The emergency is not available at night, catastrophic shortage of doctors and looting of hospitals – what is going on with health care system on Ukrainian territories occupied by Russia?
In 2023, 70 years old inhabitant of village in Kakhovka raion of Kherson oblast felt himself bad: he had problems with stomach and a set of associated diseases. His relatives succeeded in getting emergency from Kakhovka.
The only ambulance vehicle of Kakhovka hospital took the old man and tried to bring him to Skadovsk, situated 150 km away from his village. Hospital in Skadovsk had doctors who could provide emergency aid to the man. However, he died on the road to Skadovsk.
There are numerous similar cases on occupied territories of Kherson oblast. It is the direct outcome of the Russian invasion and consequent occupation.
“No matter what you do – emergency will not come”
Inhabitant of Dnipryany village of Nova Kakhovka local community lost her old father when Russian occupants cut an access to basic health care assistance during first months of the Russian occupation.
One of buildings of the hospital in occupied Nova Kakhovka, 2023. Photo from Russian occupation social media
“On the eve of the great war my father suffered from a stroke. In March 2022, he lost an access to supporting drugs. It became very difficult to find competent doctor. On April 16, 2022, he felt bad around nine in the evening. We called emergency but Russian occupants stopped it because there was already a curfew. We were told that doctors could come next morning. Father died at night”, as she told.
Residents of Nova Kakhovka and neighboring villages told the CJI that emergency still did not come at night. You can count on arrival of ambulance only in the morning and during the day when it is light outside. However, it is sometimes impossible to call emergency because Russian occupants often cut the electricity and mobile services. People are not able to make phone calls. In order to get emergency health care assistance, people have to hire expensive taxi and bring sick person to a doctor or hospital.
“There were many cases when people had to wait until morning, in order to call the emergency. When it is dark, the ambulance car does not come. No matter what you do – emergency will not come. You can pray and hope that you will survive until morning”, as told us inhabitant of Nova Kakhovka.
Representative of Russian occupation authorities in hospital of Nova Kakhovka, summer 2023. Photo: screenshot of video
However, it is difficult to receive medical assistance in this city even during the day. At the beginning of 2023, Russian occupants looted local hospital and chased the doctors away. Nova Kakhovka, situated on the bank of Dnipro river, was too close to the front line, as they explained. Then, Russians renewed the work of small number of doctors but they were unable to meet demand for basic health care services. Fearing Russian persecution, many doctors left occupied territory.
“To get sick is the worst thing under Russian occupation”
As Volodymyr Kovalenko, legitimate mayor of Nova Kakhovka, says, the situation with health care services has not improved since the beginning of Russian occupation.
“Today there are one therapist, seven other doctors and a dozen of nurses in the city. Before the Russian invasion and occupation, around 900 people worked in our hospital and primary health care center. 178 people worked in the system of primary health system. One third of them were doctors. Russian occupants tried to bring Russian doctors from Russia but these doctors did not stay long”, as says Volodymyr Kovalenko.
As he reports, residents of Nova Kakhovka local community have to go for medical assistance to Kakhovka or Novotroitske, Genichesk and Skadovsk, situated far away. In order to receive consultations of specialists, one has to go to Crimea. For example, cancer patients and people requiring surgery can receive necessary medical treatment only in Crimea.
For long time, Russian occupants were unable to provide simple blood tests for patients in Nova Kakhovka. It was unimaginable before the Russian occupation.
“As one person recently told me, the worst under occupation is to get sick. People are forced to make self-treatment. If they need more or less serious medical assistance, they have to travel to Simferopol, situated 250 km away from Nova Kakhovka. They have to hire expensive taxi, spend a lot of money on hotels and expensive meals in Crimea. Altogether it is very expensive. Many people cannot afford it”, as says Volodymyr Kovalenko.
Russian occupants seized entirely new hospital complex in Tavriisk, opened on the eve of Russian invasion. Since the beginning of Russian occupation, only two doctors – therapist and dermatologist – have worked in this hospital. According to sources of CJI, dermatologist has been recently transferred to Nova Kakhovka. Though he has been alcoholic, Russian occupants kept him as they did not have any alternative candidates.
Russians failed to restore the work of Tavriisk hospital to its pre-war level. It seems they did not even try to do it. They looted new modern laboratory, installed in 2021, and took away two pieces of modern equipment.
