Ukraine: The destruction of healthcare is deliberate and calculated

Médecins Sans Frontières / Doctors Without Borders (MSF) has released a report documenting relentless attacks on healthcare and medical personnel in Ukraine. These attacks appear to constitute a deliberate strategy to destroy the medical system and collectively punish the population - rather than being an incidental product of Russia's invasion.

In “No safe place to heal,”  MSF documents more than 20 attacks on medical facilities between April 2022 and December 2025. Four hospitals where MSF worked have been completely destroyed. Seven ambulance bases had to be abandoned.

MSF has lost access to over 80 villages it supported across six regions with primary healthcare mobile clinics. The World Health Organization documented 2,811 attacks on healthcare from February 2022 to the end of 2025, and Ukraine’s Ministry of Health reports that Russian forces have damaged or destroyed over 2,500 medical facilities in the same period, including 327 that have been completely destroyed.

“These attacks are too consistent, too frequent, and too precise to be incidental; when hospitals are struck repeatedly, when ambulances are targeted with precision drones, when medical workers are killed en route to delivering medicines in clearly marked vehicles – this is not coincidence. This is a pattern; patterns have intent behind them.”

Robin Meldrum, MSF Country Coordinator in Ukraine

A healthcare crisis

Strikes on medical infrastructure and the crippling fear of attacks on civilians have created a crisis in access to healthcare for people in need of non-emergency medical treatment or treatment for chronic conditions. An MSF survey of 187 civilians in regions close to the frontline found that those who ‘always’ or ‘most of the time’ had access to healthcare diminished from 72 percent before the war’s escalation to just 35 percent since.

Those accessing care ‘rarely’ or ‘never’ rose from 7 to 35 percent. This translates directly into suffering and even death from manageable conditions – cardiovascular disease, diabetes, epilepsy – conditions that have become life-threatening due to interrupted treatment and delayed access. 

Healthcare facilities that remain operational are cruelly understaffed: in one MSF-supported hospital in Kherson, the number of doctors has fallen by 66 percent since 2022.

MSF teams in eastern and southern Ukraine work under the constant threat of First-Person View (FPV) drone attacks — weapons that allow soldiers to identify and strike targets with precision in real time.

On 29 September 2025, a nurse and a director from an MSF-supported health centre delivering medicines in a clearly marked vehicle in Lyman, Donetsk, were struck by a Russian FPV drone. The director lost a leg in the attack. Under international humanitarian law, deliberately attacking clearly marked medical personnel or vehicles may amount to a war crime.

End attacks on healthcare

MSF medical workers near the frontline, and in an early rehabilitation treatment centre in Cherkasy, are witnessing how drone warfare is fast outstripping the medical response. Injuries were once predominantly caused by artillery. But now, drone strikes account for a growing share of trauma cases – producing multiple victims with multiple simultaneous wounds, higher infection rates, and rising rates of sepsis.

An MSF surgeon describes a patient who arrived with an amputated right leg, an open fracture of the left leg, an open fracture of the right arm, shrapnel in the left arm, and multiple wounds to the chest, abdomen and head. Five surgeons operated simultaneously for around six hours. 

The same surgeon noted: “The first battle is against bleeding. If the patient survives that, the second battle is against infection. And many lose that second fight.”

This year marks ten years since the adoption of United Nations Security Council (UNSC) Resolution 2286, which unequivocally reiterates the protection of humanitarian and medical personnel, patients, and healthcare infrastructure in armed conflict.

MSF calls on all parties to uphold their obligations under international humanitarian law; on states with influence over Russia to use it to demand an end to attacks on healthcare; and on the Security Council to properly investigate and make public denunciations about attacks on healthcare as a way of showing commitment to UNSC Resolution 2286.