Four major reference hospitals that Médecins Sans Frontières (MSF) supports have been hit by bombing and shelling in opposition-controlled areas in Rural Damascus Governorate in Syria. While Aleppo continues to be a focus of attention – military, diplomatic and humanitarian – these incidents occurred in the midst of an intensifying military surge by the Syrian Government and its allies on opposition areas around the capital, Damascus.

Khan el Shih Hospital, to the southwest of Damascus, was completely destroyed by bombing and shelling in the evening and through the night of 5 October. Four bombs and around 20 missiles or shells struck the hospital and the immediate vicinity. Two staff and two patients were killed and 11 patients were injured – nine moderately and two severely, requiring a surgical operation.

Two sections of the Rif Damascus Hospital, located in the East Ghouta suburb of Douma, were hit by missiles on the evening of Monday 3 October. The neonatal incubators and laboratory were both hit, resulting in significant damage or destruction. These were indispensable to the good functioning of the hospital, which is now severely limited in its capacity to function.

The two most important reference hospitals in Qudsaya and Hameh areas, to the north of Damascus, were hit on 5 October. Qudsaya hospital was directly hit by an artillery shell in the evening. Five patients were injured due to the strike, two of them severely. The hospital suffered some minor damage but is continuing to work. The same evening, a bomb was dropped from a helicopter very close to Hameh hospital, causing some damage; the hospital is still functional.

“This is another outrageous chapter in the story of violations of humanitarian law in the Syrian war,” says Brice de le Vingne, MSF Director of Operations. “It is one of the basic tenets of international common law that indiscriminate or targeted strikes on medical facilities are totally unacceptable, and we will continue to speak out when medical care itself becomes a victim of conflict.”