KYIV, Ukraine — In the crowded operating room, the surgeons had made the long incision down the middle of the child’s chest, cut the breastbone to spread the rib cage and reach the heart. Then the lights went out.
Generators kicked on to keep life-support equipment running on Wednesday night, and nurses and surgical assistants held flashlights over the operating table, guiding the surgeons as they snipped and cut, working to save the child’s life in almost total darkness.
“So far we are coping on our own,” said Borys Todurov, the director of the clinic, the Heart Institute, in Kyiv. “But every hour is getting harder. There has been no water for several hours now. We continue to do only emergency operations.”
In its increasingly destructive campaign to batter Ukraine’s civilians by cutting off their power and running water, Russia hammered Ukraine’s populace this week with a wave of missile strikes that was one of the most disruptive in weeks. Ukraine’s engineers and emergency crews worked desperately on Thursday to restore services through snow, freezing rain and blackout conditions. And throughout the country, people dealt with the deprivations.
As surgeons donned headlamps to work in the dark, miners were pulled from deep underground by manual winches. Residents of high-rise apartments lugged buckets and bottles of water up the stairs of buildings where elevators stopped running, and shops and restaurants flipped on generators or lit candles to keep business going.
Although Ukrainians expressed defiance at Russia’s efforts to weaken their resolve in the worsening cold, millions remained without power on Thursday night as Russia’s persistent missile strikes took a growing toll. At least 10 people were killed on Wednesday, the Ukrainian authorities said. After each missile strike, repairs have become more challenging, blackouts have lasted longer and the danger for the public has increased.
“The situation is difficult throughout the country,” acknowledged Herman Galushchenko, Ukraine’s energy minister. By 4 a.m., he said, engineers had managed to “unify the energy system,” allowing power to be directed to critical infrastructure facilities.
The barrage on Wednesday, which injured dozen of people, appeared to be one of the most disruptive attacks in weeks. Since a blast on Oct. 8 on the Kerch Strait Bridge, which links the occupied Crimean Peninsula to Russia, the Russian military has fired around 600 missiles at power plants, hydroelectric facilities, water pumping stations and treatment facilities, and high-voltage cables around nuclear power stations and critical substations that bring power to tens of millions of homes and businesses, according to Ukrainian officials.
The strikes on Wednesday took all of Ukraine’s nuclear power plants offline for the first time, depriving the country of one of its most vital sources of energy. But the energy minister said the authorities expected the plants to be working again soon, “so the deficit will decrease.”
The Kremlin on Thursday denied that its attacks were aimed at civilians. A spokesman, Dmitri S. Peskov, said, “we are talking about infrastructure targets that have a direct or indirect relation to the military potential of Ukraine,” according to Russian news agencies.
He added that the leadership of Ukraine “has every opportunity to bring the situation back to normal, has every opportunity to to resolve the situation in a way that fulfills the demands of the Russian side and, accordingly, every opportunity to end the suffering of the peaceful population.”
Ukraine’s president, Volodymyr Zelensky, has rejected any suggestion of a truce or peace talks at this juncture, saying that Moscow’s war aims have not changed and that a pause in hostilities would only give the Russian military time to regroup from recent setbacks.
In mid-October, President Vladimir V. Putin said strikes on almost a dozen Ukrainian cities were retaliation for the truck bombing of the Kerch bridge, and the Russian military has increasingly targeted civilian infrastructure since then.
But the hail of missile strikes has also reflected Russia’s persistent struggles on the battlefield, as its ground forces retreated from thousands of square miles in Ukraine’s northeast in September and then from a major southern city in November. Trying to solidify its lines on the ground — including with poorly trained, recently mobilized conscripts — the Russian military has resorted to long-range missile strikes as a means to deflect domestic criticism and inflict pain while on the defensive.
Ukraine has put its Western-supplied weapons into action against the strikes, while also pleading for more aid. Gen. Valeriy Zaluzhnyi, the top commander of Ukraine’s Armed Forces, said Ukrainian air defenses shot down 51 of the 67 Russian cruise missiles fired on Wednesday and five of 10 drones.
Mr. Zelensky, speaking Wednesday night at an emergency session of the United Nations Security Council, decried what he called a Russian campaign of terror.
“When the temperature outside 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,” he said, “that is an obvious crime against humanity.”
It remained unclear on Thursday whether his new appeal would move diplomats from the European Union any closer to a final deal to help limit Russia’s revenue from oil, an effort encouraged by the Biden administration to starve Russia of funds for the war.
Officials from all 27 E.U. member nations met late into the evening on Wednesday without settling on a top price that traders, shippers and other companies in the supply chain could pay for Russian oil sold outside the bloc. The policy must be in place before an E.U. embargo on Russian oil imports kicks in on Dec. 5.
The embargo applies only to the 27-nation bloc. So to further limit Russia’s financial gains, the group wants to cap how much buyers outside the region pay for Russian oil. That crude could be sold only outside Europe and would have to be below the agreed-upon price. Russia has repeatedly said it will ignore the policy, which analysts have said would be difficult to enforce.
The E.U. ambassadors have been asked to set a price from $65 to $70 per barrel, and to be flexible about enforcing the limit.
The benchmark for the price of Russian oil, known as the 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 the E.U. policy would be of little immediate help in easing a cost-of-living crisis around world.
As E.U. residents have prepared for a winter of high energy prices and possible rationing of supplies, Ukrainians have increasingly lived with long blackouts and water shortages from the direct damages of the war.
In Kyiv on Thursday afternoon, around one in four homes still had no electricity, and more than half of the city’s residents had no running water, according to city officials. Service was gradually being restored, city officials said, adding that they were confident that the pumps that provide water to some three million residents would be restored by the end of the day.
But the power outages created potentially dangerous conditions around the country. The scene in the Kyiv hospital echoed those in medical facilities around Ukraine, a vivid illustration of the cascading toll Russia’s attacks are having on civilians far from the front lines.
Two kidney transplant operations were being performed at the Cherkasy Regional Cancer Center in central Ukraine when the lights went out, Kyrylo Tymoshenko, the deputy head of the Ukrainian president’s office, said on the Telegram messaging app. The generators were switched on, and the transplants were successful, he said.
Christopher Stokes, the head of Doctors Without Borders in Ukraine, said that the strikes on infrastructure were putting “millions of civilians in danger.” They can feed a vicious loop, in which people living without heat and clean water are more likely to need medical care but that care itself is harder to deliver.
“Energy cuts and water disruptions also will affect people’s access to health care as hospitals and health centers struggle to operate,” he said.
Marc Santora reported from Kyiv, Ukraine, and Thomas Gibbons-Neff and Natalia Yermak from Dnipro, Ukraine. Reporting contributed by Matina Stevis-Gridneff from Brussels, Jim Tankersley and Alan Rappeport from Washington and Alan Yuhas from New York.