remains widely available in war-affected regions, health costs have been increasing in the past half-year. Surveys conducted by WHO indicate that nearly a third of the population is finding it difficult to afford certain health services.