Russian and Syrian regime forces are reported to have deliberately and systematically targeted hospitals and other medical facilities over the last three months to pave way for ground forces to advance on northern Aleppo, a report released by Amnesty International said after conducting an examination of the air strikes.
The report detailed evidence of at least six deliberate attacks in the past three months on hospitals, medical centres and clinics. The attacks, which have killed several civilians, including medical workers and injured at least 44, continue in various parts of Syria, amounting to war crimes.
Hospitals, water and electricity buildings are always first to be attacked, once that happens people no longer have services required to survive, said a doctor from Anadan, a city 12 kilometres north of Aleppo.
Syrian and Russian forces have been deliberately attacking health facilities in flagrant violation of international humanitarian law," said Crisis Response Director of Amnesty International, Tirana Hassan, in the report.
"But what is truly egregious is that wiping out hospitals appears to have become part of their military strategy, Hassan said.
She said the strategy that has destroyed scores of medical facilities and killed hundreds of doctors and nurses since the start of the conflict eliminates a vital lifeline for the civilians living in those embattled areas, leaving them no choice but to flee.
Almost 5 million Syrians have fled the civil war since 2011 and most remain in the region, mainly in Jordan, Lebanon and Turkey. Some 1.2 million are registered in Lebanon and about 630,000 in Jordan, most living outside formal refugee camps.
Additionally, according to a report released on Feb. 11 by the Syrian Centre for Policy Research, the five-year-long Syrian civil war has claimed the lives of 470,000 people.
Doctors Without Borders (MSF) stated last month that hospitals in Syria have faced at least 400 attacks and around 700 medical staff members have been killed since 2011 when the Syrian civil war broke out.
Aitor Zabalgogeazkoa, MSF coordinator in Syria told Turkeys Anadolu Agency that The air strikes targeting medical facilities in Syria violate international law.
The offensive on the northern part of Aleppo countryside
During the last week of January, Syrian regime forces supported by Russian air strikes began a ground offensive in the northern part of Aleppo.
Civilians who fled the northern part of Aleppo countryside to the Bab al Salam border crossing to make their way into Turkey told Amnesty that Russian and Syrian regime air strikes escalated in the first week of February, forcing thousands of people to flee.
With no functioning hospitals left in the area, many of those injured in the air strikes were forced to drive for hours to obtain medical help.
Interviews with doctors and medical workers in and around Aleppo indicate that health facilities were among the first buildings targeted in a series of air strikes at the start of the offensive, which they believe were intended to prevent the injured from receiving medical treatment.
Two doctors and an activist who left the city of Tel Rifaat told Amnesty that all three health facilities - a field hospital, a rehabilitation centre and kidney dialysis centre - were directly targeted by missiles last month leaving the population with no working medical facility, the report said.
A direct air strike destroyed a children with special needs centre in Tel Rifaat on 19 December, which used to received 250 children per month from all over the northern part of Aleppo countryside.
According to the report, a doctor from the Independent Doctors Association in Turkey said that the field hospital in Maskan had to be evacuated a month ago because of intensifying air strikes and ground assaults.
The report said medical workers in Anadan stated that the Russian or Syrian warplanes partially destroyed a field hospital and rendered a rehabilitation centre out of service.
Amnesty's report cited a physiotherapist at a rehabilitation centre saying:
“The air strikes intensified on 1 February. The next day at 8.30am the centre was targeted by a missile. I was on my way to work when I saw and heard the explosion. When I arrived I saw the driver’s body at the entrance, two patients and five from the medical team severely injured."
"We had to transfer them outside of Anadan. Now the centre is out of service. We lost a lot of expensive equipment. We provided treatment to whoever is in need and we have been operating since 2014.”
Amnesty said a doctor and another medical worker at Baghdad Hospital in Hreitan said a Russian or regime warplane fired missiles directly at the hospital, injuring 10 medical staff and 20 civilian patients, leaving the facility in ruins. The strike also killed medical worker Ali Hamedo.
“Not even underground hospitals are safe. We moved the hospital underground a year ago assuming that it will be protected from the air strikes. But the missiles were able to penetrate the underground levels," said a doctor.
We have spent hundreds of thousands of dollars to equip the hospital and provide treatment to the injured and sick but now Hreitan has no more hospitals.”
A family from Hreitan who fled the attacks on 6 February told Amnesty that they were the last ones to leave.
“I have lived in Hreitan all my life and I have never seen it deserted. Very few families remained because they can’t leave the city. The air strikes destroyed the city’s infrastructure including hospitals so there are no more services for us to be able to survive,” the father said.
According to the report, deliberate attacks on civilians and civilian objects, including hospitals, violates international humanitarian law and amounts to war crimes. Under the laws of war, such objects only lose their protection if they are used outside of their function, even in such cases a warning has to be issued.