Doctors in Kyiv: Shielding children from Russian missile fragments, By Anna Mamonova & Angelina Kariakina

The missile hit the hospital during surgery…Okhmatdyt’s general director, Volodymyr Zhovnir, said that there were 670 children in the hospital at the time of the explosion. Three children were lying on the surgical tables with their chest cavities open. Doctors and nurses covered the children with their bodies to protect them from fragments of glass and concrete. In addition, in Kyiv, debris of a shot-down missile fell on a building where private medical facilities are located. At least nine people were killed there. 

On 8 July, Russia fired 38 missiles of various types at Ukraine, Ukrainian Air Force Commander Mykola Oleshchuk informed. Because of the scale, and how sophisticated the attack was, it was not possible to shoot them all down.

Kyiv, Dnipro, Kryvyi Rih, Sloviansk, and Kramatorsk were attacked. At least 40 people were killed and hundreds injured. The highest number of deaths, 31, was in Kyiv, and two of them were in Ukraine’s largest children’s hospital, Okhmatdyt, which treats children with cancer and orphan diseases. The missile hit the hospital during surgery. Later, Okhmatdyt’s general director, Volodymyr Zhovnir, said that there were 670 children in the hospital at the time of the explosion. Three children were lying on the surgical tables with their chest cavities open. Doctors and nurses covered the children with their bodies to protect them from fragments of glass and concrete. In addition, in Kyiv, debris of a shot-down missile fell on a building where private medical facilities are located. At least nine people were killed there. Apartment blocks, office buildings, and industrial facilities were also damaged. In all these places, there are dead or wounded people.

Journalists from The Reckoning Project, who have been documenting war crimes, including attacks on medical facilities, since the beginning of Russia’s full-scale invasion of Ukraine, were working at the site.    

The alarm started in Ukraine at half past ten in the morning, at the beginning of the working day. Although most of the 38 missiles were shot down by Ukrainian air defence forces, the Ukrainian Armed Forces reported that, in the capital, missiles hit a residential building, the administrative building of one of the plants and, as mentioned above, the Okhmatdyt, which is the children’s hospital in the capital.

Okhmatdyt, translating as “mother and child care,” is the largest medical centre in Ukraine, which treats about 600 children having the most complex diseases every day.

It treats children with oncological, genetic and neurological diseases; rescues those with complications from infectious diseases; has a centre for orphan diseases; and performs bone marrow transplants.

Since the beginning of the Russian invasion, children from all over the country have been brought to Okhmatdyt with the most severe injuries, leading to amputations. Ukrainians come to the Okhmatdyt as the last hope to save their children, whose lives have turned into a continuous struggle for every breath. Treatment takes place in ten buildings with the most modern equipment in the country. Very often, surgeons operate on children during air raids and shelling, because they cannot delay. A Russian missile hit one of the hospital’s buildings just as they were performing such operations.

Surgical nurse Iryna says she was preparing an eight-month-old baby for heart surgery. During the explosion, the surgeon rushed to the child and covered him, saving him from the shards of glass and concrete. 

In the intensive care unit, the children were saved by being taken out on couches into the corridor, in time to hide behind two walls. These are safety measures that are known to everyone in Ukraine: during an air raid, you need at least two walls of the building between you and the street to protect you from debris.

Inna Bondarenko, a senior nurse in the intensive care unit, says it is almost impossible to bring the children down to the shelter from this unit because they are breathing through oxygen machines and cannot walk. The children are in such a serious condition that their parents are with them during treatment.

When everyone hid in the corridor, Inna Bondarenko ran to her office – she had forgotten something, and after all the shock, she could not remember what it was. At that moment, there was an explosion. The nurse was thrown against the wall, glass fell on her and cut her arms and face. Inna crawled on her knees to the door, started to climb, while her head was spinning. The building seemed to have been blown off the ground during the explosion, and everyone in it, the nurse said. As she talked about it, she cried. She is hugged by her colleague, Anna Isayeva, the head of the intensive care unit.

The women recall that in an instant, all the windows in the building broke, the doors flew open, and the suspended ceiling began to fall. The blast wave was so strong that heavy medical equipment was blown out of the wards into the corridors.

In the first moments, children and adults were numb with horror, Inna Bondarenko remembered. “Adults held their children close to them with all their might, and they cried. When the first shock passed, people started running outside. No one understood where the explosion had taken place.”

