Why Ukrainian medical workers won't receive the promised frontline bonuses — study results

Ruslana Mazurenok, a nurse and activist of Medrukh "Bud yak Mi", told about it during the Social Forum, referring to the results of surveys of medical workers in the frontline areas.

550 medical workers took part in the survey. Then some of them were interviewed.

According to Mazurenok, in May 2023, medics in the frontline territories were entitled to increased payment. In the territories of possible hostilities, doctors were to be paid 3000 hryvnias, nurses - 2000 hryvnias, and junior staff - nothing. In active combat zones the rates were higher: 8000 hryvnias for doctors, 4500 hryvnias for nurses and 1000 hryvnias for junior staff. In autumn 2025, the payments were increased: to 8,000, 4,500 and one thousand hryvnias for areas of possible hostilities and to 20,000, 15,000 and 10,000 hryvnias for active zones.

It sounds marvellous, but in reality it is not like that at all. The system of accrual of front-line surcharges remains "absolutely non-transparent," Mazurenok said.

The most alarming indicator is the decline in coverage. In 2023, 126 hospitals had funding for surcharges. In the summer of 2025, only 57 remained, although risk areas were expanding.

In Odessa Oblast, for example, seven districts received the status of territories of possible hostilities, but in the summer only one medical centre had the relevant funding package.

As a result, there were about 12,000 medics working in hospitals with funding, while in total there were more than 53,000 medics in the frontline territories. Even when by the end of 2025 funding was restored to many institutions, the state did not compensate for the period when people were already working under shelling without additional payments.

Why the money does not reach the medics

Ruslana Mazurenok identified three levels of obstacles: the status of the territory, the rules of the NHRI and the decisions of the administration of a particular medical centre.

• The first level is the legal address. The right to additional payment may depend not on where a person actually works, but on where the institution is registered. This creates absurd situations. An ambulance paramedic may work ten kilometres from the front line every day, but not receive payments because the legal base is in the regional centre. A blood transfusion department may be physically located in a frontline hospital, where everyone around them receives extra payments, but its staff remain without payments because it is subordinate to the regional centre.
• The second level is the NHSI. Even if an institution is at risk, it does not always receive funding. According to Ruslana Mazurenok, specialised dental clinics - about one and a half thousand medics in Odessa, Kharkiv, Zaporizhzhya and Sumy - were excluded from the system. There were also problems with psychiatric hospitals. Kherson psychiatric hospital was able to restore the contract only after the intervention of the Ombudsman.
• The third level is the hospital administration. It is here that additional payments often turn into a manual instrument: to whom to pay, how much to pay and under what conditions. In one hospital, an inpatient nurse can receive 2500 hryvnias, and a polyclinic nurse - 1200 hryvnias, although both work in the same institution and under the same firings. If an employee goes on sick leave or on holiday, the extra payment can be withdrawn. Staff questions are often answered simply: there is no money.

Such a system destroys the very logic of risk compensation. If a hospital is shelled, the danger does not depend on the legal address, the department or the decision of the administration. But in reality, it is these factors that can determine whether a person gets money.

"We all risk our lives the same way."

Behind the numbers are specific stories. Medics told of shelling, working under drones, travelling to shift change, and injuring colleagues. Even when a hospital has a shelter, a doctor or nurse cannot always go down there: you cannot leave a patient connected to the equipment. Often the shelters are not adapted for heavy patients.

Mazurenok quoted a phrase of one of her colleagues from the East:

Our medicine is sustained only on enthusiasm. It is a duty - you have to help people.

Another medical professional's position is even more direct:

We all risk our lives equally. Everyone needs to be paid.

According to Ruslana Mazurenok, MedRukh offers the following solutions:

• automatic and universal eligibility for supplemental payment;
• independent monitoring;
• liability of managers for non-payment;
• analysis of debts by the State Labour Service from 17 May 2023;
• active role of trade unions;
• the willingness of workers themselves to go to the labour inspectorate and the courts.

Health professionals advocate for a transparent mechanism where risk is recognised automatically, rather than after complaints, pressure and long periods of proving the obvious.

As Socialportal wrote, the frontline town of Novodonetskiy in Donetsk Region, where families with children, the elderly and low-mobility residents still live, tried to close the ambulance stations. However, thanks to the publicity these plans were abandoned

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