Twice daily, midwife Liubov Martynenko leaves the underground maternity ward in Kherson to collect meals from Luchansky city clinical hospital, located in the city's 'red zone' near the Dnipro River and Russian forces. On 4 June, just before midday, as the ambulance entered the hospital grounds, Martynenko heard an unusual sound. 'It's flying!' the driver screamed, spotting a drone nearby. 'It was so close, just a couple of metres away, a flying box with a black eye,' she recalled.
The driver reversed sharply, but the drone shot toward them, crashing into the side of the ambulance and exploding. Dazed by the blast, Martynenko ran into a nearby clinic shouting that the driver had been killed. Both survived, suffering minor shrapnel wounds and concussion. The ambulance, a donation from Italy, was clearly marked 'ambulanza' with a red cross on the roof—the internationally recognized symbol of protection. Martynenko wore a red flak jacket identifying her as a medical worker. 'If it weren't for the driver's quick reactions, the drone would have hit the front and we probably would have died,' she said. 'The Russian operators attacked precisely on the hospital grounds—and it's not the first time it has been hit.'
Global Surge in Attacks on Healthcare
The incident reflects a broader pattern. According to the Safeguarding Health in Conflict Coalition, attacks on healthcare workers and infrastructure have more than doubled since 2021, fueled by Russia's invasion of Ukraine and Israel's war in Gaza. In 2024, over 2,500 documented incidents occurred across 33 countries, a historic high. Since Israel's offensive in Lebanon began in March, there have been 247 incidents affecting healthcare and 148 health workers killed, despite ceasefires. Three hospitals in southern Lebanon were hit in one week last month, with medical workers comprising most of the 150 wounded.
International law, established in the 1864 Geneva Convention and reaffirmed by a 2014 UN Security Council resolution, grants special protection to hospitals, healthcare workers, and the wounded. However, these protections are steadily eroding. 'If you can't even protect hospitals, the first line of humanitarian protections, then it will lead to the breakdown of all international law,' said Rohini Haar, an emergency doctor and human rights lecturer at UC Berkeley. 'I believe we are seeing that.'
Dual-Use Claims and Impunity
Most attacks are now carried out by state actors, who increasingly invoke 'dual-use' claims—arguing hospitals are used for military purposes—to justify assaults. Russia and Israel, among the worst offenders, often provide little public evidence. Lawyers argue that the dual-use loophole does not legitimize attacks, as international law requires verification of a military objective, proportionality, and advance evacuation warnings. Yet no standalone conviction for a healthcare attack has occurred in international courts; such charges only appear in broader war crimes cases, like those against Bosnian Serb commanders for the siege of Sarajevo. This lack of enforcement allows states and armed groups to act with near impunity.
The nature of warfare has changed, with drones and long-range airstrikes blurring battlefields and redefining military targets. The cost is devastating: preventable deaths cascade due to lack of emergency care, disruptions to routine services, and fear that keeps people away from hospitals. Unassisted childbirths, preventable diseases, and halted vaccinations follow. The fallout can last decades, especially when trained staff are killed. Liz Harding of Médecins Sans Frontières noted: 'Humanitarians and hospitals now almost have to justify why we shouldn't be targeted rather than those launching the attacks having to explain themselves.'
Return to Work Amid Fear
After two weeks off, Martynenko is back collecting meals for the maternity ward, always in fear. CCTV footage shows the ambulance was struck just over a metre from a crater left by a previous explosion. 'I am scared to go to work after the attack, especially when I hear any kind of buzzing noise,' she said. 'I have to do my job though.'
