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Russian fighting destroys, damages nearly 400 hospitals, medical centres, Zelenskiy says

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Russia's invasion of Ukraine has devastated hundreds of hospitals and other medical institutions and left doctors without drugs to tackle cancer or the ability to perform surgery, President Volodymyr Zelenskiy said.

Zelenskiy said many places lacked even basic antibiotics in eastern and southern Ukraine, the main battlefields.

"If you consider just medical infrastructure, as of today Russian troops have destroyed or damaged nearly 400 healthcare institutions: hospitals, maternity wards, outpatient clinics," Zelenskiy said in a video address to a medical charity group on Thursday.

In areas occupied by Russian forces the situation was catastrophic, he said.

"This amounts to a complete lack of medication for cancer patients. It means extreme difficulties or a complete lack of insulin for diabetes. It is impossible to carry out surgery. It even means, quite simply, a lack of antibiotics."

In one of the most widely denounced acts of the war, a maternity hospital was all but destroyed on March 9 in the besieged port city of Mariupol. Russia alleged pictures of the attack were staged and said the site had been used by armed Ukrainian groups.

The Kremlin says it targets only military or strategic sites and does not target civilians. Ukraine daily reports civilian casualties from Russian shelling and fighting, and accuses Russia of war crimes. Russia denies the allegations.

Pavlo Kyrylenko, governor of Donetsk region, said 25 people had been injured in intense shelling in the town of Kramatorsk, site of a railway station bombing last month in which more than 50 died. He said a total of 32 residential buildings had been damaged in the shelling.

Reuters could not immediately verify battlefield reports by Russia and Ukraine.

Russia calls its actions in Ukraine a "special operation" to disarm Ukraine and protect it from fascists. Ukraine and the West say the fascist allegation is baseless and that the war is an unprovoked act of aggression. More than 5 million Ukrainians have fled abroad since the start of the invasion.

Russia has turned its heaviest firepower on Ukraine's east and south, after failing to take the capital Kyiv. The new front is aimed at limiting Ukraine's access to the Black Sea, vital for its grain and metal exports, and linking Russian-controlled territory in the east to Crimea, seized by Moscow in 2014.

In the port city of Mariupol an estimated 200 civilians, along with Ukrainian resistance fighters, are trapped undergound in the Azovstal steel plant with little food or water.

The steel works was rocked by heavy explosions on Thursday as Russian forces fought for control of Ukraine's last stronghold and the United Nations rushed to evacuate civilians.

President Vladimir Putin said Russia was prepared to provide safe passage for the civilians but reiterated calls for Ukrainian forces inside to disarm.

Putin declared victory over Mariupol on April 21 and ordered his forces to seal off the Soviet-era plant but not venture inside its underground tunnel network.

Ukraine's stubborn defence of Azovstal has underlined Russia's failure to take major cities in a 10-week-old war that has united Western powers in arming Kyiv and punishing Moscow with sanctions.

Clinging on desperately, Ukrainian fighters have reported fierce battles with Russian troops in Azovstal.

A Ukrainian fighter who said he was holed up in Azovstal accused Russian forces of breaching the plant's defences for a third day despite an earlier pledge by Moscow to pause military activity to permit civilian evacuations.

"Heavy, bloody fighting is going on," said Captain Sviatoslav Palamar of Ukraine's Azov Regiment. "Yet again, the Russians have not kept the promise of a ceasefire." Reuters could not independently verify his account or location.

The Kremlin denies Ukrainian allegations that Russian troops stormed the plant in recent days.

Aerial footage of the plant, released Thursday by Ukraine's Azov Regiment, showed three explosions striking different parts of the vast complex, which was engulfed in heavy, dark smoke.

Reuters verified the footage location by matching buildings with satellite imagery, but was unable to determine when the video was filmed.

Russia's military promised to pause its activity for the next two days to allow civilians to leave. The Kremlin said humanitarian corridors from the plant were in place.

Ukrainian Deputy Prime Minister Iryna Vereshchuk said on Thursday that people would be evacuated from Mariupol on Friday at 1200 local time (0900 GMT).

Sweeping sanctions from Washington and European allies have hobbled Russia's $1.8 trillion economy, while billions of dollars worth of military aid has helped Ukraine frustrate the invasion.

European Union countries are "almost there" in agreeing the bloc's proposed new package of sanctions against Russia, including an oil embargo, EU foreign policy chief Josep Borrell said. read more

The Kremlin said Russia was weighing responses to the EU plan.

Ukrainian officials have warned that Russia might step up its offensive before May 9, when Moscow commemorates the Soviet Union's victory over Nazi Germany in World War Two.

Health

Muttaqi appeals to WHO to help strengthen Afghanistan’s health sector

Hanan Balkhy, the World Health Organization’s director for the Eastern Mediterranean Regional Office, met in Kabul this week for talks with Amir Khan Muttaqi, the IEA’s foreign minister

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The Islamic Emirate has appealed to the World Health Organization to equip and strengthen Afghanistan’s health sector and to support Afghanistan’s pharmaceutical production sector. 

