As the war in Ukraine enters its fourth week, the World Health Organization reports that 43 hospitals, clinics, and ambulances have been bombed inside the country thus far.
"We have never seen globally this rate of attacks on health care. Health is becoming a target in these situations. It's becoming part of the strategy and tactics of war," said Michael Ryan, MD, executive director of the WHO’s Health Emergencies Program.
Targeting health care facilities and workers is not only against international law, but parties involved in conflicts are required to intentionally avoid such targets, which is not happening in Ukraine, Ryan said at a news briefing Wednesday morning.
Overall health care capacity is dropping in the country as well due to the conflict. There are 22% fewer beds with oxygen available and 20% fewer beds for surgery and treating trauma patients countrywide since the beginning of the conflict, the WHO announced.
Adding to the challenge are the locations of Ukrainian hospitals and clinics, with about 300 health facilities now in Russian-controlled territory and another 600 within about 6 miles of a front line.
Reinforcements Are Ready
Twenty international medical teams are ready to go to Ukraine, but those plans are on hold for now, the WHO announced. In an official sense, the organization is waiting for a formal request from the Ukrainian Minister of Health.
In reality, it's too dangerous at the moment.
"How can we put emergency medical teams on the ground in the very facilities that … are going to be attacked and going to be bombed and going to suffer catastrophic damage?' Ryan asked. "How can you do that in all conscience?"
This issue goes beyond the destruction of brick-and-mortar facilities, Ryan said.
"This isn't just about the destruction of buildings. This is about the destruction of hope. This is about taking away the very thing that gives people the reason to live -- the fact that their families can be taken care of, that they can be cured if they're sick, they can be treated if they're injured."
"This is the most basic of human rights."
The WHO's updates on health care in Ukraine come the same day that Ukrainian President Volodymyr Zelenskyy made a plea to the U.S. Congress for more military supplies and support.
The WHO said money also is needed to support the organization's efforts to protect health care in Ukraine.
"We face financial constraints in our ability to deliver the support needed. So far, WHO has received just 8 million U.S. dollars of our appeal for 57.5 million dollars," said Tedros Adhanom Ghebreyesus, PhD, the WHO director-general.
"Huge amounts of money are being spent on weapons. We ask donors to invest in ensuring that civilians in Ukraine and refugees receive the care they need," Tedros said.
While supply lines for essential medicines and medical supplies are now established, making use of them remains difficult during the conflict, he said.
Specific Health Concerns
Ukraine already had a high number of people being treated for HIV and tuberculosis, said Adelheid Marschang, MD, senior emergency officer at the WHO Emergencies Program.
"If their treatment is interrupted and obviously worsens, the risk of transmission increases, as does risk of antimicrobial resistance of the diseases themselves,” she said.
There's also a risk for children who cannot receive their vaccinations for rubella or measles in Ukraine, Marschang said. "There's a risk of outbreaks."
A lack of access to drinkable water in some parts of Ukraine is adding to the concerns, she said, because people now face the risk of dysentery and other waterborne illnesses.
A Global Call to End Conflicts
Although the world's attention is on Ukraine, military conflicts in Yemen, Afghanistan, and Ethiopia are straining health care systems and creating shortages of medicine and food as well, the WHO reported.
Tedros called on parties involved in these conflicts to end their sieges and blockades. "This is the only solution."