Operating under Fire
People Tell Their Stories of the Effects of Explosive Weapons on Health Care in the East of Ukraine.
Photos © Anton Skyba for International Human Rights Clinic at Harvard Law School and PAX.
Photos © Anton Skyba for International Human Rights Clinic at Harvard Law School and PAX.
Direct Harm
The use of explosive weapons puts healthcare facilities, medical personnel, patients and equipment at risk.
Facilities at Risk
In villages along the contact line in the east of Ukraine, shelling has directly hit medical facilities. Buildings have been damaged and windows have been shattered, whilst health workers have continued to provide care for their patients.
Personnel at Risk
"I heard an explosion and then felt a hot sensation in my legs. I saw I had lost a finger too. There was no light while they were operating on me, and one piece of shrapnel was left in my stomach.”
Vera Ivanovna, nurse at Avdiivka City Hospital in Avdiivka.
Vera Ivanovna, nurse at Avdiivka City Hospital in Avdiivka.
Patients at Risk
“We have a basement that we used as a bomb shelter. If possible we sent patients home. There they would also have shelters and we had no heating if it was cold.”
Dr. Natalia Dolzhenko, head of the therapy department at Maryinka District Central Hospital in Krasnohorivka.
Dr. Natalia Dolzhenko, head of the therapy department at Maryinka District Central Hospital in Krasnohorivka.
No Safe Space
"The whole clinic was in this room: the machines were on the bed, the waiting room was in the corner, the infusion set was next to it. We saw patients one after another."
Dr. Lyudmila Bagmut, executive doctor and pediatrician at the Granitne Ambulatory Clinic in Granitne.
Dr. Lyudmila Bagmut, executive doctor and pediatrician at the Granitne Ambulatory Clinic in Granitne.
No Ambulance
In June 2015, explosive weapons destroyed the ambulance garage at the Krasnohorivka ambulance substation, leaving a burnt-out ambulance in the far right bay. Fire also damaged the adjacent neurology building which is part of Maryinka District Central Hospital.
"We were hiding against the wall inside. It was a shock wave and there was also a fire. We lost the ambulance garage and one ambulance."
Dr. Victor Zinchenko, doctor at the Krasnohorivka ambulance substation.
Dr. Victor Zinchenko, doctor at the Krasnohorivka ambulance substation.
Indirect Harm
In addition to direct harm from explosive weapons, medical personnel and patients are faced with the loss of critical services. Damage to infrastructure such as water systems, electricity, heating, communication services and roads further complicates healthcare provision.
No Electricity
"Have you ever been in a home with no electricity? Cleaning surgical equipment, performing surgery by candlelight, it's terrible."
Dr. Viktoria Nikolova, head of the family services and therapy department, Avdiivka City Hospital in Avdiivka.
Dr. Viktoria Nikolova, head of the family services and therapy department, Avdiivka City Hospital in Avdiivka.
No Water
"We had no water because of the shelling. To wash our equipment and clean the operating theatres - it's crucial for survival."
Dr. Viktoria Nikolova, head of the family services and therapy department, Avdiivka City Hospital in Avdiivka.
Dr. Viktoria Nikolova, head of the family services and therapy department, Avdiivka City Hospital in Avdiivka.
No Communication
Damage to telephone lines and power plants has complicated access to medical services in the east of Ukraine. Without landlines and with 'jumping' mobile networks, it has been difficult to reach an ambulance - even when it has been be safe enough for ambulances to come at all.
"The telephone station used to be in the post office. On the first day of the shelling it was hit, so the city phone lines didn’t work."
Granitne resident.
Granitne resident.
Civilians Pay the Price
It is difficult to grasp the complex and interlinked pattern of harm that results from the shelling of towns and cities.
In the end, however, it is civilians who pay the price.
In the end, however, it is civilians who pay the price.
"My five year-old was born with cerebral palsy. Because of the shelling we were forced to stay here. We can’t take her to rehabilitation therapy. Lots of progress has been lost."
Maria Bero, Starohnativka resident.
Want to Know More?
In September 2016, researchers from Harvard Law School's International Human Rights Clinic and PAX conducted field research in nine communities in government-controlled areas along the contact line in the east of Ukraine. They interviewed 55 people, including local residents, doctors, nurses, ambulance personnel, and government health officials. They applied for but did not receive permission to travel to non-government-controlled areas. Research suggests the effects of shelling are similar on both sides of the line.
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Operating under Fire
Since the beginning of the conflict
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