By Lara Kajs
Dispatches from the Field — The Genocide Report
Washington, DC — 10 October 2022
Russia’s invasion of Ukraine has generated large-scale displacement and exposed the country’s most vulnerable populations to compounded risks, including direct violence, infrastructure collapse, and limited access to essential services.
Since February 2022, millions of Ukrainians have been displaced by ongoing hostilities. While millions have crossed international borders, a significant proportion remain internally displaced, often without the means or ability to leave the country. These populations—disproportionately women, children, the elderly, and individuals with disabilities—face heightened exposure to both immediate and long-term risks.
Civilian Targeting and Exposure
The conduct of hostilities has resulted in widespread civilian harm and extensive damage to infrastructure. Reports of mass graves, executions, and other forms of violence against civilians have prompted international concern and calls for investigation. The scale of casualties remains difficult to verify, but available estimates suggest significant loss of life, with indications that actual figures may be substantially higher.
Urban centers and populated areas have been repeatedly subjected to shelling, leaving residents trapped with limited access to basic necessities. In cities such as Mariupol and Kharkiv, prolonged attacks have severely constrained access to food, water, electricity, and heating. These conditions not only increase immediate mortality risks but also contribute to longer-term humanitarian crises.
The destruction of civilian infrastructure—including schools, hospitals, and residential buildings—further compounds vulnerability. Damage to healthcare facilities reduces the capacity to respond to both conflict-related injuries and ongoing medical needs, placing additional strain on already limited resources.
In modern conflict, vulnerability is not incidental—it is structured by who cannot flee, who cannot access care, and who remains exposed to sustained violence.”
Health System Strain and Vulnerable Populations
The collapse or degradation of healthcare systems presents a critical challenge. While conflict often raises concerns regarding infectious disease, the disruption of care for chronic conditions—such as cardiovascular disease, diabetes, and cancer—poses an equally significant threat.
Populations with limited mobility, including the elderly and individuals with disabilities, face particular barriers to accessing care or relocating to safer areas. Pregnant women and young children are also at increased risk, especially in environments where medical infrastructure is compromised.
Smaller and rural healthcare facilities have absorbed much of the burden, often without adequate supplies or staffing. This redistribution of care highlights systemic fragility and underscores the broader impact of sustained conflict on public health outcomes.
Displacement and Regional Impact
As millions of Ukrainians have fled to neighboring countries, regional healthcare and humanitarian systems have experienced increased pressure. States such as Poland, Hungary, and Moldova have become key transit and support hubs, with international organizations assisting at borders and reception points.
Despite repeated calls for humanitarian corridors and temporary ceasefires, access to safe passage has remained inconsistent. The inability to secure reliable evacuation routes has left many civilians trapped in active conflict zones, further exacerbating risk.
Beyond the immediate region, the consequences of the conflict extend into global systems. Ukraine’s role as a major grain exporter means that disruptions to production and distribution have contributed to food insecurity in other regions, particularly in parts of the Middle East and North Africa.
Humanitarian and Policy Considerations
The scale and complexity of the crisis in Ukraine highlight the interconnected nature of modern conflict. Civilian vulnerability is shaped not only by direct exposure to violence but also by the breakdown of systems that sustain daily life.
Addressing these challenges requires coordinated humanitarian responses, sustained international engagement, and mechanisms to ensure accountability for violations. The persistence of hostilities, combined with limited access to affected populations, continues to constrain effective intervention.
Atrocity Prevention Lens
The situation in Ukraine reflects multiple indicators associated with elevated atrocity risk, including widespread attacks on civilian populations, evidence of extrajudicial killings, and the systematic destruction of civilian infrastructure. The presence of mass graves and reports of executions suggest patterns that warrant close monitoring for potential escalation. The targeting—or failure to protect—vulnerable populations, particularly those unable to flee, further heightens concern. Preventive efforts should focus on documentation, accountability mechanisms, and sustained international pressure to deter further violations and reinforce protections for civilians.
Legal Framework
International Humanitarian Law (IHL)
Parties to the conflict are required to distinguish between civilians and combatants and to direct operations only against legitimate military objectives. Civilians and civilian objects are protected under IHL.
War Crimes
Serious violations of IHL, including the targeting of civilians, execution of detainees, and destruction of civilian infrastructure without military necessity, may constitute war crimes subject to international prosecution.
Protection of Civilians
The deliberate or indiscriminate targeting of civilian populations, as well as the denial of essential resources such as food, water, and medical care, may violate core legal protections afforded under international law.
Humanitarian Access
Parties to a conflict must allow and facilitate the rapid and unimpeded passage of humanitarian relief for civilians in need. Obstruction of such access may constitute a violation of international obligations.
Suggested Citation
Kajs, Lara. “Ukraine’s Most Vulnerable.” Dispatches from the Field. The Genocide Report, Washington, DC, 10 October 2022.
Photo Credit
Russia Ukraine War – Loss and horror during week of burials and tears – Ukrainian Nicolai, 41, says goodbye to his daughter Elina, 4, and his wife Lolita, on a train bound for Poland, fleeing from the war at the train station in Lviv, western Ukraine, Friday, April 15, 2022. (AP Photo/Emilio Morenatti) License by CC 2.0
About TGR
The Genocide Report (TGR) publishes analysis and educational resources on conflict, international law, and atrocity prevention. Its work seeks to bridge academic research, field realities, and public understanding of mass violence and civilian protection.
About the Author
Lara Kajs is the founder and executive director of The Genocide Report, a Washington, DC-based educational nonprofit focused on atrocity prevention and international law. She is the author of several field-based books on conflict, displacement, humanitarian crises, and international humanitarian law, drawing on extensive research and field experience in Yemen, Syria, and Afghanistan. Her writing and public speaking focus on atrocity crimes, forced displacement, the protection of civilians, and the legal frameworks governing armed conflict.