The district hospital in Hola Prystan, in Russian-occupied Kherson, has been methodically hollowed out. Equipment stolen. Furniture removed. Supplies redirected to the Russian military. Experienced staff gone. Nurse Natalia Sergeevna, who worked there for more than two decades before escaping in July, describes a facility that still receives patients but has almost nothing to treat them with. Other hospitals in occupied territories have been repurposed entirely for military use or simply shuttered. The human cost is immediate and visceral. During a C-section this year, a woman developed uterine bleeding but no blood was available for transfusion — all supplies had been sent to Russian soldiers. In another case, a patient with endometriosis was treated without anaesthesia, in darkness, by a nurse using a phone torch because there was no power. These are not edge cases. They are the operating conditions of occupied healthcare. Access itself has been weaponised through forced "passportisation." Medical services are refused to anyone without a Russian compulsory health insurance policy, obtainable only through a Russian passport. Ukrainians who refuse or cannot obtain one are told to their faces: "you're a nobody." Marina, a resident of an occupied town, went into early labour with a breech baby in 2023. Curfew prevented her reaching the hospital; Russian forces shot at her family's vehicle. She survived the night at home and underwent a C-section the next morning assisted by a neighbour who happened to be a nurse. No obstetrician, no ultrasound, no prenatal diagnostics had been available. The UN Human Rights Monitoring Mission reported in June that conditions in Oleshky and Hola Prystan were becoming desperate. Thousands of people left without food, water, and medicines. Ambulances had stopped making home visits. Medical assistance was limited to the most urgent cases, and patients were dying during attempted evacuations. The mine-infested landscape of occupied Kherson makes even reaching a clinic a potentially lethal journey. Women bear the sharpest edge. Sergeevna describes treating an 18-year-old who arrived with the letter "Z" carved into her torso with a blade. Examination revealed she had been raped, though she was too ashamed to report it and came only because the wound had become inflamed. The hospital had no resources to test for STDs, provide contraceptives, or offer psychological support. Organisations monitoring the region report anecdotal rises in maternal and child mortality, long-term health problems, and difficulties accessing contraception and abortion. The extraction logic is total. Medical infrastructure built over decades by Ukrainian communities is being stripped for Russian military logistics. Healthcare access is gated behind a coerced identity document. The civilian population — particularly women, pregnant patients, and those with chronic conditions — absorbs every cost. There is no feedback loop, no accountability mechanism, and no indication that conditions will improve. The occupied territories are being administered as a resource colony where even the furniture has strategic value and the population has none. This is not collateral damage from fighting. It is the administrative architecture of occupation converting civilian institutions into military support systems, with the population treated as an extractable externality.
