Vilnius University Hospital Santaros Clinics, located 50 kilometers from the EU’s external border with Belarus, is developing underground infrastructure, shelters, helicopter landing sites and autonomous systems to function without electricity or water supplies, according to Politico.

The hospital’s preparations mirror those across the region. Estonian authorities are procuring body armor for ambulance crews and satellite phones to maintain communications if traditional networks fail. Plans include generating an independent internet network if necessary.

“We know for certain that Russia targets the civilian infrastructure and energy structures, and that means that you cannot have these kinds of situations where the hospital doesn’t work because there are some power plant problems,” said Ragnar Vaiknemets, deputy director general of the Estonian Health Board.

Electrical generators are being installed across healthcare systems, following Ukraine’s experience with Russian strikes that routinely cut off civilian power. Many hospitals in Eastern Europe — built during the Soviet era — present particular vulnerabilities as large, high buildings concentrated in single complexes.

“I can’t imagine working on a top level … of the hospital just waiting to get hit,” Vaiknemets said, explaining plans to repurpose basements as operating theaters.

Capacity and supply challenges

European countries average 11.5 intensive care beds per 100,000 population, but wartime needs could require three to five times this capacity, according to Bjørn Guldvog, special adviser at the Norwegian Directorate of Health. Most facilities can sustain only 120-150 percent of normal surgical volume for 24 to 48 hours.

Estonia has allocated €25 million for mass casualty supplies, including orthopedic gear, tourniquets and trauma kits — “the only heavy investment we have made,” Health Minister Riina Sikkut said in February.

Latvia requires healthcare institutions to maintain a three-month supply of medicines, a policy established during Covid-19. “I have never thought that I would say thanks to Covid, but thanks to Covid … we found financial resources,” said Agnese Vaļuliene, health ministry state secretary.

The Baltic states’ proximity to potential front lines creates additional challenges for emergency supply storage. Jos Joosten, a medical adviser at the European External Action Service, said other EU countries must identify scarce resources for smaller nations and surrender some sovereignty to enable EU-level distribution decisions.

Workforce uncertainty

Staff shortages present a fundamental challenge for Baltic healthcare systems already stretched thin in peacetime. Estonia, with 1.3 million people, has nearly half the healthcare workforce per capita of Germany.

A Lithuanian survey found that over a quarter of health workers would likely flee during war, while fewer than 40 percent would stay and a third were unsure. Estonia anticipates similar patterns, with officials estimating 50-60 percent of the population don’t yet know how they would respond.

“There are patriots, the first responders, the people that we know without question will stay,” Vaiknemets said. “Of course, there are naysayers that talk about going to Spain straight away.”

Paramedic Noreikaitė signed a declaration committing to work if war breaks out in Lithuania, but acknowledged uncertainty about actual response rates. “But how it would really be — who would come and who wouldn’t — I don’t know. Personally, I don’t have children or a family yet, so I think I would stay,” she said.

Latvian pulmonologist Rūdolfs Vilde said some doctors were considering fleeing if war breaks out, especially parents who “don’t see how it would be suitable for them to ditch the children somewhere and be in the hospital in times of military crisis.”

Learning from Ukraine’s experience

Baltic medical professionals are traveling to Ukraine to observe firsthand how hospitals manage missile strikes, mass casualties and power outages. Vaiva Jankienė, a nurse who has volunteered over 20 times in Ukraine since April 2022, described the scale of injuries as “difficult to comprehend.”

“After the drone attacks, the consequences are hard to imagine,” Jankienė said. “Injuries like these,” she sighed, “every single medical professional who saw them said the same thing: We couldn’t have imagined it would look like this.”

While a trauma doctor in Lithuania might perform one amputation annually, Ukrainian hospital wards are filled with patients suffering amputations of multiple limbs plus other severe injuries. “We have very little experience treating such complex, multiple traumas,” she said.

Regional evacuation planning

The use of advanced weaponry in Ukraine — including long-range missiles and military drones — means the front line is no longer a fixed boundary. Attacks can reach targets hundreds of kilometers away, making evacuation plans essential for countries throughout the region.

Joosten warned that EU solidarity will be tested if conflicts escalate. “If Lithuania is overrun, who’s responsible for Lithuanians, because there’s no Lithuania anymore? But the European Union is (still there),” he said.

He urged EU institutions to create funds for handling civilian and military casualties, as well as displaced populations, noting that casualty numbers could dramatically exceed Ukraine’s experience. “Those 4,000 patients we moved away from Ukraine, that’s nothing, 4,000 in three years,” he said. “Let’s talk about 4,000 in two weeks, and then the next two weeks again.”

The preparations reflect a shift in mindset across NATO’s eastern flank. “It’s not a question of if [Russia] will attack,” Vaiknemets said. “It’s a question about when.”

