Investigation into Military Activity at Kyiv Oblast Psychiatric Hospital No.2 in Vorzel February-April 2022

Initial summary

• Location of incident: Kyiv Oblast Psychoneurological Hospital No.2, Vorzel, Kyiv Oblast, Ukraine. (50.56004, 30.13949)
• Sites affected: Kyiv Oblast Psychoneurological Hospital No.2, both the building and the grounds
• Date of attack: 25 February 2022 - 1 April 2022 during the alleged Russian occupation of Vorzel, precise dates of alleged hospital occupation were not found. 
• Reported damage: Grounds were used to entrench Russian artillery and possibly tanks, buildings were damaged, looted, and mined. 
• Type of attack/munition likely used: Occupation, looting, and use as a military installation of a Psychoneurological hospital; artillery systems fired from near the hospital.

Introduction

On 25 February 2022 Russian armed forces allegedly occupied Vorzel, a northwestern outer suburb of Kyiv. The town was shelled as a battle was fought in nearby Hostomel. After losing electrical power in the first 24 hours of fighting, the remaining patients and staff were evacuated first to Borodyanka, and then finally to Zhytomyr. During their alleged occupation of the area, Russian forces used the hospital to house troops, and even reportedly set up fortified firing positions on the hospital grounds. Upon their retreat from Vorzel on 1 April  2022 it was discovered that the hospital had been thoroughly looted, heavily damaged, and mined. 

Damaged munitions containers on the hospital grounds after Russian forces were pushed out.

Methodology

This investigation examines open-source documentation pertaining to the damage, alleged occupation, looting, and mining of the Kyiv Oblast Psychoneurological Hospital No.2, Vorzel, Kyiv Oblast, Ukraine during the alleged occupation of Vorzel by Russian forces of the Russian Federation, which lasted from 25 February to 1 April 2022. A variety of open source materials pertaining to the incident have been preserved and analyzed, including by cross-referencing a combination of open-source visual content and other public information. More in-depth descriptions of specific methodologies are described in greater detail in the Methods section of Ukrainian Archive’s website.

This investigation was also undertaken with an awareness of international humanitarian law, which imposes limits to how parties to a conflict may conduct hostilities and under which civilians and civilian objects – including in particular hospitals, medical personnel, and objects indispensable to the survival of the civilian population – are protected. If proved, actions that violate these protections may constitute war crimes and human rights violations.

Through collection, verification, and analysis of the investigative findings from these incidents, the authors hope to preserve critical information that may be used for advocacy purposes or as evidence in future legal proceedings seeking accountability.

Data ethics

The authors have strived to incorporate a “risk minimisation” ethical framework into its research processes. Due to the repeated targeting of hospitals, medical facilities, and medical personnel since February 2022, allegedly by Russian-backed “Donetsk/Luhansk People’s Republic” (“DPR/LPR” ), “people’s militias,” and by Russian Federation armed forces in particular, additional precautions and ethical issues were taken into consideration. Such measures include censoring any identifying features such as licence plates on photographs and only providing names of witnesses and victims if they have spoken to the press.   

The Ukrainian Archive supports transitional justice, as without accountability sustainable peace is very difficult to achieve. In order to help establish that digital content is what it purports to be, rigorous verification steps, guided  by the Berkeley Protocol, have been taken to authenticate the  findings.

Background on the affected area

Vorzel

Vorzel is a distant suburb of Kyiv, located to the west of Hostomel and Bucha. It was founded and planned out as a place for summer cottages in the late 19th century. It is best known for its spas and health sanatoriums, which remain popular today despite being long past their early 20th century heyday. Its serene forests provide a calm and peaceful environment away from the bustle of the capital, which is said to aid in the healing process. During Soviet times it was the location of many children’s summer camps, and continued to be a place of leisure since Ukrainian independence. At the time of the most recent census in 2020, the town had a permanent population of approximately 6,600 people. 

Location of Vorzel on a Google Earth map of the Kyiv metropolitan area.

