Since armed conflict broke out in Ukraine in 2014, the use of explosive weapons has directly damaged hospitals, destroyed ambulances, and killed or injured health workers. It has also indirectly affected the health care system by shutting down infrastructure—causing loss of electricity, heat, water, and communications—and creating travel risks for ambulances, medical personnel, and civilians in need.

These impacts have interfered with the provision of health care to local civilians and forced many to go without.

A new report, Operating under Fire: The Effects of Explosive Weapons on Health Care in the East of Ukraine, documents the situation, drawing on field research conducted in communities along the front line. The report was jointly released today by Harvard Law School’s International Human Rights Clinic and the Dutch peace organization PAX.

As the report makes clear, the harm attributable to explosive weapons’ use in populated areas has infringed on the availability, quality, and accessibility of health care, which are three elements of the right to health.

For example, structural damage and shattered windows have forced hospitals to abandon buildings and cut back on services. Doctors have treated patients in frigid conditions and operated by operated by candlelight due to heat and power outages. Health workers and civilians alike have had to dodge shells and risk their lives to reach local clinics.

The health care problems have exacerbated the conflict-related difficulties faced by civilians in the east of Ukraine. They also exemplify one of the many humanitarian problems associated with using explosive weapons in populated areas.

Explosive weapons encompass a range of munitions, including air-dropped bombs, artillery projectiles, rockets, and missiles. Especially when such weapons have wide area effects and are used in cities and towns, they are likely to hit civilians and the infrastructure upon which their lives depend.

In addition to spotlighting the impacts on health care in Ukraine, Operating under Fire makes the case for an international political commitment that would help minimize future harm from the use of explosive weapons in populated areas.

Download the full report.
Download the summary and recommendations.

For more information, contact Bonnie Docherty: [email protected]