MSF has been able to confirm that two hospitals in besieged east Aleppo were hit by airstrikes on 16 November, one day after airstrikes were re-launched on the opposition-held area of the city.

The two hospitals which came under attack on 16 November were a children’s hospital and a hospital specialising in surgery. That morning, the neighbourhood was reportedly struck more than 50 times. The paediatric hospital that was hit is the only specialised hospital for children in the besieged area of Aleppo. Hospital staff managed to move children, including premature babies, from cots and incubators to the basement of the building to shelter from the bombing.

This means that since the siege began in July, functioning hospitals in east Aleppo have been damaged in 29 separate attacks. Some hospitals have been hit multiple times and have been forced to close as a result. Both hospitals which were hit are supported by MSF, among other organisations.

MSF spoke with a doctor in one of the besieged area’s few remaining hospitals about the impact of new airstrikes:

"Up until Monday, the situation in east Aleppo had been relatively quiet for some weeks, with just light shelling. But on Tuesday the situation suddenly escalated, with more than 100 raids and scores of people wounded.

In just two hours, between 1pm and 3pm, 55 wounded arrived at the hospital. We admitted 13 people and three people died; the rest we sent back home. The wounded have all kinds of injuries, from superficial wounds to limb injuries to neurological injuries.

With bombardment going on outside and large numbers of wounded, we stop everything else to concentrate on treating the injured. Non-urgent operations can be postponed, until the shelling has stopped or the surgeon has more time.

When it’s quieter, we can monitor patients for longer, but in bad situations like the one now, we have to discharge them an hour or two after they’ve been operated on.

The most vulnerable patients are the ones with head wounds and neurological injuries – 70 to 80 percent of them end up dying.

We see a lot of people with limb injuries, but usually we can’t do anything for them, and it ends in amputations. There’s too little time, and too few doctors, operating theatres and medications. We don’t have many options.

On Tuesday, one shell fell about 20 metres away from the hospital, but we weren’t hit. In the past five months, we’ve been targeted five times: once in June, twice in July and twice in September. Each time, we shut down for a few days to do essential repairs and clean the place up, and then we reopen our doors.

Frankly, you can’t do much to prepare for a bombardment like this. Early last summer we started to excavate under the hospital but, when the siege started, we couldn’t get hold of building materials, so we had to stop. We began to build a wall around the hospital, too, but we haven’t been able to finish that either.

Our generators are all far away from the hospital, in a relatively safe place below ground level, but the fuel to run the generators is about to run out.

Some medications – such as those for chronic diseases – are already finished. Some painkillers and antibiotics are beginning to run out, too.

As the intensity of the bombing increases and becomes more frequent, we are seeing more and more patients, and so we are getting through supplies faster. When you have wounded patients, you can’t keep medications back for later. Treating people’s injuries is our first priority and is more important than anything else.

We hoped that the current stocks would last for 10 days but, if the bombardment is particularly violent, they won’t last for more than three or four days. Sadly, we will be able to do nothing when our supplies run out. But for now, we are doing what we can."

Identity of doctor and hospitals withheld for security reasons.