Kyiv Oblast Psychoneurological Hospital No.2

The Kyiv Oblast Psychoneurological Hospital No.2 is a state-run hospital, located in Vorzel. The institution had been operating continuously since 1978 when the full-scale invasion of Ukraine by Russia was launched in February 2022. The hospital website states that “[the hospital] is a medical institution specializing in qualified inpatient examination and treatment, as well as employment and social rehabilitation of people with psychiatric disorders.” The same website also states that the hospital was the only facility in the Kyiv Oblast with a pediatric and adolescent inpatient treatment. The text also notes that the hospital was “designated as the main healthcare facility providing psychiatric support and treatment for veterans of [the war with with Russia in the Donbas], which were wounded or injured, suffered a head injury, are afflicted by PTSD, or have difficulty readjusting to civilian life.” 

What happened (and when)? 

Summary of online reporting

Russian Armed Forces in Vorzel

Vorzel is located just over 100 km from the border with Belarus, from where Russian forces launched their initial push to capture Kyiv. The initial target of this push was the airport in Hostomel, which is located less than 10 km to the north-east of Vorzel. This means that the town was on the front lines of the fighting by 25 February 2022. Consequently, reports of damage from shelling and reports of fighting appeared that day in Ukrainian news and social media. Shelling and damage in Vorzel was reported by Ukrainian mainstream media outlet TSN.  In his evening press briefing Oleksiy Arestovych, then advisor to the Office of the President of Ukraine, stated that the greatest threat [to Kyiv] is from Russian forces around Dymer, Ivankiv, Hostomel, Vorzel, and Bucha, all to the northwest of Kyiv. Locals from Vorzel also posted multiple videos of damage caused by artillery. By 27 February 2022 Ukrainian media was already citing Ukrainian officials’ statements about the presence of Russian troops at a maternity hospital in Vorzel, confirming that the town was at least “partially” under the control of Russian armed forces. Information that Vorzel had been retaken by the Armed Forces of Ukraine [AFU] appeared in Ukrainian media on 1 April 2022.\ \ In contrast, Ukrainian Archive did not find any mention in either Ukrainian or foreign media of Kyiv Oblast Psychoneurological Hospital No.2 leaving Ukrainian control. There are two factors which could potentially explain this. Firstly, Vorzel was allegedly occupied by Russian forces just two days into the full-scale invasion of Ukraine. Foreign media was focused on the big picture at the time and was still largely reeling from the shock of the invasion. Second, since many staff and patients found themselves living under alleged Russian occupation, media outlets may have been discouraged by the authorities from writing about the incident out of concern for their personal safety.

Geolocation

The hospital is located in the northernmost part of Vorzel, just north of the M07 highway, which was a major avenue of advance for Russian forces during the first months of the war.

Location of the hospital within Vorzel on Google Earth, orientation marked by Ukrainian Archive.

Chronolocation

On 27 February 2022 both national and local Ukrainian media reported that Russian forces were in Vorzel. Following that date, information from Vorzel is scant. This is consistent with the situation in the neighboring towns of Bucha, Hostomel, and Irpin. This was caused by electricity and internet outages as well as the well-publicized indiscriminate killings of civilians allegedly by Russian forces in the Kyiv Oblast. However, satellite imagery of the hospital and surrounding areas during the alleged  occupation shows evidence of Russian military activity on and near the hospital grounds. The fields immediately to the northwest of the hospital show clear signs of military activity.

Planet Labs imagery of hospital grounds acquired on 17 November 2021, area of future fortifications marked in blue, orientation marked by Ukrainian Archive. 

The first available satellite imagery after 24 February 2022 is from 18 March 2022 and shows no significant changes around the hospital grounds as compared to the pre-invasion imagery from 17 November 2021 shown above. But in satellite imagery captured on 7 April 2022, six days after the expulsion of Russian troops from Vorzel and the remainder of the Kyiv Oblast, fortified positions, possibly for artillery or tanks (marked with a yellow polygon) can be observed. Additional fortifications or materiel, are also visible along the northwestern perimeter of the hospital (marked by orange ovals).

