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Three years after Russia invaded Ukraine, the country’s healthcare system is under severe strain. Constant missile strikes, staff shortages, and disease outbreaks have overwhelmed hospitals and clinics. Medical workers continue to provide care despite the dangers, but the situation is worsening.

Doctors Face Attacks and Shortages

On July 8, Dr. Lesia Lysytsia was preparing a young patient for eye cancer surgery at Okhmatdyt, Ukraine’s largest children’s hospital. Suddenly, air raid sirens blared. She ignored them—if doctors ran to shelters each time an alarm sounded, many children would not get the care they needed. She also wanted to get home on time to see her own children.

Then, a missile struck Okhmatdyt. Three people died, dozens were injured, and the attack left the hospital in ruins. On that day, Russia launched 40 missiles at Ukraine. Around 630 children were in the hospital when the explosion happened.

Despite the damage, Kyiv partially reopened Okhmatdyt a week later. The hospital continues to function, though conditions remain difficult. “It feels like normal days,” Lysytsia said. “We changed mentally. But we have a goal and responsibility, so we don’t show it.”

Since Russia’s full-scale invasion on February 24, 2022, Ukraine’s healthcare system has been in crisis. The war has displaced millions, destroyed infrastructure, and created a growing need for medical care. The United Nations (UN) reports that Ukraine’s population has dropped by more than 10 million due to migration and war casualties.

“No healthcare system in the world is built for full-scale war,” said Eric Adrien, who oversees Ukraine’s medical evacuations for the European Commission.

Doctors and nurses have adapted to extreme conditions. Many perform amputations, work without electricity, and treat patients while bombs fall nearby. The World Health Organization (WHO) reports that Ukraine’s healthcare system, which was reformed in 2017 to modernize services, has shown resilience. However, many problems remain.

Medical Facilities Under Attack

Since 2022, Russian forces have targeted over 1,760 hospitals, clinics, ambulances, and medical workers, according to Physicians for Human Rights (PHR). WHO reports even higher numbers.

These attacks—an average of 1.6 per day—have severely limited access to medical care. Human rights groups argue that such strikes could be classified as war crimes. The Kremlin denies targeting civilians and claims it did not hit Okhmatdyt.

Attacks on hospitals and Ukraine’s power grid have made it even harder to treat war injuries, chronic illnesses, and infectious diseases. Since the missile strike on Okhmatdyt, PHR has recorded at least 41 additional attacks on medical facilities. In January alone, two hospitals were completely destroyed, and 22 others were damaged.

The loss of healthcare workers is also worsening the crisis. Since the start of the war, 262 medical staff have died. Many others have retired, fled, or joined the military. Doctors are especially hard to find in occupied and frontline areas, leaving many patients without access to proper care.

Diseases Spread as Health Services Decline

Alongside war-related injuries, infectious diseases are spreading at an alarming rate. Ukraine has one of the world’s highest rates of multi-drug-resistant tuberculosis, which is difficult to treat. Cases of HIV, hepatitis, and respiratory infections are also increasing.

“Tuberculosis, HIV, hepatitis—these are signs of a failing healthcare system,” said Dr. Tankred Stöbe, an emergency doctor and medical coordinator for Doctors Without Borders (MSF). “The numbers keep growing, but no one seems to notice or care.”

Before the war, Ukraine had made progress in reducing HIV infections. But UNAIDS now warns that the conflict has increased risks linked to sex work and drug use. Many hospitals have been forced to reduce services such as cancer screenings and mental health support.

Anna Uzlova, a breast cancer survivor and director of the patient advocacy group Inspiration Family, said many patients are struggling. “Cancer screenings are delayed, which leads to late diagnoses,” she explained. “Patients also need psychological support. The uncertainty about the future makes it worse.”

Mental Health Crisis and Medical Burnout

The war has taken a toll on the mental health of civilians and medical workers. A recent Kyiv-Oxford study found that over 30% of Ukrainian households report “severe psychological stress.” Experts warn that untreated mental health conditions could lead to higher rates of depression, suicide, and eating disorders, particularly among teenagers.

“Mental health issues are critical now, especially in the war’s third year,” said Halyna Skipalska, CEO of the Ukrainian Foundation for Public Health. “At first, there was optimism. Now, people feel exhausted.”

For those evacuated to Europe for medical treatment, the trauma does not end. Adrien from the European Commission noted that many patients suffer from post-traumatic stress disorder (PTSD) long after they leave Ukraine.

“Medical evacuation is difficult for patients,” he said. “Psychological trauma lingers long after they leave.”

Meanwhile, the shortage of doctors and nurses is worsening. Major cities like Kyiv still have enough medical staff, but specialists are scarce. In eastern Ukraine and occupied regions, the situation is dire. Many areas lack access to basic medical services, making chronic diseases and war-related injuries even harder to manage.

The nursing crisis is even more severe. Before the war, Ukraine already had fewer nurses per capita than the European Union. Now, many nurses have left the country for better job opportunities abroad. Doctors face difficulties getting certified to work in other countries, forcing them to choose between staying or leaving the profession altogether.

Dr. Yevheniia Poliakova, an obstetrician and medical director in Zaporizhzhia, said doctors leave when attacks intensify but often return.

“I will only leave if Zaporizhzhia is occupied,” she said. “I love my job and my city. This is my home.”

Uncertain Future for Ukraine’s Healthcare System

Ukraine’s healthcare system continues to function, but it is largely dependent on international funding. Many worry that if financial aid from Western countries declines, the system could collapse.

“Yes, there are many problems,” said Inna Ivanenko, director of Patients of Ukraine. “But our healthcare system has survived. That means its foundation is strong enough.”

Despite the resilience of Ukrainian doctors and nurses, the war’s impact on the healthcare system is undeniable. Hospitals and clinics remain under attack, medical staff are overworked, and diseases are spreading. If the war continues, Ukraine’s healthcare system will face even greater challenges.

For more updates on Ukraine’s healthcare crisis and global developments, visit Financial Mirror.