Why Russia Is Bombing Hospitals In Syria

February 16, 2016
The MSF-supported hospital in Idlib province in northern Syria was destroyed in an attack on 15 February 2016. | Médecins Sans Frontières, or Doctors Without Borders (MSF)

Live Updates: Yesterday five hospitals and two schools were destroyed in Russian airstrikes in Syria. Today, moderate rebels are suffering more defeats, and civilians have far fewer hospitals to receive treatment in.

The previous post in our Putin in Syria column can be found here.

The True Price Of Russia’s Bombing Of Syrian Hospitals Is Just Becoming Clear

Yesterday we watched in horror as five hospitals in Syria and two schools were hit by airstrikes — airstrikes likely launched by Russian warplanes. At least one video definitively placed a Russian Su-34 at the scene of the crime, and cluster munitions dropped on civilian areas were blamed for some of the carnage:
At least two of the hospitals hit yesterday were run by international NGOs, including one hospital that was run by  Médecins Sans Frontières/Doctors Without Borders (MSF). Voice of America’s Jamie Dettmer has the latest death toll in that incident:

An MSF spokesperson told the press the chilling details of the attack which seem to confirm that the attack was deliberate and calculated. ABC News reports:

“This appears to be a deliberate attack on a health structure and we condemn this attack in the strongest possible terms,” said Massimiliano Rebaudengo, MSF’s Head of Mission. “The destruction of the hospital leaves the local population of around 40,000 people without access to medical services in an active zone of conflict.”

Doctors Without Borders said that the clinic had been struck by four projectiles within a few minutes and subsequently destroyed. It reported at least eight staff members missing. Doctors Without Borders said that there were two series of at least two attacks each. The dead included five patients, one patient caretaker and a hospital guard.

Doctors Without Borders said it had been supporting the hospital since 2015, providing medical supplies and running costs. The hospital had 30 beds, a staff of 54, two operating rooms and an outpatient wing, the organization said.

The human cost is disturbing, but the strategic cost could further destabilize the region.

Turkey has responded angrily to both the Russian attacks and a new offensive launched by the YPG Kurdish group which is opposed to both Turkey and the Western-backed Syrian rebels. Reuters reports:

Turkey on Monday accused Russia of an “obvious war crime” after missile attacks in northern Syria killed scores of people, and warned Kurdish militia fighters there they would face the “harshest reaction” if they tried to capture a town near the Turkish border.

An offensive supported by Russian bombing and Iranian-backed Shi’ite militias has brought the Syrian army to within 25 km (15 miles) of Turkey’s frontier. The Kurdish YPG militia – which Turkey regards as a hostile insurgent force – has exploited the situation, seizing ground from Syrian rebels to extend its presence along the border.


At least 14 were killed in the northern town of Azaz, the last rebel stronghold before the border with Turkey, when missiles hit a children’s hospital and a school sheltering refugees, a medic and two residents said. Missiles also hit a hospital in the town of Marat Numan in the province of Idlib, south of Aleppo.

The YPG has continued to advance today:

Here’s what all this means, in summary.

The YPG is a Kurdish militia group which is simultaneously in opposition to the moderate Syrian rebels, the Turkish government, and ISIS. In eastern Syria, far from Russia’s bombs and the Assad regime’s offensive, they are receiving both direct and indirect support from the US-led coalition in their attempts to fight ISIS in al-Raqqah province. But in northwestern Syria, in Aleppo province, they are indirectly supported by the Assad regime and Russian airstrikes in the Afrin (Ifrin) canton (region). 

On February 13, the Institute For The Study Of War published a paper on the status of the conflict in Aleppo. It’s important to note that this was written before yesterday’s gains by the YPG, and before yesterday’s bombing of five hospitals in northern Syria, one of which was in Azaz. An excerpt:

Syrian Kurdish YPG forces are seizing Arab-held terrain on another flank, the Ifrin canton.The YPG was largely contained within the Ifrin canton during 2015 but has sought to expand its territorial control eastwards since November 2015.17 U.S. backing for the YPG has made such gains possible inadvertently under the umbrella of the anti-ISIS fight. The U.S. helped establish a joint Kurdish-Arab force known as the Syrian Democratic Forces (SDF) in October 2015 as a new partner in the anti-ISIS fight.

The YPG leads the SDF, which includes tribal forces called the Syrian Arab Coalition (SAC) in addition to numerous local Free Syrian Army affiliates. One such affiliate, Jaysh al Thuwar, has worked with the YPG to exploit the Russian-enabled regime gains north of Aleppo City and seize opposition-held areas near the Turkish border, including the Menagh Airbase on February 11.18 The majority of the opposition in Aleppo is deeply opposed to Kurdish expansion in the province. As such, the U.S. risks reigniting the conflict between the bulk of the Aleppo-based opposition and U.S.-allied Kurdish forces in Aleppo by empowering the YPG and allied opposition factions. Regime and Russian forces have targeted civilian infrastructure. Regime and Russian warplanes regularly strike civilian targets in portions of Aleppo City held by the armed opposition, including hospital and bakeries. The destruction of hospitals and bakeries raise the cost of providing for the civilian population for armed opposition forces. Combined with the
increased Russian air campaign targeting armed opposition
LOCS, the pressure this applies on armed opposition forces –
and civilian populations – is acute.

ISW also published a map with their report, which we have added notation to in order to illustrate what’s changed in the last three days. As you can see, the YPG has now advanced east to Marea, effectively creating a new pocket for rebel groups that will be surrounded by enemies — the YPG to the west and north, ISIS to the east, and the Assad regime’s coalition to the south.

2016-02-16 19:43:14

The destruction of hospitals is not a mistake, and it’s not mindless killing. It is part of a sophisticated strategy — orchestrated in Damascus, Tehran, and Moscow — to break Western-backed rebels, the anti-Assad populace, and Western resolve.

It’s also a war crime, executed by a major world player with the kind of cold calculus and precision worthy of history’s worst tyrants.

But if there were easy answers before, it is now harder than ever for the West to intervene to stop the killing. The advance of the YPG means that if Turkey wanted to militarily intervene it would have to launch a direct assault on Kurdish forces before even reaching Assad — and act which would have clear repercussions at home and on other fronts in Syria. This is made more complicated by the fact that Turkey, a NATO power, would be bombing a group that the US, arguably the leader of NATO, is supporting elsewhere.

Furthermore, as we reported earlier in the week, Russia has deployed some of the most sophisticated anti-aircraft weapons in the world to Lattakia province.

In 2012, Assad’s air defenses had been heavily damaged and a no-fly zone would have been possible to achieve:

But now that Russia is involved and the US has signaled that it is unwilling to check Russian moves in Syria, German Chancellor Angela Merkel has backed a call from Turkey to establish a no-fly zone.

Russia is also sending a more subtle message that a war against Assad could mean a war — either an overt or covert one — against Russia. Here are some pictures of Assad’s Republican Guard using rifles that are only used by Russian airborne Spetsnaz units:

James Miller