Planet Labs imagery of northwest hospital grounds on 18 March 2022 (left) and 7 April 2022 (right). Russian fortified positions or material are marked with a yellow polygon and orange ovals by the Ukrainian Archive. 

The imagery from 07 April 2022 was taken almost a full week after Ukraine restored control over Vorzel, but it is extremely unlikely that the images depict a Ukrainian entrenched position. This is because Vorzel was recaptured by Ukrainian forces along with huge swaths of the Kyiv Oblast in early April immediately following Russia’s announcement that it would withdraw troops from northern Ukraine, making it improbable that Ukrainian units would take the time to dig artillery positions while their enemy was in full retreat, and in places outright routed, to the border. According to Ukrainian authorities Vorzel was still under Russian control on 31 March 2022, but the next day on 01 April 2022, a Ukrainian journalist posted an image of the Ukrainian flag being hoisted over the historical Countess Uvarova House in Vorzel. The building was identified using the distinctive tower and yellow color.

Telegram image, taken on 1 April 2022 the day Russian forces were expelled from Vorzel (left) and an open-source image of the building from 2018 (right).

Damage

While the buildings of the hospital remained largely intact, the observed damage and apparently thorough looting left the facility ransacked. According to the hospital chief, the Russian soldiers slept and lived in the hospital’s garages, and took all the mattresses and bedding there. She also states that of the nine ambulances in the garage, all but two were destroyed beyond repair. Of the overall state of the facility she stated:

“I come here and don’t even know where to start. Where should I hang the locks? Is there anywhere to even fasten them? Everything is torn apart or broken… They just walked around and shot into doors. The senior nurses have metal doors on their offices because inside are safes which contain controlled substances. They shot all of them open. They stole all the drugs, painkillers, and blood pressure medication. They took the new ultrasound machine too. What do they even need it for? They also carried off the portable ECG. Although they did leave the EEG, they probably didn’t know what it was.”  

Additionally, in the same article, the hospital chief talks of a weeks-long demining operation to clear up explosives and traps left behind by Russian troops. She states that for two weeks she would come to the hospital and listen for explosions to see if demining was still happening.  

Munitions used

As visible in photographs and satellite images, firing positions were set up and used on and/or near the hospital grounds. An image of the position and spent shell casings was posted by Ukrainian journalists who visited the site in May 2022. By comparing the firing position, grove, and red roofed building as landmarks, the approximate vantage point from which the image was taken was able to be identified. 

Artillery shell casings near the firing position in 07 May 2022 Rubryka image

Vantage point on photograph shown on a Planet satellite image captured on 07 April 2022, orientation marked by Ukrainian Archive

The shell casings appear consistent with 152-mm artillery rounds, commonly used by both parties in this conflict. The straight-wall casing design, the gray color of the spent shells, and the green ammunition crate remnants are all consistent with this type of munition. No other common weapons system used by any party in this conflict leaves behind similar artifacts. These munitions were widely produced by the USSR, Warsaw Pact states, and their successors. Ukraine and Russia both had large stockpiles of these types of ammunition at the start of the conflict. 

Victims of the attacks

There were 297 patients at the hospital on the morning of the 23 February 2022 according to Natalia Ponomarenko, the director of the facility. Throughout the day, the hospital staff urged families to pick up those patients who could live at home without medical assistance. The same source reports that by the early morning of 24 February, 62 patients, 12 of them children, remained at the hospital. During the Russian attacks on Hostomel Airport, located just a few kilometers to the north during the first hours of the invasion, the explosions “shook the entire building” forcing the patients and staff into the basement shelter.  According to Ponomarenko, on the morning of the 25th the electricity and running water stopped, and with no way to prepare food or stay warm, the staff decided it was necessary to evacuate the patients to nearby Borodyanka. Borodyanka itself, however, was under the control of Russian forces by 5 March 2022, with Chechen Kadyrovites taking over the hospital to which the patients from Vorzel were evacuated.    \ \ The twelve children were transferred to Zhytomyr either during or immediately after the alleged occupation, and they were physically unharmed. However, four patients who were suffering from advanced disease and were bedridden did not survive to 1 April. The head of the hospital in Vorzel does not give a reason for their death other than saying that it was “not from bullets.”

