Four years of full‑scale war have turned Ukrainian medicine into one of the main targets of combat operations. The new report by the organization “Doctors Without Borders” (MSF) titled “No Safe Place to Heal” documents that attacks on hospitals, ambulances and medical staff are not abating, but rather gaining momentum, especially due to the increasingly frequent use of drones. The document, covering the period from April 2022 to May 2026, combines medical statistics with dozens of testimonies from patients and doctors from the east and south of the country.
Civilian Under Constant Shelling
According to data from the UN Human Rights Monitoring Mission, since the start of the Russian invasion almost 15,000 civilians have been killed and more than 40,000 wounded. In 2025 the number of civilian casualties rose by 30% compared to the previous year and by 70% compared to 2023. At the same time the country lost about 10 million residents through displacement and emigration: more than 5.8 million people fled abroad as refugees, and another 3.7 million remain internally displaced.
MSF medical staff working in frontline hospitals observe a change in the nature of injuries. While artillery was previously the main cause of trauma, civilians are increasingly being struck by drones during everyday activities—waiting for pensions, using public transport, or near their own homes. In some hospitals the number of mass casualty arrivals in a single week forced staff to activate emergency triage protocols multiple times.
Drones Change the Nature of Injuries
Surgeons working in MSF‑supported hospitals in the east describe a fundamentally different type of injury compared to 2022–2023. Drone debris scatters in various directions, creating deep, uneven wounds that are practically impossible to fully clean surgically. This increases the risk of sepsis even in patients who survived the initial operation. According to one surgeon, the first battle for doctors is stopping bleeding, the second is fighting infection, and many patients lose the second battle.
Early rehabilitation center statistics in Cherkasy confirm this trend: the number of multiple fracture cases rose by 51%, and multiple amputations tripled. According to the Ukrainian Ministry of Social Policy, since February 2022 the number of people with disabilities in the country has increased by at least 300,000 and exceeded three million.
Medical Personnel Under Fire
The report separately documents attacks directly on medical workers. One of the most detailed episodes concerns the director of the primary health center in Lyman, Andriy Rebrov, and nurse Valentyna Kolomatskaya, who on September 29, 2025, were struck by an FPV kamikaze drone while transporting medicine between two medical facilities. The vehicle was clearly marked with a red cross, yet this did not prevent a direct hit. Rebrov had to have his leg amputated; both victims suffered concussions and hearing damage.
The report also describes the tactic of a “double strike,” where a subsequent shelling is deliberately aimed at rescuers and random bystanders who came to help after the first explosion. One such incident occurred on February 1, 2026 near Terivka, when a bus with miners suffered two consecutive drone strikes. Of the 16 patients transported to the hospital, nine were classified as severe cases—twice or three times more than usual during mass casualty arrivals.
According to the World Health Organization, since the start of the full‑scale invasion, 233 medical workers and patients have been killed in attacks on medical facilities and transport, and another 930 have been wounded.
Читайте також:
«Лікарі без кордонів» розширюють мобільний скринінг туберкульозу на півдні України
Hospitals Vanishing from the Map
The Ukrainian Ministry of Health recorded damage or destruction of over 2,500 medical facilities between February 2022 and November 2025, of which 327 were completely destroyed. The number of attacks documented by WHO, after a decline in 2023, began to rise again: 370 attacks in 2023, 488 in 2024, and 580 in 2025.
MSF itself recorded over 20 attacks on facilities it supported or closely collaborated with from April 2022 to December 2025. Eight hospitals had to be evacuated, four of them—Kostyantynivka, Selydove, Pokrovske, and Pokrovske—are now completely destroyed. The city of Pokrovske turned into a ghost town, and Selydove remains under Russian occupation.
A particularly striking case is that of a trauma surgeon, an MSF partner, who survived an attack on the hospital in Kurakhivske, moved to what seemed a safer village 82 kilometres from the front, only to see five air bombs destroy that hospital in December 2025.
