The Al-Quds hospital in Aleppo city, destroyed by Russia and Assad regime airstrikes in spring 2016

There have been 578 attacks on medical facilities in Syria since the start of the uprising in March 2011, according to Physicians for Human Rights.

The advocacy organization detailed that more than 90% of the assaults through July 2019 — a total of 521 — were carried out by Assad regime or Russian forces.

Of the remainder, 24 were by anti-Assad groups, 10 by the Islamic State, and four by a US-led coalition. Nineteen could not be attributed.

PHR said it has “credible reports” of strikes on 46 facilities during the current Russian-regime offensive to seize part of the last major opposition area in northwest Syria. It has “fully verified” 16.

“All the Hospitals Have Been Systemically Targeted”

Surgeon Yasser al-Samm describes to Al Jazeera English how he was on duty in the emergency ward of the Ma’arat al- Nu’man hospital in Idlib Province on July 10 when four explosions shook the walls: “I was confused but there was no time for confusion. We started to evacuate the patients to the basement.”

Samm thought the hospital might be safe, despite Russian and regime attacks on civilian sites across Idlib: “The coordinates of the hospital were shared with the UN and Russia.”

But as in previous cases, such as the assault on eastern Aleppo city in 2016 — where every hospital was struck at least once — the coordinates did not protect the medical facilities.

The surgeon says, “I think that was a wrong step. Because all the hospitals have been systematically targeted by the Russians and the Syrian regime through the war.”

The hospital provided medical services to more than a million of the 3 million people — about 20% of Syria’s remaining population — in the greater Idlib area. Most of them had been displaced from other parts of Syria.

UN Concern and an Inquiry

Two weeks ago, UN Secretary-General António Guterres authorized an inquiry into the attacks, after 10 of the 15 Security Council members of the Security Council issued a statement.

UN head for humanitarian affairs Mark Lowcock said the provision of the GPS coordinates will be investigated: “I have asked the Russian Federation for clarification of what it does with the information.”

Syria Daily, July 31: Call for UN Investigation of “Scorched Earth” Russia-Regime Attacks in Northwest

Last week Panos Moumtzis, the UN’s humanitarian chief for Syria, said 39 medical facilities were among the civilian sites and infrastructure hit by the Russia-regime attacks.

The Assad regime’s ambassador to the UN, Bashar Ja’afari, declared that all medical facilities have been taken over by “terrorist groups”. Dmitry Polyanskiy, Russia’s deputy ambassador at the UN, said the inquiry was a “mistake”.

“We Knew It Was Russians”

In Hass in Idlib Province, the local hospital’s chief nurse Abu Abdallah said all staff were evacuated before it was struck, thanks the early-warning system of local aircraft observers.

He echoed Dr Samm’s account of a Russian attack:

We knew it was Russians because aircraft observers told us that warplanes took off from Hmeimim and were headed towards our area. Everyone knows how destructive the Russian raids are. The sound of the rockets is different, the impact is much larger and more terrifying. The warplanes fly much higher.