By Galina Korol | 2025-01-09

KYIV -- Since the start of Russia's full-scale invasion of Ukraine, energy infrastructure has become a primary target of attacks.

Russia is targeting Ukrainian power plants, transformers and power lines, condemning millions of Ukrainians not only to days and nights without light and heat but also to a seriously impaired healthcare system.

"We decided to investigate the consequences of attacks on Ukrainian energy infrastructure," Roman Koval, chief of research at Truth Hounds, a human rights organization that investigates international crimes and human rights violations in Ukraine and other conflict-affected regions, told Kontur.

Together with the NGO Physicians for Human Rights (PHR), Truth Hounds published a report on December 4 titled, "Healthcare in the Dark: The Impacts of Russian Attacks on Energy in Ukraine."

Saving lives in extreme conditions

The researchers interviewed 2,261 healthcare workers across Ukraine, both in person and online.

More than 92% of them reported regularly losing electricity because of attacks on the power grid.

They noted 36 instances of patient harm and 20 deaths related to the outages.

Without electricity, doctors are forced to save lives in extreme conditions.

"You have to be able to do different things in different specialties," Sergei Baksheyev, an obstetrician-gynecologist and fertility specialist in Kyiv, told Kontur.

Because he always films his maternity patients' deliveries, he documented the first birth attended to by his colleagues in a bomb shelter February 25, 2022.

"The Ukrainian medical system is facing challenges that have never affected our country on such a scale, because the enemy is deliberately destroying Ukraine's infrastructure," said Baksheyev.

The report's authors noted that 1,539 attacks on medical facilities and workers have been recorded since February 2022. Of these, 104 cases involved damage to water and power supplies to hospitals.

Targeting children's hospital

Okhmatdyt, one of Ukraine's largest pediatric hospitals, which has been saving children from cancer, rare diseases and severe injuries for more than 130 years, has come under numerous attacks.

Russian air strikes shattered its windows in March 2022 and forced the transfer of seriously ill patients to shelters.

In October 2022, an Okhmatdyt doctor was killed by a missile on her way to work.

The worst attack came last July 8 after months of hardship when surgeons frequently had to operate by flashlight.

Koval recalled the words of one of the doctors interviewed.

"[The doctor] said that until July 8, 2024, despite all the existing difficulties, she believed that she was protected at work. She didn't expect to be in danger while she was in a children's hospital," Koval told Kontur, referring to the day when Russia deliberately launched a missile into Okhmatdyt's toxicology building.

In that strike, "two civilians perished, another 50 were injured and water and power disappeared in the hospital," the researchers wrote.

"It was dark and dusty all around. I heard the beep of devices signaling errors. I heard the screams of children," recalled pediatrician and Okhmatdyt department chief Anastasiia Zakharova, as quoted in the investigative report.

Her colleague, Dr. Svitlana Lukyanchuk, was killed.

It took several days to bring temporary power systems back online.

"You can work in these conditions for a couple of years but not forever," pediatric ophthalmologist Lesia Lysytsia told the researchers. "For me, Okhmatdyt was a fortress. I thought the children's hospital wouldn't be hit."

Relocating clinics

A 16-hour working shift might have only "40 minutes of power, sometimes an hour and a half," Olena Lazariyeva, an intensive care anesthesiologist at Mariupol Provincial Hospital, told the researchers of her working conditions in both Mariupol and Kyiv.

"If there are critically ill patients, if they need oxygen, artificial lung ventilation, without electricity, it can be bad."

Authorities moved the hospital to Kyiv during the wartime evacuation.

During the assault on Mariupol in February and March 2022, the original hospital suffered several direct strikes and soon lost electricity. Russian troops later turned it into a military base.

Neurosurgeon and oncologist Anton Shkiryak had to evacuate his own clinic at the start of the war, from Kyiv to Uzhhorod in western Ukraine.

Ukrainian military, Security Service and police personnel helped him "carry away equipment from the clinic in several trucks at night during the period when combat in Kyiv was at its hottest," he told Kontur.

War has forced him to operate two clinics now -- the new one in Uzhhorod and the original one in Kyiv.

The Kyiv location is subject to Russian attack with Shahed missiles, so "we receive patients simply for consultations [in Kyiv] ... while those who are admitted for treatment, for an operation, we send to Uzhhorod," Shkiryak said.

Ukrainian medical care has advanced, tragically, under the pressure of the invasion: it has adapted to new realities, taken on more responsibility for patients and found new ways to ensure uninterrupted service.

"I believe that Ukraine has the most experience in military medical care in the world," said Baksheyev.