Last week, Russia bombed a maternity hospital and a children's hospital in the Ukrainian port city of Mariupol. At least three people were killed and 17 injured in the bombings, according to local officials. The incident sparked international outrage, with the United Nations saying that hospitals should not "ever, ever be a target."
In the aftermath of such an attack, it is natural to think that it might have been a mistake. It is against the laws of war to target civilian infrastructure. Pregnant women and children in a hospital are clearly not combatants. However, Russian officials have issued aggressive denials of the attack and not indicated that it was a mistake.
An accidental bombing seems extremely unlikely, as Russia has a history of bombing hospitals as a tactic in war. In its intervention to prop up Syrian dictator Bashar al-Assad, Russia repeatedly bombed hospitals that were not under control of the central government. According to Physicians for Human Rights, at least 583 hospitals have been bombed in the Syrian Civil War, 266 of them since Russia intervened in September 2015, killing over 900 medical workers.
Whether the targeting was reckless or intentional, there are three reasons why Russia bombs hospitals. The first is to try to break the resistance of the civilian population, causing havoc, division, and terror. The second is to harden Western opinion against Russia, leading to greater sanctions. The Putin regime needs an external enemy in the West to rally people around Russia being under siege by the West. (Putin cannot sell a war against fellow Russian-speaking Ukrainians on its merits, which is why the government introduced wartime censorship and it is still being called a "special military operation" on state television -- there is no mention of these attacks in domestic media.) The third reason is that hospitals are where people -- and soldiers -- get well after being injured. Without functioning hospitals, it is hard to have a functioning society and to have troops to come back to fight.
In the city of the hospital attack, the situation is grim. Local officials have said that 2,187 civilians have been killed in the siege of Mariupol; others say over 10,000, out of a population of about 447,000. It is hard to know. Nobody can get into the city; people cannot leave. There is no phone service; people whom I interviewed from there in 2015 are unreachable.
One of the few international observers on the ground, the International Committee for the Red Cross, posted a series of tweets on March 12 about the city's condition:
There's no electricity, water and gas supply. Meaning no means for heating. Some people still have food, but I’m not sure for how long it will last. Many report having no food for children. People report varying needs in medicine. Especially for diabetes and cancer patients. But there is no way to find it anymore in the city. People are getting sick already because of the cold. We keep the shelter, the basement, only for children and their mothers. All other adults and children above twelve sleep in the office.It’s really cold. We still have some fuel for generators – so we have electricity for 3-4 hours a day. We brought all the food that we have in our homes. We also visited the destroyed and damaged houses of our colleagues to pick up remaining food there. We will have food for a few days. We found a way to collect some water. We still have some storage of potable water. When we run out of the stock, we will boil water from the stream. So we have [it] comparatively good compared to others. We have now approximately 65-66 people in our building. Plus, we also give a host to half of the people who are located in the same building. So their small children can sleep in the basement because people are afraid.
Russia may try to apply the tactics it has used in Mariupol -- surround the city; starve it; and bomb its hospitals -- to other Ukrainian cities. The playbook is there. From late 1999 until early 2000 Russia flattened Grozny, the capital of the Republic of Chechnya. Thousands died, many of them were elderly people who could not leave. During the time, Russian Prime Minister Vladimir Putin took over as president -- he became popular because of his ruthless handling of the war. In 2003, the United Nations called the Chechen capital the most destroyed city on earth. The Ukrainian capital of Kyiv could be next.
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