The warning came in a report titled "No Safe Place to Heal", published by the humanitarian medical organization.
The World Health Organization has recorded 2,811 attacks on healthcare facilities in Ukraine between February 2022 and the end of 2025, MSF said, while Ukraine's Health Ministry reports that Russian forces damaged or destroyed more than 2,500 medical facilities over the same period.
MSF said it had documented more than 20 attacks since April 2022 on facilities linked to its own operations. Four hospitals where the organization worked were completely destroyed, seven ambulance stations had to be abandoned, and MSF lost access to more than 80 villages across six regions that it had supported through mobile primary healthcare clinics.
"These attacks are too regular, too frequent, and too precise to be considered random", Robin Meldrum, MSF's head of mission in Ukraine, said. "It is not a coincidence when hospitals are repeatedly struck, when ambulances become targets of precision drone strikes, and when healthcare workers are killed while trying to deliver medicine in clearly marked vehicles. This is a pattern, and behind patterns lies intent".
MSF noted that deliberately attacking clearly marked medical personnel or vehicles can constitute a war crime under international humanitarian law. It said "double-tap" strikes — a second attack following shortly after an initial one, targeting rescuers and bystanders responding to the first strike — occur regularly.
"The logic is deliberate: the first strike draws in rescuers, and the second — often within minutes — targets the rescue operation itself", MSF said, adding that this makes providing aid deadly, increases casualties and deters future rescue efforts.
Medical teams, it said, can no longer decide whether to approach a strike site based on medical need alone, but must also weigh the likelihood of a follow-up attack.
MSF said attacks on medical infrastructure, combined with fear of strikes on civilians, have caused a collapse in access to care. A survey of 187 civilians in front-line regions found the share who "always" or "mostly" had access to healthcare fell to 35% from 72% before the escalation, while those with "rare" or "no" access rose to 35% from 7%.
The group said this has led to suffering and death from treatable conditions such as cardiovascular disease, diabetes and epilepsy, which have become life-threatening due to interrupted treatment and delayed care. At one MSF-supported hospital in Kherson, the number of doctors has fallen 66% since 2022, it said.
MSF cited a U.N. Security Council resolution, now a decade old, requiring protection of humanitarian and medical personnel, patients and healthcare infrastructure in armed conflicts. It called on states with influence over Russia to press for an end to the attacks, and urged the Security Council to investigate and publicly condemn strikes on healthcare facilities in line with Resolution 2286.
The report draws on cases witnessed by MSF staff in Ukraine, quantitative medical data collected under the organization's standard protocols, the civilian survey conducted in the Mykolaiv, Dnipropetrovsk, Kherson and Zaporizhzhia regions, and 30 interviews with MSF staff and patients. MSF said testimonies were gathered with informed consent and have largely been anonymized and shortened to protect those interviewed.
(jh)
Source: PAP