UNITED NATIONS (AP) — Russian strikes are inflicting unimaginable suffering on the people of Ukraine and more than 40% of them need humanitarian assistance, a senior U.N. official told the U.N. Security Council on Tuesday.

Ramesh Rajasingham, director of coordination in the U.N. humanitarian office, said thousands of civilians have been killed in strikes on homes, schools, fields and markets since Russia’s invasion in February 20022. The U.N. human rights office has formally verified 9,900 civilians killed, but he said “the actual number is certainly higher.”

Ukrainian civilians are suffering “horrendous humanitarian consequences” and “unimaginable levels of suffering” from the Russian strikes, Rajasingham said. About 18 million Ukrainians — more than 40% of the population — need some form of humanitarian assistance, and as winter approaches “needs will be magnified,” he said.

Rajasingham said significant damage and destruction of critical infrastructure continues to severely impact civilian access to electricity, heating, water and telecommunications, “a particular concern as winter fast approaches,” which will put the elderly, disabled and displaced most at risk.

The Russian military methodically targeted Ukraine’s power stations and other critical infrastructure with missile and drone strikes during the last winter season, resulting in frequent power outages.

To prepare for the freezing temperatures this winter, the U.N. official said, the humanitarian community is helping people carrying out household repairs and ensuring that water and heating systems are functional.

“The aim is to ensure that every civilian has access to somewhere both safe and warm during the winter ahead,” Rajasingham said.

Ukrainians must also deal with diminished health care, he said.

Since the invasion, the U.N. World Health Organization has verified over 1,300 attacks on health care – more than 55% of all attacks worldwide during the same period, he said. And 111 health care workers and patients have been killed, with 13 health facilities impacted by attacks just since the beginning of September.

As the war continues, it has become more dangerous for humanitarian organizations to operate, with the number of aid workers killed more than tripling from four in 2022 to 14 so far in 2023, Rajasingham said.

Despite the risks, more than 500 humanitarian organizations – the majority of them local -- reached nine million people with aid in the first nine months of 2023, thanks to more than $2 billion contributed by donors to the U.N.’s $3.9 billion appeal for this year, he said. But over 40% of the appeal is still unfunded.

U.S. Deputy Ambassador Robert Wood told the council Russian attacks reduced Ukraine’s power generating capacity to roughly half its pre-war capacity, according to a U.N. estimate in June. And between October 2022 and March 2023, many civilians spent roughly 35 days without power.

He said Russian attacks on critical infrastructure have already resumed, “risking critical services and exacerbating the humanitarian crisis.”

Wood pointed to a single day in September when Russia launched 44 missiles at energy facilities in six regions, and a Ukrainian government report that from Oct. 11-12, Russia launched artillery, missiles and drones against the Kherson region “an estimated 100 times.”

From mid-July, when Russia pulled out of the initiative enabling Ukraine to ship critically needed wheat and other foodstuffs from Black Sea ports, until mid-October, Russian attacks destroyed nearly 300,000 tons of Ukrainian grain, he said.

“We call on the international community to continue providing essential humanitarian support to Ukraine, including supporting Ukraine’s efforts to restore its energy grid,” Wood said.

Russia’s U.N. Ambassador Vassily Nebenzia claimed it is Ukrainian missiles – not Russian airstrikes – that hit “civilian objects.” And he accused the Kyiv government of making up “lies about Russia” and blaming Moscow for “high profile tragedies” in Ukraine in order to elicit Western support for more military assistance.

While Western diplomats speak out about casualties and destruction in Ukraine, Nebenzia added, they never mention anything about casualties and destruction in the eastern Donbas region, which Russia illegally annexed in October 2022.

Ukraine’s U.N. Ambassador Sergiy Kyslytsya expressed gratitude to the U.N. and donors for assisting the government in preparing for winter.

He said Russia shows no intention of abandoning the “terrorist” practice of targeting civilian infrastructure, saying that “makes it imperative to obtain additional air defense systems to safeguard these critical facilities during the winter.”