As Lithuania’s deputy health minister Daniel Naumovas put it in February: “We have bad neighbors here: Russia and Belarus.” While all EU countries face similar challenges, some are “in the vanguard where the water is cold,” he said. “Water is splashing on our face; water of war.”

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Today, we will discuss the increased Russian provocations and calls for the denazification of the Baltic countries. Not wanting to be caught off guard and taking these threats seriously, these countries are already taking measures to improve their security.

He accused these nations of showing high aggressiveness and claimed they were underestimating the devastating consequences of provoking Moscow.

This statement echoed a wave of similarly hostile rhetoric from Russian state officials and media figures over the past two years.

Questioning the sovereignty of nations

Russian officials, including former president of Russia, Dmitry Medvedev, now deputy chairman of Russia’s Security Council, have repeatedly questioned the sovereignty of the Baltic countries.

Medvedev declared that the Baltic states belong to Russia and accused NATO of harboring anti-Russian intentions. State television host Vladimir Solovyov has gone even further, stating that these countries don’t need independence and that their sovereignty is a joke.

Such statements are not isolated; they reflect a coordinated campaign to frame the Baltics as illegitimate states and NATO’s eastern flank as a battleground ripe for denazification, a chilling repeat of the Russian justification for its war on Ukraine.

The return of a dangerous word: “denazification”

The term denazification is particularly troubling, as it has historically been used by Russia as a pretext for aggression. Prior to its 2022 invasion of Ukraine, Moscow framed its war aims in identical terms, alleging that Kyiv needed to be cleansed of Nazis despite Ukraine being a functioning democracy with a Jewish president.

Now, with similar language being used against Estonia, Latvia, and Lithuania, the fear is that these statements may not be mere propaganda but early signs of a more expansive regional strategy.

NATO’s Achilles heel

From a military standpoint, the Baltic states represent a significant weakness for Russia, making them a tempting target.

Kaliningrad, Russia’s exclave on the Baltic Sea, is completely isolated and surrounded by NATO territory, so prominent Russian media and political figures are constantly calling for the establishment of a direct land route to Kaliningrad.

Most important is the narrow Suwalki Gap between Poland and Lithuania, as control over it would either sever or restore Russian land access to Kaliningrad, depending on who holds it.

Russia’s Baltic fleet faces a NATO wall

At the same time, since Finland and Sweden joined NATO, the Baltic Sea has become almost entirely encircled by NATO members, severely limiting Russian maritime maneuverability.

Russia’s Baltic Fleet, already small and aging, is no match for the combined naval power of NATO states in the region. On land, the Baltic countries host forward-deployed NATO battle groups and conduct regular military exercises to prepare for rapid mobilization.

These factors make any quick land grab by Russia, a tactic used in Crimea and eastern Ukraine, far less likely to succeed here. This only seems to enrage the Russian government further, fueling its hostile campaign.

No longer just words

Russia’s scare tactics extend beyond mere threats. The Kremlin actively invokes the presence of Russian-speaking populations in the Baltics, around 24% in Estonia and Latvia, as a rationale for intervention, much like it did in Ukraine.

These demographics are a legacy of Soviet-era population transfers and remain a sensitive issue.

Russian state media routinely portrays these ethnic Russians as oppressed and in need of protection, laying the narrative groundwork for a potential future military action.

Russia repeats Ukraine’s playbook

The Baltics are not ignoring these signals. They have witnessed firsthand how Russia used similar rhetoric to justify its invasion of Ukraine.

What was once dismissed as empty words has become a forerunner of real war. As such, Estonia, Latvia, and Lithuania are bolstering their defenses, strengthening their ties with NATO, and preparing for the possibility of battle.

The line between information warfare and justification for full-scale war is growing thinner, and with every new threat from Russia, the sense of urgency increases.

Overall, Russia’s repeated calls for the denazification of the Baltic states and its threats of direct retaliation are viewed with the utmost seriousness by their governments.

The parallels with the lead-up to the war in Ukraine are stark, and after a series of provocations in the last months, the stakes are higher than ever.

For Estonia, Latvia, and Lithuania, preparing for the worst is not paranoia. It’s a necessity, and they are actively working to improve their security.

In our daily frontline report, we pair up with the military blogger Reporting from Ukraine to keep you informed about what is happening on the battlefield in the Russo-Ukrainian war.

Exclusive

Tiny Latvia sends thousands of drones in heavyweight military aid to Ukraine. Latvia got burned by the USSR. Now it’s sending 12,000 drones to help Ukraine return the favor in 2025.

Russia sends ordinary criminals unrelated to war for exchanges instead of soldiers or activists. Ukraine claims it had limited ability to influence the composition of exchange lists. That’s why among the 120 civilians returned in the recent three-day exchange, many were individuals who had lived and worked in Russia before being convicted of non-war crimes, rather than Ukrainians who remain in captivity due to war since 2022 or even 2014.

