Contributors: Marsha Fowler,
Deborah Kenny & Elizabeth Peter

Introduction

Soon after Russia invaded Ukraine, it became apparent that immediate action is needed, as innocent lives continue to be lost. We nurses are in a perfect position to do so. Nurses have a large, trusted, and strong voice to advocate for the Ukrainian people and issue a call to action for legislators to put an end to these amoral acts. Sometimes during war, civilian collateral damage is unfortunate and inevitable, but Russia’s targeting of healthcare facilities, churches, schools, and other non-military objectives clearly represents war crimes. To assist all nurses in this advocacy, Dr. Marsha Fowler (US) crafted the attached letter with further input from Dr. Deborah Kenny (US).

Please download and distribute widely the attached letter via your professional social networks and organizational channels. Send to your state Congressional representatives or other leaders representing your individual country. Please tailor for your own country as necessary. Distribute it to nursing students to show them how to advocate through policy action. Together nurses can have a tangible and significant impact on the global health and wellbeing of all individuals. Nurses can be a compelling force for good in the world. Call upon your respective nations governments to take swift and decisive action to end these war crimes against humanity.

US nurses: We encourage each nurse to contact your own Congressional legislators (or legislative body members) and the White House. Congressional members can be found through https://www.congress.gov/members.  Additionally, nurses can flood the White House switchboard at (202) 456-1414. It is staffed by live volunteers who tally calls. Call the White House to express your concern and you may use the letter as a template.

Download Letter in PDF format
Download Letter in Word format

Letter

Attn: President Biden, Vice President Harris, Sec. Blinken, Speaker Pelosi, Majority Leader Schumer, Congress, Chairman Milley, Secretary–General Guterres, President von der Leyen, President Roberta Metsola, Director–General Ghebreyesus:

We write to express our profound concern regarding the unjustified, unprovoked, and illegal invasion of Ukraine. Those who sign below represent nurse-leaders, many specializing in bioethics and, as such, we hold dear human life, health, well-being, human solidarity, dignity, freedom, and social justice as core values of our profession. These core values of the nursing profession, affirmed by the fields of bioethics, ethics, and social ethics, are themselves desecrated in Russia’s military invasion of Ukraine. Our concerns and requests are several:

We call upon the United States and the UN and its member nations to hold President Vladimir V. Putin of Russia accountable for multiple and egregious violations of the Hague Regulations of 1907, the Geneva Conventions of 1949 and its associated Additional Protocols, and the Rome Statute of the International Criminal Court.

Under Mr. Putin’s command, the Russian military have committed numerous violations of these regulations, conventions, protocols, and statutes. In particular, we draw your attention to violations of Geneva Conventions that specifically require:

• respect for “hospital and safety zones and localities so organized as to protect from the effects of war, wounded, sick and aged persons, children under fifteen, expectant mothers and mothers of children under seven.”
• respect for neutralized zones
• protection of civilian hospitals
• that “Persons regularly and solely engaged in the operation and administration of civilian hospitals, including the personnel engaged in the search for, removal and transporting of and caring for wounded and sick civilians, the infirm and maternity cases, shall be respected and protected.
• that “Convoys of vehicles or hospital trains on land or specially provided vessels on sea, conveying wounded and sick civilians, the infirm and maternity cases, shall be respected and protected in the same manner as the hospitals provided for…”

Moreover, we express our outrage at the multiple violations of virtually every regulation under Article 51 of the Additional Protocol of the Geneva Conventions on the Protection of the Civilian Population. These have been made visible to the public through multinational war correspondents. The Hague and Geneva Law identify many of these violations as war crimes, e.g., the illegal use of thermobaric blast weapons against civilians and civilian sites.

We call upon the United States and the UN and its member nations to investigate, document, retain evidence, and try Mr. Putin for the commission of war crimes, genocide, crimes of aggression, and crimes against humanity, consistent with the evidence that is obtained, including but not limited to:

• Intentionally directing attacks against the civilian population as such or against individual civilians not taking direct part in hostilities;
• Intentionally directing attacks against civilian objects, that is, objects which are not military objectives;
• Intentionally launching an attack in the knowledge that such attack will cause incidental loss of life or injury to civilians or damage to civilian objects or widespread, long-term and severe damage to the natural environment which would be clearly excessive in relation to the concrete and direct overall military advantage anticipated;
• Attacking or bombarding, by whatever means, towns, villages, dwellings or buildings which are undefended and which are not military objectives;
• Making improper use of a flag of truce, of the flag or of the military insignia and uniform of the enemy
• Intentionally directing attacks against buildings dedicated to religion, education, art, science or charitable purposes, historic monuments, hospitals and places where the sick and wounded are collected, provided they are not military objectives;
• Pillaging a town or place, even when taken by assault;
• Employing weapons, projectiles and material and methods of warfare which are of a nature to cause superfluous injury or unnecessary suffering or which are inherently indiscriminate in violation of the international law of armed conflict. (From: Article 8 of the Rome Statute of the International Criminal Court)

While sanctions do not stop material aggression, harm, and damage to life, infrastructure, and environment, we call upon the United States and the UN and its member nations to place, consistently tighten, and maintain sanctions against Mr. Putin and his government so that he is economically and forcibly constrained in his action.

