By Galina Korol | 2025-09-09

Cockroaches crawl over the walls and scurry across the floor as though they own the place: in the gastroenterology unit of the Republican Clinical Hospital in occupied Luhansk, patients see hordes of the ghastly insects everywhere.

The disturbing footage was filmed by hospital patient Lidiya Klymenko, Realnaya Gazeta reported in August.

"I'll never forget what it felt like to be in the gastroenterology unit of the Republican Clinical Hospital. Probably only the cockroaches feel better than everyone there," Klymenko said in comments to her video, adding that patients had to buy their own traps.

The wards are in disrepair, with battered walls, torn and stained mattresses and peeling paint on walls and ceilings. The Yellow Ribbon movement posted photos of the hospital August 15 on its Telegram channel.

Ironically, such conditions are seen as "lucky" because at least the patient has a hospital bed.

"An ambulance could be driving through the city for up to four hours. This has happened more than once -- there have been cases where people have died of strokes before the medics could reach them," Nadezhda Velichko, a Luhansk resident, told Realna Gazeta.

A surge in mortality

What residents are experiencing with medicine in the occupied territories is not merely a crisis or the result of negligence. Rather, it is a deliberate policy by the pseudo-authorities appointed by Russia, the Ukrainian National Resistance Center says.

"We are documenting systemic and discriminatory restrictions on access to medicine," the center's spokesperson with the code name Lipa told Kontur.

Medicine under the occupation is no longer driven by concern for human beings. Observers say that even basic care now depends directly on having Russian documents.

Without a passport, it is impossible to see a doctor, get a prescription or gain access to a pharmacy. Similar barriers extend to housing, where the sale of real estate in the so-called "new territories" is possible only with Russian citizenship.

"This is a form of pressure, a form of subordination, an apparatus to change identity," Sergei Danilov, deputy director of the Center for Middle East Studies, told Kontur.

Mortality has surged under the occupation, while diseases have "gotten younger," he noted.

Danilov said that whereas timely treatment saved lives in the past, now diagnoses are given too late and people die.

Chronic disease is also causing death. Viktor Dudukalov, the deputy chairman of the Berdyansk district council and a service member in the Ukrainian army, said he knows of specific incidents from Berdyansk.

"People over 50 were managing their chronic diseases, but after the occupation began, the occupiers failed to provide even basic medical attention or routine care," he told Kontur. He added that essential drugs were either unavailable to keep patients stable or of such poor quality that they were ineffective.

Medical deserts

Under Russian occupation, the healthcare system is deteriorating every year and has already entered a deep crisis.

"Entire districts are medical deserts," the press service of the National Resistance Center said, noting that existing medical facilities are overflowing mainly with service members, while civilians are served only as an afterthought.

"All the medical facilities are constantly monitored by the [Russian Federal Security Service] FSB and police, and doctors are continually monitored to see who is writing what on the messaging apps, so Ukraine doesn't find out how many wounded people there are or who is wounded and in the hospital," Dudukalov said.

In addition, the acute labor shortage persists.

"In many towns there are no doctors, and there are so-called rotations from Russia [short tours by specialists] that may include fourth- and fifth-year students," Lipa said.

This is because Russian specialists who had been lured with high salaries are now refusing to go.

"Doctors from all over Russia came to the Kherson Region, either voluntarily or forcibly, because they could earn good money. But starting in 2024, the additional payments were taken away," Danilov said.

According to Dudukalov, in just Berdyansk, in Zaporizhzhia Region, there is a 50% shortage of medical personnel, and this figure is as high as 80 percent in some departments.

"This is a catastrophe," Dudukalov said. He recalled a story about a doctor who had come on the Russian program but could not provide suitable care because he was a veterinarian, not a general practitioner.

"He said, 'I'm a veterinarian,' I don't really understand any of this. The problem is that back home [in Russia] they forced me to leave. They said, go, but you'll have problems," Dudukalov said.

Expired quack remedies

In places where there are no hospitals, the occupiers came up with a pseudo- solution: the "Medical Train," an August report by Realna Gazeta said.

In reality, this initiative is just an ordinary bus in which people get their blood pressure taken, are given painkillers and told, "We've put you on record."

Sometimes the advice seems like a mockery.

"You can pick a blade of grass, drink a little, put leeches on your varicose veins," Realna Gazeta quoted a woman named Olha Shvetsova as saying.

People need to travel to get anything they need.

Dudukalov cited one egregious example: to purchase common medicine to treat a child's fever, one Berdyansk resident had to travel 120 kilometers to Melitopol because the Russians "don't treat and don't help."

"There's a chronic shortage in pharmacies, while the occupiers' 'mobile pharmacies' sell expired drugs," Lipa said. Residents must travel hundreds of kilometers for basic tests, sometimes as far as Rossosh in Russia's Voronezh Region.

"I won't try to predict the long-term repercussions right now because we're already seeing irreversible consequences," Dudukalov said, stressing the severity of the situation that has developed under the occupation.

According to estimates by the National Resistance Center, even after the Ukrainian territories are liberated, it will take years to rebuild the healthcare system.

The state needs new hospitals and healthcare workers but also to restore people's trust in the healthcare system that the occupiers have undermined.

"International experts confirm that the need for medical care in these territories is massive. But while combat is ongoing, the Russian authorities are neither able nor, judging by their actions, interested in correcting this state of affairs," Lipa said.