More Ukrainians May Die in Attacks on Medical Sites in 2024, W.H.O. Data Suggest

A Russian missile strike on Ukraine’s largest children’s hospital on Monday highlighted the growing number of deadly attacks on medical facilities, vehicles and workers in the country this year. It adds to data from the World Health Organization and suggests that more Ukrainians may be on track to be killed in such attacks this year than last year.

Before the strike on the Ohmatdyt Children’s Hospital in Kyiv, the W.H.O. documented 18 deaths and 81 injuries from more than 175 attacks on health care infrastructure in Ukraine for the first half of 2024. The organization also recorded 44 attacks on medical vehicles in that period.

In all of 2023, the organization tallied 22 deaths and 117 injuries from 350 such attacks, and 45 more specifically on medical vehicles like ambulances. Other organizations put the death toll even higher.

In the attack on Monday, at least one doctor and another adult were killed at the hospital, and at least 10 other people, including seven children, were injured during a Russian barrage across the country. In all, the bombardment killed at least 38 people, including 27 in Kyiv, Ukraine’s capital, local officials said.

Attacks on civilian hospitals are prohibited under Article 18 of the Geneva Convention, which was ratified by United Nations member states after World War II. And Article 20 of the convention says that health care workers must be protected by all warring parties.

Russia has repeatedly attacked Ukrainian health care infrastructure, experts say, in a campaign that some say amounts to war crimes.

In a statement on social media on Monday, Russia’s Ministry of Defense denied purposefully hitting civilian targets in Ukraine. Video of the attack taken by a Kyiv resident and verified by The New York Times showed a missile moving downward at high speed before striking the hospital.

Christian De Vos, an attorney and the director of research and investigations at New York’s Physicians for Human Rights, said the world had yet to see a prosecution in an international court in which an attack on health care infrastructure was the main focus of the case.

Experts said Russia’s attack targeted people at their most vulnerable and strained a Ukrainian health care system already stretched thin.

“Under international humanitarian law, hospitals and health care facilities are protected precisely because civilians are seeking care,” Mr. De Vos said. “These are sites that are meant to ensure the protection of the civilian population and spare them from the horrors of war.”

The W.H.O. defines an attack on health care infrastructure as any act or threat of violence that interferes with the availability, access or delivery of heath services. Its data includes both confirmed attacks and probable ones, which the organization defines as attacks with one witness account or two secondary accounts confirmed to a W.H.O. partner.

Attacks on hospitals and health care workers in conflicts around the globe are rising, experts say, and in Ukraine, the increase comes as little surprise to some emergency workers.

“We are constantly having to review where we are working and pull back from areas that become impossible,” said Christopher Stokes, the emergency coordinator for Doctors Without Borders in Ukraine. The war there has stretched on for than two years.

Earlier this year, the organization tried to set up an emergency department in the Kherson region, but the hospital kept being bombarded, Mr. Stokes said. By the sixth attack, he said, the decision was made to abandon the effort.

Some hospitals try to take precautions, experts said, covering windows with sandbags and moving patients and operating rooms to lower floors. Higher floors are considered too risky because of strikes.

“These hospitals are not sanctuaries where you can feel safe, especially patients,” Mr. Stokes said.

Uliana Poltavets, the emergency response coordinator for Physicians for Human Rights, documents attacks on health care infrastructure and said she heard the explosion from the strike Monday morning in Kyiv. She said it was part of “a pattern of violence” that had been repeated in Ukraine since February 2022, when the war began.

“The full-scale invasion began with an attack on a maternity home in Mariupol,” she said. “Three years into war, children are seemingly targeted.”