This text is translated from Norwegian with UiO GPT.
– Around 60 percent of the attacks on hospitals, clinics, and other health infrastructure were conducted with precision weapons. From this, we can conclude that the attacks were targeted and not random, says Scott Gates, Professor of Political Science at the University of Oslo.
Disregard for the Geneva Conventions and human rights
Scott Gates emphasizes that war has always been terrible throughout history. What particularly concerns him now is that the Geneva Conventions no longer seem to apply. Fundamental rights for the treatment of the wounded, the sick, prisoners of war, and the protection of civilians in conflict are being set aside.
– Since World War II, most states have adhered to the Geneva Conventions from 1948. However, in recent years, we have seen Russia, Syria, and Israel attack medical facilities. All three countries have ratified the convention, yet commit war crimes on a large scale, which must be stopped, says Scott Gates.
Gates is a co-author of a study, not yet published, that summarizes the extent of attacks on healthcare infrastructure in Ukraine since the Russian invasion on February 24, 2022. Together with Melanie Sauter from the University of Mannheim, Gates examined data and facts from two larger public datasets: Insecurity Insight and Violent Incident Information?provided by the News Agency (VIINA).
Systematic in remote areas near the frontline
– We found that the most systematic attacks on healthcare infrastructure occur and have occurred in areas close to the frontline, within a 20-kilometer zone. They do not happen directly at the frontline, says Gates, noting that this pertains to more rural areas where 73 percent of the targeted attacks occur. Despite hospitals and clinics being attacked on a large scale in urban areas such as Kyiv and Kharkiv, it is more challenging for researchers to conclude that these attacks are targeted.
– In fact, one of the hospitals in Kyiv has been struck over fifty times, although it should be acknowledged that in urban areas, more buildings than those explicitly targeted may be affected, says Gates.
– Whether the attacks by the Russians are intentional or not is harder to prove in densely populated areas, Gates emphasizes.
Repeated attacks
For researchers to conclude that attacks on medical institutions were intentionally targeted, another of the criteria was that the attacks had to be repeated.
– The fact that 65 percent of the medical institutions were attacked multiple times was also a factor indicating that there was intentional targeting, says Gates. He also refers to video evidence showing drones attacking Ukrainian ambulances, but notes that the Russians have focused on hitting hospitals and larger clinics because it yields more significant results.
Contributing to psychological terror
– In addition to significantly weakening Ukraine's healthcare infrastructure, the targeted attacks also induce psychological terror against healthcare personnel and patients. Healthcare personnel become afraid to work, and the injured do not feel safe even when brought to hospitals.
Gates and Sauter found that the attacks on hospitals and healthcare infrastructure occurred after the Russians lost territory – and not, for example, after Ukrainian attacks on Russia or significant Russian losses.
– This means that the loss of Russian lives appears to be something Russian authorities do not prioritize. It is only the loss of territory that prompts them to attack or punish Ukraine by destroying hospitals and clinics, says Gates.
Gates and Sauter have mapped the scope of Russian attacks on medical institutions from the outbreak of the war until the study concluded in late autumn 2024. They found a large degree of overlap between the two datasets. According to Gates, this makes the findings largely unambiguous.
The data contains, according to Scott Gates, 1821 reports of attacks on medical institutions, with 1179 of these being repeated attacks.