Dr. Hanan Balkhy, the World Health Organization's director for the Eastern Mediterranean Regional Office, met in Kabul this week for talks with Amir Khan Muttaqi, the IEA’s foreign minister. 

During the meeting, Muttaqi asked the World Health Organization to assist Afghanistan and to help it achieve self-sufficiency in the pharmaceutical production sector. 

Balkhy meanwhile said that he was trying to garner support for Afghanistan from leading health experts around the world. 

Christopher Elias, head of global development for the Bill Gates Foundation, also attended this meeting and said his organization was trying to take effective measures to eliminate the polio virus in Afghanistan. 

Polio cases increase

Elias’ comment comes after the WHO stated that the forced repatriation of Afghan nationals from Pakistan was a “major setback” for polio eradication efforts and that it contributed to the regional resurgence of the disease.

Pakistan and Afghanistan are the only two polio-endemic nations in the world and so far this year, the two countries have reported 49 and 23 cases respectively; up from only six cases each in 2023.

The latest case in Pakistan was confirmed last week in the southwestern province of Balochistan, which sits on the Afghan border and accounts for half the cases reported in 2024.

The United Nations High Commissioner for Refugees has said that Pakistan's crackdown on undocumented foreign nationals has resulted in more than 730,000 Afghan migrants returning to Afghanistan since August 2023.

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UNICEF ensures 6.1 million people have access to basic health services in Afghanistan

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More than six million people accessed essential health and nutrition services at UNICEF-supported health facilities last month, the UN agency said in its latest Humanitarian Situation Report for September 1 to 30.

UNICEF said of the 6.1 million people who accessed essential health and nutrition services, half of them were children under the age of five.

In addition, 50 schools in 10 provinces gained access to safe water, handwashing facilities, and newly constructed or rehabilitated toilet facilities.

However, as of September, UNICEF’s Humanitarian Action for Children (HAC) appeal for children in Afghanistan is only 41 percent funded.

Afghanistan remains one of the world’s largest humanitarian crises, with 23.7 million people in need of humanitarian assistance following decades of conflict, extreme climate shocks, and severe economic decline.

UNICEF also stated that this year, 33 percent of the population receives most of their income from unsustainable income sources, compared to 26 percent in 2023.

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Polio vaccination campaign kicks off in Afghanistan

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Public Health Ministry officials have confirmed that a polio vaccine campaign across 16 provinces was launched on Monday.

Sharaft Zaman Amarkhil, the spokesperson of the Ministry of Public Health, says that the campaign got underway on Monday in a number of provinces including Kabul, Kandahar, Helmand, Uruzgan, Zabul, Farah, Nangarhar, Laghman, Kunar, Nuristan and some other provinces.

Amarkhil said the campaign will last for three days and an estimated 6.2 million children under the age of five will receive the anti-polio vaccine.

Zaman called on parents, religious scholars and ethnic elders to cooperate with the ministry's vaccinators in implementing the anti-polio vaccination campaign for children under five years old in the mentioned provinces.

The World Health Organization meanwhile published its latest Polio Bulletin on Monday and confirmed Afghanistan has recorded 23 cases of Wild Polio Virus so far this year.

Pakistan meanwhile reported two new cases this week - one in Khyber Pakhtunkhwa province and the other in Balochistan province.

Pakistan has recorded a total of 41 cases of polio so far this year, bringing the total between the two countries to 64, against last year’s total of 12 (Afghanistan 6 and Pakistan 6).
World Polio Day

Marking World Polio Day last week, UNICEF pointed out that the current data issues a stark warning that the life-threatening disease continues to thrive in areas where conflict, natural disasters, humanitarian crises, and other destabilizing factors make it difficult to deliver critical healthcare.

“In conflict, children face more than bombs and bullets; they are at risk of deadly diseases that should no longer exist,” said UNICEF Executive Director Catherine Russell.

“In many countries, we are witnessing the collapse of healthcare systems, destruction of water and sanitation infrastructure, and the displacement of families, triggering a resurgence of diseases like polio. Children are being left paralyzed, unable to walk, play, or attend school."

A global decline in childhood immunization has also led to an increase in polio outbreaks, including in countries that had been polio-free for decades.

Nowhere is this more evident than in conflict-affected areas, with 15 out of 21 such countries – including Afghanistan, Democratic Republic of Congo, Somalia, South Sudan, and Yemen – currently battling polio.

In recent months, UNICEF and partners have intensified emergency responses to surges in polio outbreaks.

In Gaza, for example, UNICEF, in partnership with WHO, reached nearly 600,000 children under 10 years during the first round of a polio vaccination campaign in mid-September. The second and final round has been successfully implemented in south and central Gaza, but renewed mass displacement and bombings have delayed the process in the north.

The campaign follows the return of polio to Gaza for the first time in 25 years.

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