Mr. Putin has waged an unprovoked and unjustified war on a sovereign, democratic nation and has indicated his intent to carry through to the end his invasion until he achieves the full surrender, submission, and subjugation of the Ukrainian people. He has thus indicated that he will not negotiate withdrawal, rendering diplomatic solutions null. He has also indicated that sanctions will not affect his plans for Ukraine. Past statements have indicated his general contempt for Ukrainians and that Ukraine has no right to exist as a country. His invasion and wanton killing in Ukraine are genocidal. And, there is no indication that he will stop with Ukraine, following as it does his military actions in Syria, Chechnya, Georgia, Crimea—including the razing of Grozny.

We call upon the United States and the UN and its member nations, to intervene with increased humanitarian aid both, for the Ukrainian nation and its refugees, and to increase aid to refugee-receiving nations and conflict adjacent nations.

In addition to increased governmental aid, we ask that a central website be established for Americans (and in other nations) with links to authenticated governmental or non-governmental organizations, where donations can be specified for and directed toward aid to Ukrainians and/or Ukraine resistance and Ukrainian refugees.

We call upon the United States and the UN and its member nations, to markedly increase aid to the Ukrainian citizenry to increase their capacity for resistance to Russian invasion.

We support increasing the supply of rations/food, protective gear, field first aid and medical supplies, communications equipment, and those supplies necessary to support the resistance of the Ukrainian people. In addition, we also support the provision of arms, weapons, munitions, armored vehicles, armored fighting vehicles, planes, surveillance equipment, drones, classified surveillance information, cybersecurity expertise, and more.

We call upon the United States and the UN and its member nations, to provide for the medical and nursing needs of the Ukrainian populace, and nurses (and physicians) giving care under wartime conditions.

This war follows upon the heels of the Covid pandemic which had already strained medical and nursing resources in Ukraine. We ask our nation and the UN and its member nations to increase its provision of medical and nursing resources including but not limited to clothing, birthing kits, hygiene kits; cleaning, disinfecting, and sterilizing supplies and equipment; medical and surgical supplies and instruments; head lamps; tourniquets, bandages, and wound care kits; nutrition support for infants, children, and adults; blankets, towels, diapers, isolettes, bassinets, medications, antibiotics, and infusions; disposable scrubs; ambulances, and stretchers. In addition, nurses and physicians are living in hospitals in Ukraine and need personal support with food, warm clothing, ground cold-barrier foam for sleeping, blankets, clothing, and personal care items.

We call upon the United States and the UN and its member nations, to provide the necessities and comforts for the particularly vulnerable in Ukrainian society.

Many of the women, children and elderly persons have had to take cover in underground stations, basements, subway tunnels, and bunkers. We ask that our nation coordinate with NGOs and the International Red Cross to increase the donation of such things as clothing, shoes/boots and socks, blankets, ground-insulating foam rolls, food; child education and amusement kits and comfort toys; hygiene kits; feminine hygiene supplies, reading materials, communications tools; candles and flashlights and batteries, head lamps; supportive religious items; warm clothing, and other necessities.

We call upon the United States and the UN and its member nations to create collaborative and coordinated structures that can support the work of volunteer nurses and midwives who enter conflict zones to ameliorate the excess demands that fall upon the nursing and midwifery work of nationals in conflict zones.

The world is never free of war. War places even greater demands upon both military and civilian nurses and midwives. We call for the creation of an international structure and system of coordination and support for nurse and midwife volunteers who are willing to serve in conflict zones. The remarkable Médecins Sans Frontières, is a model that could be extended to an international cooperative and collaborative system of organizations and agencies, that are materially supplied by their nations of origin or international donations.

We are, collectively, horrified both at the invasion and the conduct of this war. As Mr. Putin appears to accept no diplomatic solution other than utter surrender and accession of the Ukrainian nation and its people into Russia, we ask our nation, and the UN and its member states, to do all in their power to force an end to this war, to maintain the sovereignty of the Ukrainian nation and its populace, to aid the Ukrainian resistance, to bring aid to the people of Ukraine and its refugees, to aid refugee–receiving nations, and to harden other nations against Russian expansionism, invasion and cyberattack.

In affirmation of the dignity of human life; the value of health, well-being, respect, and freedom; the hallowed nature of the natural environment, and our commitment to justice and peace as nurses and bioethicists, we humbly submit these requests and urge stringent intervention to halt this unjustified war, to punish war crimes, and to restore Ukraine and the Ukrainian people to sovereign status.

Sincerely,