Medical equipment stolen by Russians in Tavriisk. Photo: screenshot of 2021 video – Ukrainskii Pivden
“It has been funny – after seizure of our hospital complex, occupants could not work on modern equipment in the laboratory. They did not have necessary reagents. They failed to find necessary specialists. That is why they stole our equipment and brought very old laboratory machines. They conduct tests by outdated methods”, as told us Mykola Rizak, the Head of Tavriisk City Military Administration.
Number of doctors in Kakhovka is decreasing. In summer 2025, six therapists worked there. Now only doctors do. There is only one ophthalmologist but he is not able to cope with demand as inhabitants of Nova Kakhovka also try to get an appointment. Before the Russian occupation, three ophthalmologists worked in Nova Kakhovka. Now there is nobody there.
“Doctors from Russian regions do not want to work in Kakhovka or Nova Kakhovka. Though, Russian occupants keep saying that they are trying to recruit specialists”, as told us employee of Kakhovka hospital.
“First “chief doctor” stole 20 million, allocated by Russians for the hospital”
63-years old Valentyna Shkurat witnessed how Russian occupants and collaborators seized and looted local hospital and primary health care center in Kakhovka. She has worked as medical director of the center for years. In spring 2023, she headed for a month “Kakhovka central raion hospital”, illegally created by Russian occupants. Russians merged both health care institutions into this organization.
Painted over Ukrainian word on the building of hospital in Kakhovka, 2025. Photo: Russian occupation social media
According to Valentyna Shkurat, immediately after seizure of Kakhovka City Council on April 1, 2022 and appointment of local collaborator Pavlo Filipchuk as “the mayor”, representatives of Russian occupation authorities proposed her and other doctors to head “the hospital”.Legitimate managers of the hospital and center refused to cooperate with occupants. One employee of the hospital agreed and announced that he was new “chief doctor”.
“It has been pharmacist Oleksandr Irza. Nobody made his official presentation as “chief doctor”. Russians just told us that he was our new supervisor. He has become the only “chief doctor”, directly appointed by Pavlo Filipchuk, his old friend. There were rumors that Irza supplied drugs to Filiphuk who has been drug addicted for many years. Employees of the hospital were shocked as Irza had bad reputation. After appointment, he did not intervene into the work of the hospital, and we worked as usual.
Since August 2022, Russian occupants have paid 10 thousand Rubles per month to each employee. Chief accountant of the hospital gave them in cash. Later I realized that, in autumn 2022, occupants set up “Ministry of Health Care of Kherson Oblast” and introduced their own system of salaries. But we did not see those money! Irza took everything. It was revealed after his dismissal that he together with chief accountant stole around 20 million Rubles from Russians. They were allocated for our salaries and the hospital”, as recalls Valentyna Shkurat.
Oleksandr Irza, first “chief doctor” of Kakhovka hospital. Photo from social media
Looting of health care institutions started under first “chief doctor”, according to Shkurat. Oleksandr Irza “privatized” the car, transferred to primary health care center of Zelenopidska village community of Kakhovka raion. Later he broke it in car accident. Valentyna Shkurat says that she tried to find out whereabouts of this car but failed. Representatives of occupation authorities told her that the car could not be repaired.
After disappearance of Irza, Valentyna Shkurat was told that Russians initiated criminal investigation against him. They found out large quantities of “Nalbufin” in the hospital without any necessary documents. It is strong painkiller, very popular among drug addicted. It is unknown how it has been supplied to occupied Kakhovka. Pavlo Filipchuk also suffered from this case but later the scandal was somehow settled.
“Total looting was called “evacuation”
Chaos has embraced Kakhovka from November 2022 till January 2023 when representatives of Russian occupation authorities were scared by the Ukrainian liberation of Kherson and Right Bank of Kherson oblast and fled from the city. It was revealed later that Russians ordered their subordinates in October 2022 “to evacuate” everything possible from the city, including the hospital.
Valentyna Shkurat, ex-“chief doctor” of hospital in occupied Kakhovka, 2025. Photo: Oleg Baturin/CJI
“On January 13, 2023, I met Irza. He showed me October order of the “Ministry of Health Care of Kherson Oblast” about evacuation of our hospital. But new “hospital manager” Igor Vasyliev was introduced to us in one week. Occupation authorities organized general meeting of employees of the hospital and primary health care center for the first time and made this announcement. Igor Vasyliev was inadequate person and I did not have good relations with him. He started financial revision and found out that no employees received salaries allocated by Russians. Irza with chief accountant falsified documents and took our money.
