Under the blows of missiles, Ukrainians churn water, while surgeons operate in the dark

KYIV, Ukraine — In a crowded operating room, surgeons made a long incision down the middle of a baby’s chest, cutting through the breastbone to spread out the rib cage and reach the heart. Then the lights went out.

Generators were running to keep life-support equipment running Wednesday night, and nurses and surgical assistants placed spotlights above the operating table, guiding surgeons as they cut and cut, working to save the baby’s life in almost complete darkness.

“So far we are dealing on our own,” said Boris Todorov, director of the clinic, Heart Institute, in Kyiv. “But every hour it gets more difficult. There has been no water for several hours now. We only continue to do emergency operations.”

In its increasingly destructive campaign to strike civilians in Ukraine by cutting off electricity and running water, Russia struck the population of Ukraine this week with a wave of missile strikes that was one of the most disruptive in weeks. Engineers and emergency crews in Ukraine worked desperately on Thursday to restore services through snow, sleet and blackout conditions. And all over the country people dealt with deprivation.

While surgeons wore headlamps to operate in the dark, miners were pulled from the depths of the earth by hand winches. High-rise residents hauled buckets and water bottles up the steps of buildings as elevators stopped working, and shops and restaurants turned on generators or lit candles to keep going.

Although Ukrainians voiced their defiance of Russia’s efforts to weaken their resolve amid the worsening cold, millions remained without power Thursday night as persistent Russian missile strikes took a mounting toll. Ukrainian authorities said at least 10 people were killed on Wednesday. After each missile strike, repairs became more difficult, power outages lasted longer and the danger to the public increased.

Ukraine’s Energy Minister Herman Galushenko acknowledged that “the situation is difficult across the country.” By 4 a.m., he said, engineers had managed to “standardize the power system,” allowing power to be routed to critical infrastructure facilities.

Wednesday’s barrage of attacks, which injured dozens of people, appeared to be one of the most disruptive in weeks. Since the October 8 explosion on the Kerch Strait bridge, which connects occupied Crimea with Russia, the Russian military has fired about 600 missiles at power plants, hydroelectric facilities, water pumping stations, treatment facilities and high-voltage cables around them. Nuclear power plants and critical substations provide power to tens of millions of homes and businesses, according to Ukrainian officials.

Wednesday’s strikes put all of Ukraine’s nuclear power plants out of action for the first time, depriving the country of one of its most vital energy sources. But the energy minister said authorities expect the plants to be operational again soon, “so the deficit will decrease.”

The Kremlin denied on Thursday that its attacks targeted civilians. A spokesman for Dmitry S. Peskov, “We are talking about infrastructure targets that have a direct or indirect relationship to the military potential of Ukraine,” according to Russian news agencies.

He added that Ukraine’s leadership “has every chance to bring the situation back to normal, it has every chance to resolve the situation in such a way as to meet the demands of the Russian side and, therefore, every chance to end the suffering of the Russian peaceful population.”

Ukraine’s president, Volodymyr Zelensky, has rejected any proposal for an armistice or peace talks at this point, saying that Moscow’s war aims have not changed and that a cessation of hostilities would only give the Russian military time to regroup after recent setbacks.

In mid-October President Vladimir Putin said the strikes on nearly a dozen Ukrainian cities were in response to the truck bomb bombing on the Kerch Bridge, and the Russian military has increasingly targeted civilian infrastructure since then.

But the barrage of missile strikes also reflected Russia’s ongoing struggles on the battlefield, as its ground forces retreated from thousands of square miles in northeastern Ukraine in September, then from a major southern city in November. In an effort to solidify its lines on the ground — including with poorly trained and recently mobilized conscripts — the Russian military has resorted to long-range missile strikes as a way to deflect domestic cash and inflict pain on defense.

Ukraine put its weapons supplied from the West into action against the strikes, while at the same time pleading for more aid. General Valery Zaluzhny, the supreme commander of Ukraine’s armed forces, said that Ukrainian air defenses shot down 51 out of 67 Russian cruise missiles launched on Wednesday and five out of 10 drones.

Mr. Zelensky, who was speaking Wednesday night at an emergency session of the United Nations Security Council, denounced what he described as Russia’s campaign of terror.

He said, “When the outside temperature drops below zero and tens of millions of people are left without electricity, heat and water as a result of Russian missiles hitting energy facilities, this is a clear crime against humanity.”

It was not clear on Thursday whether his new call would push EU diplomats closer to a final deal to help limit Russia’s oil revenue, an effort encouraged by the Biden administration to strip Russia of funds for the war.

Officials from all 27 member states of the European Union met late on Wednesday without settling on the highest price traders, shippers and other companies in the supply chain can pay for Russian oil sold outside the bloc. This policy must be in place before the EU ban on Russian oil imports kicks in on December 5th.

The ban only applies to the 27-nation bloc. So, in order to limit financial gains for Russia, the group wants to limit how much buyers outside the region pay for Russian oil. This ore can only be sold outside of Europe and it must be lower than the agreed price. Russia has repeatedly said it will ignore the policy, which analysts said would be difficult to implement.

EU ambassadors were told to set a price of $65 to $70 per barrel, and to be flexible about enforcing the limit.

The price of Russian oil, known as Urals Blend, has traded from $60 to $100 per barrel in the past three years. In the past three months, the price has ranged from $65 to $75 per barrel, suggesting that EU policy will be of little immediate benefit in easing the worldwide cost-of-living crisis.

As residents of the European Union prepare for a winter of soaring energy prices and possible rationing of supplies, Ukrainians have increasingly suffered from prolonged power outages and water shortages due to the direct damage of the war.

In Kyiv on Thursday afternoon, about one in four homes were still without power, and more than half of the city’s residents had no running water, according to city officials. City officials said service has been gradually restored, adding that they are confident the pumps providing water to about three million residents will be back on by the end of the day.

But the power outage created potentially dangerous conditions across the country. The scene at the Kyiv hospital echoed those in medical facilities across Ukraine, and is a vivid example of the cascading toll of Russian attacks on civilians far from the front lines.

Kyrylo Tymoshenko, deputy chief of the Ukrainian president’s office, said on messaging app Telegram that two kidney transplants were being performed at the Cherkassy Regional Cancer Center in central Ukraine when the lights went out. He said the generators were turned on, and the transplants worked.

Christopher Stokes, head of Doctors Without Borders in Ukraine, said the strikes on infrastructure put “millions of civilians at risk”. They can feed a vicious cycle, as people who live without heat and clean water are more likely to need medical care but that care itself is difficult to provide.

“Power outages and water outages will also affect people’s access to healthcare as hospitals and health centers struggle to operate,” he said.

Mark Santora Reported from Kyiv, Ukraine, and Thomas Gibbons Neff And the Natalia Yermak From Dnipro, Ukraine. Contribute to the preparation of reports Matina Stevis Gridnev from brussels, Jim Tankersley And the Alan Rapport From Washington W Alan Yohas from New York.

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