Russian–Syrian hospital bombing campaign

After Russia began military operations in Syria, aerial bombardment intensified.[7] In 2015, there were more than 300 attacks on medical facilities by Syrian and Russian forces.[8] From May to December 2016, medical facilities were attacked about 200 times by Russian and Syrian forces.[9]

Hospitals in Aleppo were attacked multiple times. Before March 2016, more than six hospitals were attacked in the Aleppo Governorate.[8] In April 2016, over two dozen were killed when a Russian airstrike hit a hospital;[10] the hospital served as the area's primary pediatric care facility.[11] In July 2016, M2 Hospital was attacked by aircraft.[12] By the end of the month, six hospitals in Aleppo had been destroyed.[13] In October 2016, M10 Hospital was attacked by airstrikes.[14]

Hospital attacks were not limited to Aleppo. In October 2015, a Russian aircraft attacked a medical facility operated by the Syrian American Medical Society in the town of Sarmin.[15] In February 2016, a children's hospital was hit in Azaz; Russians claimed they targeted ISIL infrastructure.[16] That same month two hospitals in Maarrat al-Nu'man were attacked by Syrian forces, one being a Doctors Without Borders supported facility;[17] Syria claimed that one of the attacks was done by American forces.[18] In July 2016, a hospital was attacked by Russian forces in Atarib.[13] In August 2016, a medical facility was attacked once every 17 hours.[5] One of these attacks was an attack on the last functioning hospital in Darayya;[5] the attack was done with barrel bombs filled with napalm.[19] In April 2017, a hospital was attacked in Maarat al-Nu'man.[20] After a chemical attack on Khan Sheikhoun, a clinic treating those who were gassed was attacked by Syrian forces;[21] due to this event U.S. launched a missile strike against Shayrat Air Base.[22]

In September 2017, Qasioun News reported that Syrian government warplanes carried out several airstrikes on Rahma Hospital in Khan Sheikhon city, southern Idlib, causing material damage to the building and causing the hospital to go out of service, as well as injuries among civilians. Furthermore, Syrian government warplanes carried out 3 airstrikes on Orient Hospital, near Kafranabl area, south of Idlib, but no casualties were reported.[23] Also on same date, the Russian warplanes conducted airstrikes on al-Tah Hospital in the countryside of Idlib, killing two nurses and some patients, and inflicting heavy damage to the hospital, as well as causing some injuries among the doctors.[24]

In October 2017, the ICRC said that up to 10 hospitals had been reportedly damaged in the past 10 days, cutting off hundreds of thousands of people from access to healthcare, voicing alarm at the situation from Raqqa to Idlib and eastern Ghouta. "For the past two weeks, we have seen an increasingly worrying spike in military operations that correlates with high levels of civilian casualties," Marianne Gasser, head of the ICRC's delegation in Syria, said.[25]

Attacks on hospitals in Idlib continued into early 2018, following use of chemical weapons against areas controlled by forces opposed to the Syrian government.[26] In April 2018, chemical weapons were used in an attack on a hospital in Douma;[27] the hospital had been supported by the Syrian American Medical Society.[28] Non-Russian and non-Syrian claims were that the chemical attack was carried out by Syrian forces.[29] The Syrian government denied making a chemical attack.[30] Russia denied that chemical weapons were used in Douma;[31] later it claimed that the attack was staged by the United Kingdom.[32] As a result of the attack on Douma, Israeli aircraft attacked an air base in Syria on 9 April;[33] French, British, and American forces attacked targets in Syria on 14 April.[34]

The UN humanitarian office said that, between late April and June 2019, a total of 24 health facilities and 35 schools were hit by the Syrian government and Russian air raids and rocket fire on the Idlib region.[35] The coordinates of nine of those health facilities were shared with the UN, which passed them to Russia in an effort to protect them from being bombed and encourage some form of accountability for attacks. Instead, they also came under fire.[36][37] On 15 May 2019, Syrian government forces bombed the Tarmala Maternity and Children's Hospital in South Idlib, completely destroying the facility, which had served about 6,000 people a month. According to the Union of Medical Care and Relief Organizations, it was the 19th health-care facility bombed in Syria since 28 April.[38]

Assembled a large body of evidence such as social media posts from Syria, interviews with witnesses, records from charities, Russian Air Force radio recordings, and plane-spotter logs, The New York Times reported that, within 12 hours from 5 to 6 May 2019, four hospitals in southern Idlib province were attacked and the bombings were traced and tied Russian pilots to each one, and the audio recordings featured Russian pilots confirming each bombing.[39] These hospitals were Nabad al Hayat Surgical Hospital, Kafr Nabl Surgical Hospital, Kafr Zita Cave Hospital, and Al Amal Orthopedic Hospital.[39]

In October 2019, The New York Times published a story that proved that Russian forces deliberately bombed four hospitals in opposition-held Idlib province in May 2019.[40] Dr. Amani Ballour, a Syrian pediatrician, worked at a secret underground hospital in East Ghouta known as the Cave, said the hospital was bombed by Russian warplanes on 28 September 2015, killing three male nurses and injuring two female nurses.[40] Since 2016, the staffs did everything they could to shore up the infrastructure above and below ground so it could withstand bombings. During the final month of the Cave, the site was hit five or six times by barrel bombs.[41]

In February 2020, Russian warplanes hit two hospitals, as well as residential areas, in the northern town of Darat Izza near the Turkish border, wounding civilians and forcing the medical facilities to close.[42] At this time, the World Health Organization (WHO) said that over half of the country’s health facilities had been damaged or destroyed since the start of the civil war in 2011.[42]

In May 2020, Amnesty International documented 18 attacks on civilian facilities, including medical facilities, by either Syrian government or its Russian ally between 5 May 2019 and 25 February 2020 in and adjoining the opposition stronghold in northwest Syria.[43] The report which contained 40 pages revealed thoroughly how the Syrian government forces intentionally attacked civilian facilities such as schools and hospitals.[43] Among the documented attacks were Russian air strikes near a hospital in the town of Ariha on 29 January that flattened at least two residential buildings and killed 11 civilians.[43]