It was destroyed anyway.
This story has been updated.
The Médecins Sans Frontières-supported hospital that was attacked by airstrikes in Syria Monday did not provide its location to the Syrian government because its staff feared that would prompt a deliberate attack.
In a phone call with Foreign Policy on Tuesday, Fabrice Weissman, director of research at MSF’s Center for Reflection on Humanitarian Action and Knowledge, said that the Syrian doctors working at the clinic in the northwestern town of Maarat al-Numan had been attacked multiple times in recent years and believed they were protecting themselves by refusing to reveal their location to forces carrying out airstrikes in the region.
Instead, the doctors — who had the authority to make the decision without needing the approval of MSF — may have just been delaying the inevitable.
Four missiles struck the hospital Monday in an attack that MSF believes was purposefully carried out by either the Syrian government or its Russian allies — accusations Moscow has categorically denied. At least 11 people — including five staff members and five patients — were killed, and another two people are still missing. At least four other medical facilities and two schools were also hit by airstrikes Monday, killing dozens of civilians.
Weissman told FP the staff in Maarat al-Numan feared that offering their GPS coordinates “would just do the opposite of protecting them and instead help loyalist forces to find them and target them.”
MSF runs three hospitals in Syria — two near Aleppo and one in Atmeh — and has provided the coordinates for those three locations to the Syrian military. But it also supports a network of around 150 clinics and hospitals throughout the country, many of which are operating in areas where staff fear they will be attacked if government forces believe their medical workers are caring for members of the opposition. A number of those facilities — including the one bombed Monday — have kept their locations secret from the government in order to try to protect themselves from such attacks.
Speaking to a group of reporters outside the U.N. Security Council, Bashar al-Jaafari, Syria’s U.N. envoy, called MSF a “branch of the French intelligence operating in Syria.”
“They assumed the full consequences of their act, because they did not consult with the Syrian government and they did not operate with Syrian government permission,” he said, accusing the U.S.-led coalition of carrying out Monday’s strike.
According to Weissman, the precision of Monday’s strikes indicates Russia is most likely to have perpetrated the attacks. “It reminds us of what we experienced in Chechnya during the war where there was this scorched earth policy being waged by the Russian army against health facilities,” he said, referencing the conflict there in the 1990s.
Russia angrily denied any involvement in the strike. In Geneva, Russian Health Minister Veronika Skvortsova said bombing a hospital “contradicts our ideology.”
Moscow has steadily rejected Western accusations — many from the White House — that its forces are deliberately striking civilians or the moderate rebels working to oust Syrian President Bashar al-Assad.
The bombings came just one day after U.S. President Barack Obama urged the Kremlin to pump the brakes on its bloody campaign in Syria ahead of a ceasefire expected to begin on Friday. U.S. State Department spokesperson John Kirby said Monday that the severity of Monday’s attacks “casts doubt on Russia’s willingness and/or ability to help bring to a stop the continued brutality of the Assad regime against its own people.”
Syria’s conflict, which spiraled into civil war after Assad refused to step down following anti-government protests in 2011, has killed hundreds of thousands of people, displaced 11 million more, allowed for the rise of the Islamic State, and helped the region descend into turmoil. The U.N. announced in 2014 that it would stop counting the dead, but the Syrian Centre for Policy Research said this month that they believe the war has killed around 470,000 — either directly or indirectly — over the past five years.
Medical workers can be counted among some of the most regular victims. By the end of 2015, Physicians for Human Rights, a nonprofit that advocates for medical professionals, estimated that at least 240 health clinics across Syria had been struck and that close to 700 medical staff had been killed. Roughly 90 percent of those attacks were carried out by the Syrian regime, according to PHR.
Weissman told FP that MSF personnel felt the deaths at Maarat al-Numan particularly keenly because the organization’s international staff used to visit the facility regularly before being evacuated from Syria after their colleagues were kidnapped by the Islamic State in 2014.
“We know the doctors personally; we know exactly how they function,” Weissman told FP, adding that the facility provided care to around 40,000 people living in the town as well as some 80,000 displaced people who moved there to try to escape the war. The only doctors left at these facilities are Syrians who have refused to leave despite the dangers of their work.
Monday’s attack adds to a growing list of MSF patients and doctors who have died at their clinics and hospitals as a result of airstrikes in the past six months. In October, 42 people — including medical workers and patients — are believed to have been killed after a botched U.S. airstrike partially destroyed an MSF clinic in Kunduz, Afghanistan. According to MSF, hospital staff made repeated attempts to call or text U.S. and Afghan authorities once the aircraft began its assault.
Multiple MSF-supported hospitals have also been struck in Yemen, and MSF believes the Saudi-led coalition working to oust Houthi rebels could be responsible for some of those attacks. In January, MSF said that these attacks have persisted despite the fact that the Saudi-led coalition and other parties are “regularly informed of the GPS coordinates of the medical sites where MSF works.”
For Weissman, the greatest disappointment is that MSF has identified all of the perpetrators of these attacks as either permanent members of the United Nations Security Council, or as local allies backed by one of those five countries. In Kunduz, it was the United States; in Yemen, it was the U.K.-backed Saudi coalition; and in Syria, he believes Russia either carried out the attacks or backed the Assad regime that did.
“There is an obvious pattern from the past six months,” he said. “We are not talking about war lords in unruled, armed groups. We are talking about the five members of the Security Council or their local allies being involved in hospital targeting.”
Colum Lynch contributed reporting from New York.
Photo credit: STRINGER/AFP/Getty Images