Devoting vast resources to treating wounded soldiers in Ukraine has led to a lack of care for civilians—leading to a wave of hospital closures in Russia’s rural areas.
Peace negotiations among Ukraine, Russia, and the United States are slowly moving forward. The two sides are attempting to lay out a framework for an initial 30-day ceasefire—which, if properly implemented, would enable a more permanent arrangement to end the largest conflict Europe has seen since the end of World War II.
Analysts have devoted much attention to Ukraine’s dwindling resources and weakening position. It is a fact that the Ukrainian military has lost the key strategic initiative that would enable it to win the war. Moreover, Kyiv relies on foreign security aid to stay in the fight.
However, it is not just Ukraine that needs peace. Although Russia might not be in the same position as Ukraine, Moscow is not faring well after more than three years of bitter fighting.
After Three Years of War, Russia’s Position Is Growing Weaker
Although the Ukrainian government is under real pressure to accept the ceasefire and take steps toward ending the conflict, the Kremlin also has some strong incentives to pursue peace.
First and foremost, the Russian state is starting to show signs of serious war exhaustion. The Russian economy is struggling to balance between international sanctions and a full-scale conventional conflict. Moreover, the Russian defense and aerospace industries are facing serious shortages of parts and technology. As a result, the Kremlin has to rely on other countries, notably North Korea and Iran, to maintain its “special military operation” in Ukraine.
Russia’s crumbling medical system—which seems to be collapsing under the weight of the war’s casualties—is perhaps most emblematic of why the Kremlin also has an interest in seeking peace.
Russian Civilian Hospitals Are Shutting Down
The extremely high rate of Russian casualties in the fighting—around 900,000 men killed and wounded, according to the latest Ukrainian estimates—have shocked the country’s medical system.
According to data released by the British Ministry of Defence in a recent intelligence estimate, the Kremlin closed down “at least 160 public hospitals” in 2024. As a result, “Russian civilians in small towns and villages have frequently been left with reduced or unavailable medical care as a result of the closures, including now limited pre-hospital services.”
The Russian medical system is struggling to sustain the level of attrition experienced by the Russian forces throughout the three-year conflict. This problem is made worse by the fact that most Russian casualties are wounded—and thus require further medical treatment—rather than killed. Out of the approximately 900,000 casualties the Russian forces have taken since February 24, 2022, most estimates suggest that more than half—around 500,000 in total—are wounded.
“It is almost certain the scale of Russian casualties (over 500,000 Russian service personnel wounded so far) continues to strain the Russian Military Medical System at all levels of medical care, causing significant logistic problems and resulting in a shortage of military medical personnel,” the British Ministry of Defence added.
Devoting vast resources to treating wounded soldiers has led to a lack of care for civilians—leading to the hospital closures in Russia’s rural areas.
“This negatively impacts care delivery and has likely led to the diversion of medical resource[s] from the domestic civilian population to the military, further contributing to the large-scale impact to civilian hospitals,” the British Ministry of Defence concluded in its intelligence assessment.
About the Author: Stavros Atlamazoglou
Stavros Atlamazoglou is a seasoned defense journalist specializing in special operations and a Hellenic Army veteran (national service with the 575th Marine Battalion and Army HQ). He holds a BA from the Johns Hopkins University and an MA from the Johns Hopkins’ School of Advanced International Studies (SAIS). His work has been featured in Business Insider, Sandboxx, and SOFREP.
Image: Shutterstock / Evgeny Haritonov.
