The lives of millions will be under threat in Ukraine this winter, the World Health Organization has warned.
Half of Ukraine’s energy infrastructure is either damaged or destroyed, and 10 million are currently without power.
Dr Hans Henri P Kluge, WHO regional director for Europe, gave a bleak analysis of the challenges facing Ukraine with temperatures predicted to plunge to -20C in some areas.
The WHO has documented 703 attacks on health infrastructure since Russia’s invasion began.
Last week, Russia hit more energy installations and civilian buildings in one of its heaviest aerial bombardments of the war.
This has been a recent Russian tactic following setbacks on the battlefield, and its impact is starting to be felt more acutely as winter sets in.
Dr Kluge told a news conference in the Ukrainian capital Kyiv: “Put simply, this winter will be about survival.”
He added that Ukraine’s health system is “facing its darkest days in the war so far”, and the best solution is for the conflict to end, he added.
Due to the attacks, hundreds of hospitals and healthcare facilities are “no longer fully operational, lacking fuel, water and electricity to meet basic needs”, he said.
Maternity wards need incubators, blood banks need refrigerators and intensive care beds need ventilators, he said, adding that “all require energy”.
Up to three million people could flee their homes in search of warmth and safety, the WHO says.
Dr Kluge said 17,000 HIV patients in Donetsk may run out of life-saving antiretroviral drugs.
Much of Donetsk is under Russian control and Dr Kluge said he was “urgently calling for the creation of a humanitarian health corridor into all newly regained and occupied areas”.
He said on covid: “With low basic vaccination rates - let alone boosters - millions of Ukrainians have waning or no immunity to Covid,” Dr Kluge said.
Kiyiv is already snow covered but winter has not officially started and temperatures will drop much lower.
The Zaporizhzhia nuclear power plant, which used to produce more than 25% of Ukraine’s electricity and is under Russian control, no longer generates power. There was renewed shelling at the plant over the weekend.
The head of the International Atomic Energy Agency, Rafael Grossi, said the shelling was another “close call” at Europe’s biggest nuclear power plant.
Russia and Ukraine have accused each other of carrying out the attacks.