Humanitarian missions themselves suffered. The MSF office in Pokrovske was completely destroyed by a missile strike on April 5, 2022, killing an organization staff member and a 14‑year‑old boy. In December 2025 an explosion damaged the MSF office and staff housing in Slovyansk, just meters from the building—after which the organization restricted staff movement in the city.
Staff Collapse in Frontline Hospitals
The shortage of medical staff near the front line reached critical levels. In one MSF‑supported hospital in Kherson, the number of doctors fell from 79 to 27—a 66% drop; nurses decreased by 59%; technical staff by 50%. Meanwhile, the number of beds in the facility increased from 220 to 270 during the same period, meaning the remaining staff faced higher workloads.
Across the country, the total number of registered doctors fell from nearly 144,000 in 2021 to just over 127,000 in 2024—a loss of more than 16,000 specialists. In frontline regions this process is significantly more intense than the national average. Young specialists, especially those with children, leave, and some male doctors are mobilized to the Armed Forces.
Those who remain describe chronic exhaustion combined with a paradoxical adaptation to constant danger. Air alerts and the threat of drone attacks have become part of daily routine, and the sense of professional duty remains the main factor keeping the system from total collapse.
Chronic Diseases Enter Critical Stages
Beyond direct combat injuries, the report documents a parallel, less visible crisis—the destruction of access to planned medical care. A survey of 187 civilians in Dnipropetrovsk, Kherson, Mykolaiv, and Zaporizhzhia regions, conducted by MSF in February–March 2026, shows the scale of the problem: before the full‑scale invasion 72% of respondents could always or almost always receive medical care; now that figure has fallen to 35%. The share of those who rarely or never receive care rose fivefold—from 7% to 35%.
More than three‑quarters of respondents had at least once been without necessary medication, and almost 90% reported that their overall health had worsened since the escalation of the war. Emergency department data confirm this picture: in the Kherson hospital supported by MSF, the number of cardiovascular emergencies rose by a third, diabetic complications by almost half, and asthma and chronic obstructive pulmonary disease exacerbations more than doubled. The number of epileptic seizures, likely related to treatment interruptions and chronic stress, increased by 432%.
The causes of this are not limited to medical factors. Almost all respondents (92%) live without stable electricity, two‑thirds lack adequate heating, and most face food access difficulties. Doctors note a sudden rise in thyroid problems even in coastal regions where iodine was previously sufficient—chronic stress, poor nutrition, and sleep deprivation affect the body systemically.
How MSF Adapts Work Under Constant Danger
When in 2022–2023 medical teams could work 15–20 kilometres from the front line, the spread of long‑range drones made even 50‑kilometre areas dangerous. In response, MSF switched to a two‑week rotation system, with staff living directly on the hospital or ambulance base, minimizing the number of trips on roads that are regularly shelled.
Where mobile clinic trips became physically impossible, the organization introduced remote consultations via video or phone with local paramedics and nurses who remain in frontline villages. Since launching this program in September 2025, MSF has conducted over 1,500 such consultations in eastern regions and over 500 in Kherson. Patients with stable chronic conditions now receive prescriptions for three months at a time to reduce dependence on unstable pharmacy access.
In Cherkasy, the early rehabilitation team developed a model of care for injured civilians immediately after surgery, now being spread to hospitals in Odesa, Dnipro, Zaporizhzhia, and Poltava to reduce the risk of long‑term disability and complications from delayed rehabilitation.
Calls for Accountability
MSF concludes the report with a plea to Russian armed forces to cease attacks on civilians, medical workers, and infrastructure, and to adhere to international humanitarian law and UN Security Council Resolution 2286, adopted ten years ago specifically to protect medicine during armed conflict. A separate appeal is addressed to UN member states and the Security Council—to consistently and publicly condemn such attacks and support independent investigations of war crimes against the health system, including a retrospective review of the entire war period.
Читайте також:
“Doctors Without Borders” ceased operations in Russia