Who is dancing and where if journalism is dead? Trump and Orbán know. When journalism dies, propaganda doesn’t mourn—it gets to work. At the Lviv Media Forum, experts showed how Trump and Orbán turned media into their loudest ally.

Why is Russia bombing Ukraine with 1990s-era training drones?. The Dan-M target drone was designed to simulate US cruise missiles. Now it’s been turned into one, kind of—and launched at Ukraine.

Hungary and Slovakia expand Russian fuel use while EU cuts imports. New findings show both countries increasing reliance on oil, gas, and nuclear fuel from Russia despite available alternatives.

Russia just spent $ 3 mn to blow up planes that don’t even fly. Ukraine’s 1970s drone shotguns were so vexing that Russia decided to blow them into bits with a $3mn Iskander missile. But an epic intel failure got in the way.

Military

Russia claims evening drone attack in occupied Crimea. Russian forces claimed they shot down a Ukrainian drone over occupied Crimea on Saturday evening, marking another reported attack on the peninsula that Moscow annexed in 2014.

Second Russian pocket emerges in Sumy Oblast near Oleksandria village – Deep State. Russian forces seized territory near Oleksandria village in Sumy Oblast within 24 hours, creating a second pocket of occupied land along Ukraine’s northern border, according to DeepState military analysts.

Russia “significantly” intensifies activity in Zaporizhzhia sector – Syrskyi. Commander-in-Chief Oleksandr Syrskyi said Ukraine struck 58 military targets inside Russia during May while defending against escalated Russian offensive actions in the Zaporizhzhia direction.

Frontline report: Drones become pivotal in countering Russian advance to Ukraine’s most strategic Donbas cities. Ukraine deploys elite drone units to counter Russian forces that have punched through Ukrainian defenses using “suicide squads” to locate positions, gaining 10 km (6 miles) in just two months.

Drones hit alleged Russian military positions in Kursk amid threats of new offensive from this direction. Russians officials claim that the attack struck residential buildings and injured civilians.

Russia’s estimated losses in Ukraine as of day 1193 of its all-out war, according to the Ukrainian Army’s General Staff.

International

“Not very serious”: Zelenskyy criticizes Russia’s lack of clarity before talks. Ukrainian President Volodymyr Zelenskyy has cast doubt on Russia’s commitment to peace negotiations, saying Moscow has not provided clear information about its agenda for talks scheduled in Istanbul on 2 June.

Former Secretary of State Pompeo: US did not do enough to stop the war in 2014. Speaking at the Black Sea Security Forum, former US Secretary of State Mike Pompeo said America “lost deterrence” against Vladimir Putin in 2014 and regretted the US failed to prevent Russia’s 2022 invasion.

Merz-Trump face-off: Ukraine war tops agenda in first White House meeting. German Chancellor will come to the White House on 5 June, sitting down with US President to discuss Ukraine aid, Middle East policy, and trade disputes that have strained transatlantic ties.

“Let’s get real”: European officials abandon hope for US backing in Ukraine. European officials have quietly shifted from deploying peacekeeping troops to providing long-term military support for Ukraine without US involvement, following concerns that President Trump will abandon his mediator role.

Top EU diplomat says US criticism of Europe shows “love nonetheless”. Europe’s top diplomat welcomed criticism from Washington as a sign of continued American engagement during weekend defense talks in Singapore.

Lithuania at risk: Ex-CIA chief warns Russia to target Baltic State after Ukraine. Former CIA director David Petraeus warned that Lithuania faces the highest risk of Russian invasion among NATO countries if Moscow succeeds in Ukraine.

Erdogan urgently calls Zelenskyy as Istanbul braces for Russia peace talks. Ahead of the Istanbul talks, Erdogan pressed Zelenskyy to hold direct talks with Putin and Trump “without delay.”

Humanitarian and social impact

Ukrainian high-schoolers hold graduation ceremony at cemetery. Russian missile killed their classmate and his two siblings. The students brought toys, cards, and pieces of birthday cake to the gravesite on the graduation day that “should have been filled with joy, hugs, tears of happiness” but turned into a day of mourning.

Russian bomb kills child, injures teen in massive attack. Terror of Ukrainian civilians continues.. On the night of 31 May, Russian forces launched over 100 drones and 5 missiles at Ukraine, damaging homes and other civilian infrastructure.

Political and legal developments

Swedish music competition secretly funded Russian war supporters, investigation finds. A prestigious music competition in Stockholm has been secretly channeling entry fees to a sanctioned Russian bank while employing jury members from institutions that support the war in Ukraine, a Swedish media investigation reveals.

The MT: Kremlin stages Putin helicopter drone incident to portray “heroic leader” sharing “war suffering”. The alleged drone strike was designed to counter public dissatisfaction as ordinary Russians face flight cancellations and internet outages due to increasing Ukrainian drone attack on military-industrial targets.

Read our earlier daily review here.