Total looting of health care institutions of our raion was launched under Vasyliev. It was called “evacuation”.Kahovka hospital stopped its work. As of February 9, 2023, everything was taken out”, as recalls Valentyna Shkurat.
She says that closure of the hospital became the cause of her conflict with Igor Vasyliev. People regularly addressed doctors. Some needed medical treatment, other asked about death certificates. Upon her own initiative, Shkurat introduced voluntary servicing by doctors. She says that two family doctors, two pediatricians and several nurses kept working in the closed hospital. Though, they were left without any equipment.
Segment of the news of Russian occupation Telegram channel, May 2023
In March 2023, Russian “mayor of Kakhovka” Pavlo Filipchuk criticized decision of occupants to close the hospital. Occupation authorities resumed its work.
“Later Filipchuk boasted that he saved the hospital. But he did nothing to renew the work of the hospital. He did not live in Kakhovka. Since November, he resided in resort area Lazurne in Skadovsk raion. After creation of the occupation “Ministry of Health Care” in autumn 2022, he did not have the power to influence the work of the hospital and appointments. After dismissal of Vasyliev, I received from “the Ministry” the list of equipment, “evacuated” from the hospital, and searched our equipment all around Kherson oblast. Nobody from occupation authorities worried about it; they perceived me as “crazy woman”. I found machines for anesthesia and some other equipment in the warehouse for vegetables of Novotroitska hospital. I found one car, taken out by Vasyliev. It was appropriated by “Minister” Artysh Sat. I showed documents and returned the car”, as says Valentyna Shkurat.
“Chief doctor” from PMC “Wagner”
When Vasyliev completed “evacuation” of equipment, he was dismissed and moved to Novotroitske. Valentyna Shkurat says that she contributed to the appointment of new “chief doctor” by “the Ministry”. Doctor Maryna Yaremchenko moved from Kherson before the Ukrainian liberation of the city in November 2022.
“She settled in Korobky and looked for job. I told about her in “the Ministry” and she was appointed. But she did nothing as the director because she did not know this work. She was interested only in money. After her, Russians appointed Aleksandr Shylovich as the new “chief director”. Yaremchenko continued working as the “head” of policlinic. As final appointment of Shylovich was delayed, I was appointed as “acting chief director”, in order to sign documents and authorize the payment of salaries. I performed these duties for less than a month”, as says Valentyna Shkurat.
Aleksandr Shylovich, ex-“chief doctor” of hospital in occupied Kakhovka, 2024. Photo: screenshot of video
According to Shkurat, the delay was caused by some problems with biography of Shylovich. Russian occupants spent a lot of time for its examination. Shkurat saw his biography in the HR unit of the hospital. She noticed that “new director” served in dubious Russian private military company “Wagner”, participated in occupation of Beryslav raion and worked as surgeon in Russian local military hospital. There were many records in his working biography. As a rule, he worked at one place no more than 1,5-2 years. He brought his deputy – Orel Viktor Aleksandrovich, resident of Moscow.
At the end of 2024 Shylovich disappeared, and local doctor Volodymyr Murashov was appointed as new “chief director”.
Before his disappearance, Shylovich accused Shkurat of sabotage work and initiated internal investigation. On June 18, 2024, she resigned. At that moment, she with her family prepared their departure from occupied territories. It has been high time for her granddaughter to go to school. The family did not want her to study in accordance with Russian programs. So, in 2024, they fled to the territory under Ukrainian control.
Volodymyr Murashov (the third from left), current “chief doctor” of Kakhovka hospital at the meeting with Russian occupation authorities, October 2025
Valentyna Shkurat believes that she did nothing illegal when she worked in the occupied hospital and temporary held the position of its “chief doctor”.
“Russian occupation of Kakhovka has been a shock for me and my family. I am originally from Kadiivka of Alchevsk raion in Luhansk oblast. I saw how Russians seized my native city and I did not want to work for them. In summer 2014, Russian occupants abducted my 30 years old daughter who worked in pharmacy and broke her kneecap. We left everything in Kadiivka. In 2024, we had to flee Russian occupation for the second time – now from Kakhovka”, as says Valentyna Shkurat.
“WTF you come here? Go to your hospitals!”
