Just a few years ago, Pavlo Kovtonyuk’s goal was to rebuild Ukraine’s healthcare system. Now its task is to chronicle its systematic destruction by Russian forces invading Ukraine.
While serving as Ukraine’s deputy health minister until 2019, Kovtonyuk was part of a team of reformers on a mission to reform the country’s healthcare system and modernize its long-neglected medical infrastructure. This included funding and building new primary and family health care clinics.
One of these new clinics was located in Makariv, a small town some 40 kilometers west of Kyiv. The clinic, which started operating in 2018, was clean and friendly with modern equipment. Before the war, it served as a hub for COVID-19 vaccination efforts in the city.
A banner promoting the vaccination campaign still hangs on the site, but that banner is all that remains of the facility. The rest of the clinic is now a pile of bricks and concrete rubble with glass and plastic fragments, pieces of wood and broken equipment. Heavy mortars leveled the clinic in March as part of the Russian army’s failed offensive against Kyiv.
The destruction of a modern medical clinic in Makariv is not an isolated incident. Kovtonyuk notes that a total of at least 169 Ukrainian medical facilities have suffered significant damage since the Russian invasion began in February, while 18 medical personnel have been killed.
Subscribe DAILY to UkraineAlert
As the Russian crisis in Eastern Europe escalates, UkraineAlert DAILY delivers the best advice from experts from the Atlantic Council, the online publication UkraineAlert and beyond, to your inbox Monday through Friday.
Kovtonyuk says the Makariv attack is part of a deliberate campaign. Thanks to the work of his team at the NGO Ukrainian Healthcare Center, Kovtonyuk believes he has enough evidence to demonstrate that the Makariv clinic and several other medical facilities were intentionally targeted as part of Russia’s genocidal campaign to destroy the state and nation of Ukraine.
“It could be argued that the destruction of medical facilities is only part of the overall Russian policy of attacking Ukrainian civilians and civilian infrastructure. These are war crimes within the meaning of the Geneva Convention. But it’s more than that. This is the unprecedented militarization of the destruction of health care by the Russian Federation,” Kovtonyuk said during a recent visit to the Makariv site.
To back up these claims, he notes that the clinic is located near a larger hospital campus. While the clinic was completely destroyed by the advancing Russian army, the other structures suffered limited damage. Similarly, buildings in the surrounding area are relatively spared. There are also no conceivable military targets nearby.
The targeted nature of the attack on the clinic convinced Kovtonyuk that it was an intentional act rather than random destruction. A former senior official of the World Health Organization (WHO), he is precise and conservative in his allegations and investigations. Indeed, it compiles hard evidence for a possible future case before the International Court of Justice.
Kovtonyuk believes evidence gathered at Makariv and dozens of similar sites points to a systematic Russian plan to destroy Ukraine’s medical infrastructure. “The Russians are destroying health care here to terrorize citizens and force genocide through migration,” he says. “They think they can get away with it. They think the WHO won’t act, the world won’t notice, and the few people left here will eventually have their memories erased in a new Ukraine under Russian control. This cannot be allowed.
At the Makariv site, Kovtonyuk reports a series of evenly spaced crater holes in the grass around the destroyed clinic extending in a straight line towards the target. A Ukrainian artillery officer trained to inspect impact sites later confirms that this firing pattern indicates soldiers attempting to pin down a target. He believes that a two-person Russian mortar team was probably operating about a kilometer away, while an observer with communications directed their fire within visual range of the target. This suggests that a group of Russian soldiers not only accepted an illegal order, but also knew exactly what they were aiming for and chose to destroy it.
Eurasia Center Events
Russian attacks on Ukrainian medical facilities have yet to trigger a major international reaction. Kovtonyuk is particularly critical of the World Health Organization (WHO). He points out that it was not until the forty-second day of the war that the Director General of the WHO issued a statement condemning the invasion. According to Kovtonyuk, no internal sanctions under the WHO Constitution have been applied to the Russian Federation, while a recent resolution indicated that WHO officials may consider certain measures if Russia continues its shares.
Kovtonyuk considers this insufficient. “The Russian Minister of Health still sits on the Executive Board of the WHO. He is also at Putin’s cabinet table with Defense Minister Shoigu. He is directly guilty, but the WHO has done nothing to sanction the Russians even slightly. He didn’t even disinvite them from a single Zoom meeting,” he comments.
The former Ukrainian deputy health minister admits to being frustrated with much of the Western response to the Russian invasion and accuses the Western establishment of not fully grasping the gravity of the situation. At the same time, he points out that Ukraine has exceeded all expectations. “There is one thing that no one counted on, whether it was the Western establishment or the Russian despots. Namely that the victims of this situation, the Ukrainians, would refuse to play this role. The victim will not be victimized. We fight, each in their own way. We don’t fade or bend,” says Kovtonyuk.
That fighting spirit turned an early three-day military visit into Europe’s biggest conflict since World War II. Ukraine’s remarkable resilience has won worldwide admiration, but the country continues to pay a terrible price for its courageous stance. The deliberate targeting of Ukrainian health facilities is one of many war crimes that Russia is currently accused of as Putin seeks to break Ukraine’s will to resist. The attacks on health facilities will serve as a focal point for ongoing investigations as the international community seeks to hold Russia accountable for crimes committed in Ukraine.
Pete Shmigel is an Australian writer with a background in politics, mental health and Ukrainian issues.
The opinions expressed in UkraineAlert are solely those of the authors and do not necessarily reflect the opinions of the Atlantic Council, its staff or its supporters.
The Eurasia Center mission is to strengthen transatlantic cooperation in promoting stability, democratic values and prosperity in Eurasia, from Eastern Europe and Turkey in the West to the Caucasus, Russia and the Central Asia to the East.