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Operating Under Fire

Logo https://stories.paxforpeace.nl/operating-under-fire

“Shelling started, and I fell into the ditch. I was thinking, will I be useful if I die?

Dr. Lyudmila Bagmut, executive doctor and pediatrician in Granitne, a village near the contact line in the east of Ukraine.

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People Tell Their Stories of the Effects of Explosive Weapons on Health Care in the East of Ukraine.

Photos © Anton Skyba for International Human Rights Clinic at Harvard Law School and PAX.

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Explosive Weapons in Populated Areas

The bombing and shelling of towns and cities is a key cause of death and destruction around the world. Explosive weapons inflict both direct and indirect harm on civilians. When weapons of this sort are used in populated areas, 9 out of 10 of those wounded and killed are civilians.

The indirect impact is often overlooked. But the destruction of water services, electricity networks, roads, schools and hospitals often have a long-lasting and profound effect on civilians.
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Since the beginning of the conflict in Ukraine in April 2014, the use of explosive weapons has caused widespread destruction, including in medical facilities.

The stories of health workers operating under fire and civilians not receiving needed care are told in this story.
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The use of explosive weapons puts healthcare facilities, medical personnel, patients and equipment at risk.
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In villages along the contact line in the east of Ukraine, shelling has directly hit medical facilities. Buildings have been damaged and windows have been shattered, whilst health workers have continued to provide care for their patients.
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"I heard an explosion and then felt a hot sensation in my legs. I saw I had lost a finger too. There was no light while they were operating on me, and one piece of shrapnel was left in my stomach.”


Vera Ivanovna, nurse at Avdiivka City Hospital in Avdiivka.
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“We have a basement that we used as a bomb shelter. If possible we sent patients home. There they would also have shelters and we had no heating if it was cold.”
Dr. Natalia Dolzhenko, head of the therapy department at Maryinka District Central Hospital in Krasnohorivka.
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Ukranian for 'SHELTER'
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"We have a basement that we used as a bomb shelter. If possible we sent patients home. There they would also have shelters and we had no heating if it was cold."

Dr. Natalia Dolzhenko, head of the therapy department at Maryinka District Central Hospital in Krasnohorivka.

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"The whole clinic was in this room: the machines were on the bed, the waiting room was in the corner, the infusion set was next to it. We saw patients one after another."

Dr. Lyudmila Bagmut, executive doctor and pediatrician at the Granitne Ambulatory Clinic in Granitne.

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In June 2015, explosive weapons destroyed the ambulance garage at the Krasnohorivka ambulance substation, leaving a burnt-out ambulance in the far right bay. Fire also damaged the adjacent neurology building which is part of Maryinka District Central Hospital.
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"We were hiding against the wall inside. It was a shock wave and there was also a fire. We lost the ambulance garage and one ambulance."

Dr. Victor Zinchenko, doctor at the Krasnohorivka ambulance substation.

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In addition to direct harm from explosive weapons, medical personnel and patients are faced with the loss of critical services. Damage to infrastructure such as water systems, electricity, heating, communication services and roads further complicates healthcare provision.
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"Have you ever been in a home with no electricity? Cleaning surgical equipment, performing surgery by candlelight, it's terrible."

Dr. Viktoria Nikolova, head of the family services and therapy department, Avdiivka City Hospital in Avdiivka.
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"We had no water because of the shelling. To wash our equipment and clean the operating theatres - it's crucial for survival."

Dr. Viktoria Nikolova, head of the family services and therapy department, Avdiivka City Hospital in Avdiivka.
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Damage to telephone lines and power plants has complicated access to medical services in the east of Ukraine. Without landlines and with 'jumping' mobile networks, it has been difficult to reach an ambulance - even when it has been be safe enough for ambulances to come at all.
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"The telephone station used to be in the post office. On the first day of the shelling it was hit, so the city phone lines didn’t work."

Granitne resident.
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It is difficult to grasp the complex and interlinked pattern of harm that results from the shelling of towns and cities.

In the end, however, it is civilians who pay the price.
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"My five year-old was born with cerebral palsy. Because of the shelling we were forced to stay here. We can’t take her to rehabilitation therapy. Lots of progress has been lost."

Maria Bero, Starohnativka resident.
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