November 30, 2023

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The attacks against health care facilities in Ukraine constitute war crimes, and as such could lead to indictments against the perpetrators, a World Health Organization Foundation official said Friday.

“We should not assume, because we are seeing so many attacks in our living rooms, that these are normal things,” the WHO Foundation’s chief strategy and impact officer, Emanuele Capobianco, told POLITICO in an interview. “These are war crimes; these are against international law.”

Capobianco was speaking two days after the bombing of a maternity hospital in the southern Ukrainian city of Mariupol killed three people and wounded 17, drawing condemnation from world leaders. Images from the scene showed bloodied pregnant women walking or being stretchered to safety through the rubble.

Mariupol, which had a population of more than 400,000 before Russia invaded two weeks ago, has been cut off by Russian troops. Repeated attempts to evacuate residents via humanitarian corridors have failed due to shelling of the exit route. Aid agencies say the situation in the city is catastrophic, and local leaders say that more than 1,000 residents have been killed, with some being buried in mass graves.

The WHO Foundation is a body that’s raising money from individuals and companies for the global health group’s Ukrainian emergency response appeal, and is a separate legal entity from the WHO. 

For its part, the WHO hasn’t called the attacks war crimes, but Mike Ryan, executive director of the WHO’s health emergencies program, said Wednesday that the organization was carrying out surveillance and verification of these attacks. 

Current figures indicate that around 60 health facilities are not functional in Ukraine, with 26 facilities having been the target of attacks. 

The shocking reports from Ukraine may result in an outpouring of financial support, but Capobianco said there are “still enormous gaps that exist in funding to sustain the response.”

Call for donations

The WHO has asked for around $57 million to cover the first three months of its response. While the foundation has received a “positive response” to this appeal, it “remains largely unfunded” as it takes time for pledges to be converted into actual cash in hand, explained Capobianco. There is also the fear that even if the initial response can be sustained, the health crisis in Ukraine may last far longer than three months, with donor interest likely waning.

In the meantime, the situation is getting direr by the day. The most urgent need is to access the 1,000 health facilities that lie within 10 kilometers of the front line. But at the moment, it “is extremely difficult, if not impossible to provide medicines to those facilities,” said Capobianco. 

On the list of what’s urgently needed are trauma kits that include instruments to remove bullets; generators to power facilities; oxygen; drugs for chronic conditions; and mental health services. 

While support for injured soldiers and civilians may be front of mind, without access to chronic medications such as insulin or medication to treat hypertension, patients could die and other conditions like HIV could worsen. 

Despite the difficult situation, Capobianco said that remarkably, surveillance systems such as that for COVID-19 cases, are still functioning. “The resilience of the [health] system has been quite remarkable. It is not a system that has collapsed yet,” he said. 

The WHO is working with the Ukrainian health ministry to identify what medical support is needed, including health workers. The WHO’s Emergency Medical Teams system has been activated, but the deployment of health workers depends on safety on the ground. 

Despite WHO chief Tedros Adhanom Ghebreyesus’ plea for humanitarian corridors, the situation is currently “very bad” with regards to this request, said Capobianco. “In order to have safe access, you need ceasefires, you need agreements that vehicles transporting medicines will not be looted or bombed … that ambulances will not be shot at, and in many places in Ukraine at the moment that safe access is being denied,” he said. 

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