Ambulances began to arrive at the hospital from all over Kyiv. The sound of sirens did not stop. Small patients wrapped in sheets and carrying oxygen bags were being carried into ambulances. In the shadows of one of the smashed buildings, children with bald heads from chemotherapy sat in a line. They were in wheelchairs, leaning on adults who hugged them with one arm and held drips in the other. Those who could walk on their own, leaning on their parents, got into ambulances.

Broken glass crackled underfoot. There were boxes of medicine and children’s drawings everywhere. The video taken by doctors in the first minutes after the explosion shows the hospital yard filled with smoke and dust, with small pieces of colourful film floating in the air, which had been used to cover the windows of one of the hospital buildings. When the windows shattered, the film was cut into millions of pieces and it covered the hospital yard like snow. It fell on people in the streets, who stood hugging each other and crying. Everyone was looking towards the Toxicology and Intoxication Department, where children were receiving dialysis. The two-floor building was half destroyed. Smoke, dust and fire were rising from the ruins.

Doctors and nurses were the first to clear the rubble. Many of them were wearing white medical coats covered with blood. They had cuts on their hands.

Debris obstructed access to the rubble. The smoke stung eyes. In a moment, a human chain was formed and people were passing each other lumps of broken bricks and cement. Hot stones burned their hands. No one knew if there were doctors and children under the rubble.

One of the doctors recorded an appeal on social media: “I’m alive, I need help clearing the rubble.” At that moment, residents of the neighbouring blocks ran to the children’s hospital to help. They were carrying bottles of water. Some began to clear the rubble, while others entered the smashed wards of the hospital and carried children in their arms.

Ambulances began to arrive at the hospital from all over Kyiv. The sound of sirens did not stop. Small patients wrapped in sheets and carrying oxygen bags were being carried into ambulances. In the shadows of one of the smashed buildings, children with bald heads from chemotherapy sat in a line. They were in wheelchairs, leaning on adults who hugged them with one arm and held drips in the other. Those who could walk on their own, leaning on their parents, got into ambulances. Children stood out among the crowd because of their bald heads.

Gradually, the hospital yard was filled with hundreds of people – rescuers, police, military and civilians from Kyiv. Everyone was carrying bottles of water. It was hot in Kyiv, near a scorching building, in the smoke and dust, and everyone was thirsty.

Rescuers flooded the building with firebombs, but it did not stop burning. Approximately three hours after the attack, the air raid siren sounded again, and someone went into the shelter, but the work did not stop. People went into the affected buildings to clean up. There were at least two hundred volunteers on each floor. They were raking up glass with shovels and brooms, cutting open blocked doors with grinders. Hundreds of construction bags of garbage were passed from hand to hand, from the sixth floor to the street. Nurses were handing out medical masks and respirators to prevent volunteers from breathing the dust. Many people were getting sick from the stuffiness and nurses took them out into the fresh air. Doctors were searching for remaining medical equipment among the rubble and taking them to a safe place.  

After about five hours, the intensive care building was cleaned. In one of the wards, which was not badly damaged, a nurse put a drip on a sick child. She and her mother had not yet been taken to another hospital, and it was impossible to interrupt treatment.

Having cleared one building, the volunteers moved on to another. The explosion damaged five hospital buildings, along with the destroyed building.

There were bags of rubbish everywhere in the hospital yard. Men were throwing them onto trucks to free up space.

There were so many people willing to help that the police stopped letting them into the hospital. Traffic stopped around the hospital itself. People were carrying water, food and medicine in large numbers. Rumours spread in the city that children and doctors were trapped under the rubble.

The destroyed building was still smoking, although six hours had passed since the explosion. A large concrete slab made it impossible to dismantle the rubble. A construction crane was brought to the hospital to remove it.

At around 9 p.m., after 10 hours of rescue operations, at the entrance to the Okhmatdyt hospital, Ukrainian Health Minister Viktor Lyashko said that 50 people had been injured in the hospital due to the missile attack, two adults had died – one of them a 30-year-old doctor, Svitlana Lukyanchuk. She had worked as a pediatric nephrologist. In the destroyed building, she was treating children who needed dialysis. 8th July was her first day back to work after an holiday. The second victim was a relative of a patient. The children in the hospital did not die, but seven were injured. The youngest of them is two-and-a-half years old. The conditions of the wounded children are satisfactory.