Shkurat states that people must show their Russian social insurance number if they want to receive free medical assistance in Kakhovka. However, there are no necessary doctors in the city.
“Russian occupants destroyed the health care system. My cousin died from intestinal obstruction on occupied territory. Before the Russian occupation, doctors made various surgeries in Kakhovka. Today people must go to Crimea to receive consultations of cardiologist, neurologist and other specialists. But nobody welcomes patients from Kherson oblast”, as sums up Valentyna Shkurat.
The same situation happens in hospitals on occupied territory of Kherson oblast. As local Telegram channels recently reported, pensioner from occupied Oleshky has been expelled from the hospital in occupied Skadovsk.
“Woman cried and asked to get examination by doctor because she spent a lot of money for taxi to get to Skadovsk. But she was expelled. “What the f*ck you all coming here? Go to your hospitals”, as shouted hospital employee at old woman. She accused her that “alien patients” made excessive load on local doctors and they had to resign”; as reported local Telegram channel.
Russian occupants introduced physical therapy department from stolen equipment in Kakhovka, 2024. Screenshot of video
In December 2025, Oleksandr Schur, employee of Russian occupation “Ministry of Health Care of Kherson Oblast”, recognized serious shortage of surgeons, rheumatologists, neonatologists and other specialists as well as middle level medical personnel in Kherson oblast.
Russian occupation media also talk about acute shortage of pediatricians, cardiologists, endocrinologists, dentists and infectious disease specialists. Some hospitals do not have even anesthesiologists. Nobody is able to do anesthesia.
“Heavily promoted Russian program “Country doctor” is just PR event. Though salary for doctors was increased to 2 million Rubles within this program, only 65 specialists came to Kherson oblast during last years, together with paramedics. Many of them left oblast when their contract was over. A few people would like to work here”, as reports Russian occupation media.
Paramedic center in Kakhovka raion, 2025. Photo from Russian occupation social media
It means that Russian occupants admit that they are unable to solve acute issues with human resources within health care system and provide local residents with basic health care services.
Crime against humanity
Human rights activists state that full scale destruction and appropriation of assets of health care institutions, not justified by military needs, is the war crime, as with an example of Kherson oblast.
“Russia as an occupation state is obliged to maintain the order on occupied territory as it has been before its occupation. Expanding its own laws and legislative requirements on occupied territory (like mandatory receipt of Russian social insurance number or Russian citizenship as precondition for receiving medical assistance) is the violation. Mandatory acceptance of Russian citizenship is also violation. The obligation of Russia to maintain the well being on occupied territory includes its obligation to secure medical services and provide people with medical materials. If their supply is not sufficient, Russia is obliged to provide adequate supply. Aggressor-state can expropriate medical equipment for the needs of its occupation armed forces only under fair compensation and if respective demands of local population are properly satisfied”, as says Onysia Synuk, legal analyst of the Center for Human Rights ZMINA.
Onysia Synuk. Photo: ZMINA
As she says, aggressor-state is not allowed to restrict the professional activity of medical personnel on occupied territory. If functioning of civil medical services is disrupted by fighting, then, aggressor-state is obliged to provide assistance and access to any place where services are needed. Refusal to let the emergency go to sick person is the crime, regardless of whereabouts of sick person.
Occupants can expropriate assets of hospitals exclusively for the urgent treatment of wounded and sick army personnel. As Onysia Synuk emphasizes, occupants cannot expropriate assets and reserves of hospitals, necessary for the needs of civilians. These measures can be temporary. As soon as the urgent need to treat wounded and sick soldiers disappears, hospitals should be able to return to their usual work.
Hospital in Beryslav destroyed by Russians, October 2023. Photo: Facebook/Олександр Прокудін
“Aggressor-state does not have the right to make advantages or discriminate anybody in his or her access to medical assistance, as summarizes Osynia Synuk. – It is not acceptable when access to doctors is forbidden because person does not have Russian passport. It is the violation of the right for health because it includes access to proper medical assistance and the right to be free from inhuman treatment. Together with other violations of Russia on occupied territories, it can be qualified as the crime against humanity”.
Investigation is conducted under the support of program “Stronger Together: Media and Democracy”, implemented by WAN-IFRA in partnership with Association “Independent Regional Publishers of Ukraine” and MBL under the assistance of Norway. The views expressed by the authors do not necessarily reflect the official position of the program partners.
