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The effect of conflict on medical facilities in Mariupol, Ukraine: a quasi-experimental study

Poole, D. N.; Andersen, D.; Raymond, N. A.; Parham, J.; Howarth, C.; Hathaway, O. A.; Khoshnood, K.; Yale Humanitarian Research Lab,

2023-08-06 public and global health
10.1101/2023.08.01.23293508 medRxiv
Show abstract

Medical facilities are civilian objects specially protected by international humanitarian law. Despite the need for systematic documentation of the effects of war on medical facilities for judiciary accountability, current methods for surveilling damage to protected civilian objects during ongoing armed conflict are insufficient. Satellite imagery damage assessment confers significant possibilities for investigating patterns of war. We leveraged commercially and publicly available satellite imagery and geolocated facility data to conduct a pre-post quasi-experimental study of damage to medical infrastructure in Mariupol, Ukraine as a result of Russias invasion. We found that 77% of medical facilities in Mariupol sustained damage during Russias siege lasting from February 24 - May 20, 2022. Facility size was not associated with damage, suggesting that attacks on medical facilities are not a residual of physical infrastructure characteristics. This is the first geographically comprehensive pre-post study of the effects of an ongoing conflict on specially protected medical infrastructure.

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