Resulting damage

The damage also had continuing effects after the alleged occupation that extended beyond the expected cleanup and reconstruction. Authors of an article about the destruction at the hospital noted that “because the invaders shot every single monitor in every office, and took out the computer powerpacks, the digital hospital administration system is locked. This makes it impossible to purchase any food, inventory, construction materials, or medication through Prozorro [Ukraine’s public state procurement platform] as is required by law.” 

As of 18 May 2022, when the article was published, the hospital was working toward reopening. The hospital website has been updated since Ukraine returned Vorzel to its control, but the information is of a general nature and doesn’t indicate whether the hospital is open or not. 

Potentially responsible

Due to the strong indicators of military presence at the site, such as the artillery emplacements and shell casings, it is clear that a military force with enough logistics capability to support several large-calibre artillery pieces was based at the site. This means that either the Ukrainian or the Russian military must have deployed to the site. However, the circumstantial indicators associated with open source content documenting the attack and its context strongly suggests that the armed forces of the Russian Federation were deployed to the site.  

According to two reputable projects dedicated to mapping the front lines of the conflict Deep State and LiveMap UA, Vorzel and the surrounding villages in all directions were under the control of Russian troops until 1 April 2022. 

Vorzel (marked in yellow) on LiveMapUA (left) and Deep State (right). The darker shaded areas on both maps represent Russian control until 1 April 2022, orientation marked by Ukrainian Archive. 

The demarcation of areas that were occupied and those that Russia failed to take reflected on both maps is corroborated by news from the adjacent municipalities of Hostomel, Nemishaeve, Bucha, Irpin, and Mykhailivka-Rubezhivka. With all towns and villages in either direction documented as being under Russian control until 1 April 2022, it would be practically impossible for a Ukrainian artillery unit to neatly dig in and fire on Russian forces from behind the Russian lines.\ \ It is also highly unlikely that Ukrainian forces set up artillery positions after they regained control of the site based on the timeline of the retreat. Ukrainian authorities announced the full withdrawal of Russian troops from the Kyiv Oblast by 2 April, meaning that less than a day after Ukrainian forces regained control of Vorzel, all Russian units were well outside the 40 km firing range of the farthest-reaching 152mm artillery system in use by the AFU. Given that artillery pieces are only brought in after an area is secured, and are never set up on the front lines due to vulnerability to enemy fire, there was simply not enough time for the AFU to secure the area, bring in engineering vehicles, set up artillery positions, and conduct fire missions in the 24 hours between Ukraine retaking Vorzel and Russian forces leaving the Kyiv Oblast.

Maximum 40 km firing range of the 2A36 Giatsint-B towed 152-mm gun on Google Earth map, orientation marked by Ukrainian Archive.

The multiple confirmations of Russian military presence in Vorzel and all its surrounding municipalities during March-April 2022, the timeline of the Russian retreat from the Kyiv Oblast, the testimonies of the hospital staff of their experience during February-May 2022 all indicate that the armed forces of the Russian Federation are with great likelihood responsible for the occupation, damage, and use of the hospital to wage war. 

Conclusion

Analyzed open source documentation indicates that  Kyiv Oblast Psychoneurological Hospital No.2 was used as a base by Russian troops; following their departure the staff returned to find the hospital looted and damaged in a systematic way. While a lack of sufficient documentation means Ukrainian Archive is unable to state with certainty that  the looting and damage to the hospital was caused by the armed forces of the Russian Federation,  circumstantial indicators, such as the established presence of Russian troops at the site as well as systemic damage to the hospital using firearms, points to a high likelihood that the damage was caused by occupying Russian personnel. What we can say with certainty is that the use of any hospital or medical facility as a military base contradicts the internationally agreed upon principles of medical neutrality and that in doing so Russian forces may have violated international humanitarian law.