Good morning. We’re covering Russia’s aggressive turn east, South Africa’s catastrophic floods and Myanmar’s collapsing health system.
Russia scales up its eastern attack
Moscow declared that its offensive for control over Ukraine’s east was underway as it bombarded hundreds of targets overnight across the country’s industrial heartland.
Ukraine said it was resisting Russia’s initial thrust, but its contested region is bracing for a full-force attack. Hundreds of thousands of civilians remain trapped there. Here’s the latest.
The Pentagon estimated that Russia had already moved 8,000 to 11,000 more soldiers into the east and had tens of thousands more in reserve. The sprawling offensive could reshape the conflict.
Analysis: Russia’s military campaign appears much more methodical than those it pursued in the war’s first days. Ukrainian and Pentagon officials said Russian forces appeared to be engaged in “shaping operations,” which are smaller attacks that are often precursors to larger troop movements or distractions from other fronts.
Tactics: Ukrainians are using internet memes and selling merchandise to rally international public support. It’s working.
State of the war:
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At least 1,000 civilians were trapped at a large steel factory in Mariupol along with Ukrainian forces that were waging what appeared to be the last defense of the city.
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At least three more people were killed in Kharkiv by a Russian artillery strike.
Other updates:
A state of disaster in South Africa
More than 440 people have died and nearly 4,000 homes have been destroyed after catastrophic floods swept through the Durban area last week. About four dozen people remain unaccounted for, and survivors are struggling to reassemble their lives.
“This is probably one of the worst things I’ve seen,” one rescue worker said. “Just the large scale of the devastation.”
On Monday, President Cyril Ramaphosa declared a state of disaster. “We are a nation united in our grief,” he said.
The government is making plans to clean and repair the area while also trying to recover dozens of bodies believed to have been buried under mud or washed out to sea. Much of the death and destruction occurred in settlements of flimsy shacks constructed by people who could not otherwise afford stable housing.
Analysis: A string of powerful storms has recently devastated southern and eastern Africa, killing hundreds and destroying communities already struggling with poverty. For many, the floods have underscored the increasing toll of climate change, especially on the most socioeconomically vulnerable communities.
Myanmar’s health care collapse
In recent weeks, security forces in Myanmar intensified their crackdown on doctors who oppose the military junta, arresting them at their homes and hospitals. The soldiers have revoked the licenses of prominent physicians and searched hospitals for wounded resistance fighters.
April 19, 2022, 4:33 p.m. ET
As a result, Myanmar is now one of the most dangerous places in the world to be a medical worker. At least 140 doctors have been arrested since the coup; 89 of them remain behind bars, a rights group said. At least 30 doctors have been killed, another rights group said.
Analysis: Myanmar faces a continuing health emergency, with a severe shortage of medical professionals and a chronic lack of resources. Many hospitals and clinics have closed. Anti-regime doctors estimate that hundreds of people are dying each week because emergency surgeries are not being carried out.
Quotable: Dr. Kyaw Swar was performing surgery when soldiers came looking for him. He hid in the operating room and kept going. “If they had found us, they would have arrested us,” he said. “But I will not run away while I am operating on a patient. It is not a crime for a doctor to treat patients.”
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Door-to-door digital autopsies
Developing countries do not always keep official death records. Nine out of 10 deaths in Africa, and six out of 10 globally, are not registered.
That can have profound implications: The W.H.O. estimates that 15 million people around the world had died as a result of the coronavirus pandemic by the end of 2021 — more than double the existing official toll of six million.
Russia-Ukraine War: Key Developments
In a novel effort, researchers are going door-to-door to try to create an electronic record of loss: an “electronic verbal autopsy.”
In countries like Sierra Leone, they canvass an entire village, interviewing people about those who died in the past two years. The information goes into a nationwide survey, which doctors review to classify each death.
It is an extraordinarily labor-intensive approach. But in Sierra Leone, where a vast majority of people die from preventable or treatable causes, it’s necessary.
The country began its digital autopsies in 2018. The first big surprise was learning that malaria was the biggest killer of adults in Sierra Leone. The second was better news: Its maternal mortality rate was half of what the U.N. estimated, suggesting that government efforts were paying off.