The Reckoning Project has been documenting attacks on medical facilities in Ukraine since the famous case of a Russian aircraft strike on the maternity ward of a children’s hospital in Mariupol, a large city in southern Ukraine, in the midst of the fighting, on 9 March 2022.  At least 33 people were injured in the attack, three of who died in the maternity ward. Among them was a pregnant woman and her unborn child.

Patients numbering 670 were evacuated to other hospitals in Kyiv. After the shelling, the hospital is unable to continue its work, and the Ukrainian government is looking for newer premises so that doctors can resume helping children. However, some of the medical equipment cannot be transported from the Okhmadyt and there is no alternative in the country. Doctors are currently assessing which medical equipment has been damaged and whether they can be repaired. Scheduled surgeries have been suspended, including dozens of operations for which the children had been preparing for six months. It is difficult to carry them out in other medical institutions.

While rescue works were underway at Okhmatdyt, another Russian attack in another district of Kyiv hit private medical facilities. A missile launched by Russia managed to be shot down by the air defence forces over the city, and allegedly its debris fell on a building housing two hospitals. The medical centre was partially destroyed. Nine people died there, including employees of companies whose offices were also located in the building.

“I personally saw the body of a girl. It seemed to me that she had come to make an appointment at the hospital. She was lying there and not breathing,” said Oleksandr Kariakin, who worked in an office in the building that was attacked. He survived, but two of his colleagues were killed.

The Reckoning Project has been documenting attacks on medical facilities in Ukraine since the famous case of a Russian aircraft strike on the maternity ward of a children’s hospital in Mariupol, a large city in southern Ukraine, in the midst of the fighting, on 9 March 2022.  At least 33 people were injured in the attack, three of who died in the maternity ward. Among them was a pregnant woman and her unborn child. The maternity ward was part of the newly renovated Central Hospital No. 3 “Health of Mother and Child,” which provided a wide range of medical services to the entire southern part of Donetsk region.

Before the war, the facility was carrying out 18 to 20 deliveries a week, Lyudmyla Mykhailenko, who served as the hospital’s acting director, told The Reckoning Project earlier. During the war, the number of births in the department, which was the only one in the area, increase significantly, as it became impossible to move around Mariupol due to the intensity of the attacks. Some hospitals were too far away, while others were destroyed or damaged.

On the day of the airstrike, there were 37 pregnant women and 20 children, including premature babies, in the hospital. Medical staff tried to accommodate as many women as possible in the corridors. “When I arrived at the maternity hospital, I was sure I was safe. No one in their right mind would bomb a maternity hospital. It’s like bombing a church, isn’t it?” said Anastasia Piddubna, one of the survivors. She and her baby son, who was born two weeks after the air strike, managed to escape Mariupol together.

According to International Humanitarian Law, hospitals and clinics cannot be targeted. They are recognised as civilian objects with special protection. Article Eight of the Statute of the International Criminal Court states that the intentional targeting of hospitals and places where the sick and wounded are concentrated, constitutes a war crime.

A number of international and human rights organisations – including eyeWitness to Atrocities (eyeWitness), Insecurity Insight, Media Initiative for Human Rights (MIHR), Physicians for Human Rights (PHR), and the Ukrainian Healthcare Centre (UHC) – have created a map of strikes on Ukrainian medical facilities since the start of the full-scale invasion in February 2022.

In total, as of April, they had recorded 1,442 attacks on medical facilities; in 742 cases, hospitals and clinics were damaged, and at least 210 medical workers were killed.

Ukraine is not the first country to face such warfare tactics. In October 1999, Russian missiles hit a maternity hospital in Grozny. The attack killed at least 30 people that day, including women and newborn babies, according to the AP news agency. Grozny was leveled to the ground, in a manner similar to Mariupol. In 2016, in Syria, Russian airstrikes on Aleppo destroyed almost all the hospitals and medical facilities in the city.  

In all regions of Ukraine, Russia continues to attack power plants, heating and water supply stations. People can survive without access to electricity, heating and water. It is impossible to live in cities without hospitals.

The shelling of Ukraine’s largest children’s hospital, which treated the most vulnerable and was a symbol of hope and salvation for parents across the country, is also a blow that should have broken people’s morale.

In Kyiv, more than two thousand rescuers, police, military and volunteers joined the rescue operation. In the first ten hours, $2.5 million was raised for the hospital.

Anna Mamonova and Angelina Kariakina wrote via The Reckoning Project.