Pro-Russia separatists fighting off a Ukrainian government offensive have commandeered ambulances to transport retreating gunmen, taken cover in hospitals and threatened medical staff treating their wounded,
The New York-based rights agency said it had documented numerous violations of the laws of war that protect medical workers, hospitals and patients from exposure to hostilities.
"Pro-Russian insurgents' attacks on medical units and personnel are putting sick and vulnerable people and those who care for them at risk," said Yulia Gorbunova, a lawyer and researcher for Human Rights Watch's Europe and Central Asia division. "This appalling disregard of people who are sick or wounded can be deadly and needs to stop immediately."
As government troops drove the separatists out of Slovyansk in early July, the gunmen seized four ambulances from the local emergency services station and evacuated their fighters from the front to their stronghold in Donetsk, Human Rights Watch said.
The militants, who Ukrainian and Western officials contend are armed and instigated by Russian President
Ambulances are among the medical services and equipment that are protected by the laws of war, and able-bodied separatists are presumed to be using them for transport to avoid attack by government troops, who have been racking up significant territorial gains in recent weeks.
On Tuesday, Ukrainian forces were reported to have recovered control of at least one checkpoint at the edge of Donetsk, and a military spokesman in Kiev, the capital, said the government was closing in on the insurgents' main stronghold.
Government buildings in central Donetsk, a city of a million residents and the industrial heart of eastern Ukraine's mining and metals production, were seized by the militants in April and were under their control until the government counteroffensive began gaining ground a month ago. The gunmen are now at risk of having their forces divided between Donetsk and embattled Luhansk, the latter on the verge of a humanitarian
Much of the civilian population of both cities has fled. The United Nations' refugee agency on Tuesday dramatically increased its estimate of those displaced by the fighting, saying that 730,000 had left eastern Ukraine for Russia and 117,000 were taking refuge elsewhere in Ukraine. The Geneva-based Office of the High Commissioner for Refugees said half of the Luhansk city population of nearly 500,000 had left, and the remaining 250,000 were living without water, electricity, communications or grocery stores.
As the rebellion against rule from Kiev appeared to be foundering, Ukrainian officials raised the alarm over a mounting Russian troop buildup on the eastern border and massive air defense exercises announced by the Kremlin on Monday.
Russia has deployed 45,000 soldiers, 160 tanks, more than 1,300 armored vehicles, 192 war planes and 137 helicopters to the volatile border area, Ukrainian security council spokesman Andriy Lysenko said at a news briefing in Kiev.
Putin has been the target of stepped-up Western sanctions since the downing of a Malaysia Airlines passenger jet July 17, which killed all 298 on board. U.S. intelligence has reported that a surface-to-air missile fired from separatist-held territory brought down the plane, and it accuses Moscow of having supplied the sophisticated Buk launching system to the proxy fighters struggling to take territory for annexation to Russia.
Sanctions have targeted the Russian economy as punishment for Putin's seizure of Ukraine's Crimean peninsula in February, and as pressure builds on the Kremlin leader among Russian nationalists to come to the separatists' aid, some analysts fear he may be calculating that he has little to lose with a full-scale invasion of Ukraine.