Strengthening hospital readiness in Ukraine amidst war

WHO recommends that at least 80% of hospital pipeline systems should be in good working condition to transport medical gases, water and other fluids and enable hospitals to function.

Kharkiv Regional Clinical Hospital is just 40 km from the front line of the war in Ukraine. On the morning of 18 April 2025, explosions in the city killed 1 person and injured over 100. Later that day, WHO and the hospital staff calmly inspected the hospital’s critical systems as part of a Hospital Safety Index assessment. They used globally recognized WHO tools to ensure that their hospital could continue functioning and providing life-saving interventions to the injured.

Air raid sirens during a training in Kharkiv reminded all participants of the reality of the situation. However, the training continued, even underground in the shelter.

Recognizing the special situation of hospitals in war-affected areas, WHO is providing guidance and support to hospitals in Dnipropetrovsk, Kharkiv, Kyiv and Mykolaiv. The initiative titled “Strengthening hospital readiness in Ukraine” aims to ensure that health infrastructure continues to function throughout any adverse event, such as an attack on health care, a flood or a power outage.

Health workers from 4 hospitals, along with Ministry of Health officials, gathered in Kyiv.

Hospital administrators, emergency planners and health-care professionals from 4 war-affected Ukrainian cities gathered for a workshop in Kyiv to share practical strategies to keep hospitals functioning under extraordinary circumstances. They explored using the Hospital Safety Index tool to navigate emergencies, including from chemical, biological, radiological and nuclear threats, and learned how to develop hospital emergency response plans.

“You are here because of your experience. Your stories, your lessons – they matter. We’re building on them,” said officials from the Ministry of Health of Ukraine, who were also in attendance.

Damage sustained by Okhmatdyt children’s hospital in Kyiv, where children were receiving intensive care and life-saving haemodialysis.

Since February 2022, WHO has documented more than 2418 attacks on health in Ukraine, impacting health providers, supplies, facilities, warehouses and transport, including ambulances. To be better prepared for such emergencies, and as part of the Strengthening hospital readiness in Ukraine initiative, hospitals conduct assessments of all areas, from basements to rooftops, from operating theatres to power generators, mapping their vulnerabilities and potential areas of improvement.

“Each crisis is different, but every time we respond, we learn. I hope we never have to face it again, but now we’re more agile and better prepared,” shared a participant in the initial Kyiv workshop.

The damaged wing of Okhmatdyt hospital in Kyiv still has its windows boarded up, months after the July 2024 attack.

Understanding the personal experiences of hospital staff can help to ensure that hospitals are better prepared and that plans reflect the realities of emergencies. In July 2024, Okhmatdyt hospital in Kyiv, Ukraine’s biggest children’s medical facility, sustained extensive damage in an attack.

“In the first hour, we were just trying to understand what was happening. Only after that could we begin to organize. We set up a small committee, gathered staff and tried to assess who survived and what was needed,” said a workshop participant representing Okhmatdyt hospital.

“One side of the building was destroyed, but the other one was still functioning. There was no electricity, no internet and over 1000 people showed up. The traffic stopped. Rumours spread that the water was poisoned.”

A closer look at the small yellow placard hanging on a damaged building of Okhmatdyt hospital reveals an image of a young doctor who lost her life in the 2024 attack.

Six hundred patients and as many staff were in the hospital at the time of the attack. Ukraine’s only blood disease and cancer laboratory was damaged and the hospital’s toxicology building and trauma department were completely destroyed. There were 3 additional attacks on other health-care facilities that day. In total, 9 people were killed and 71 were seriously wounded.

“We lost some of our colleagues – that was the worst part. It’s not about the building, it’s about the people,” said one participant of the Strengthening hospital readiness in Ukraine workshop. “I hope this experience will help if anything like this ever happens again.” 

Mechnikov Hospital has been a lifeline since the beginning of the full-scale invasion, receiving and treating a relentless flow of casualties from across the eastern front.

With its proximity to the front line, Mechnikov Hospital in Dnipro City is often the first place where seriously injured patients are sent for treatment.

“We thought we understood conflict from 2014, but 2022 was different – we had to learn about mass casualty response immediately,” said a health worker from Mechnikov Hospital.

Member of an assessment team climbs onto the roof of Mykolaiv Regional Clinical Hospital. The Hospital Safety Index requires hospitals to have high building integrity to withstand shocks and maintain the safety of their occupants.

In 2022, the staff from Mykolaiv Regional Clinical Hospital also had to adapt to the realities of conflict overnight. The military arrived and doctors started living in the hospital under sustained shelling.

“During one attack, the roof was damaged while the night staff were inside. We moved dialysis patients to safer parts of the building and just kept going,” said a staff member from Mykolaiv.

The Strengthening hospital readiness in Ukraine initiative is supported by the WHO Regional Office for Europe and the WHO Country Office in Ukraine, in collaboration with the Ministry of Health of Ukraine, and funded by the Government of Germany. The hospital emergency response plans developed in pilot hospitals will benefit the entire country. As the initiative rolls out nationally, the plans will be used as examples for other institutions, ensuring that all hospitals are equally well prepared.