How Assad Is Using Hospital Bombings to Win His War in Syria

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A group of doctors working in the northwest of Syria decided this week to stop sharing the locations of their hospitals with the United Nations, a practice that is intended to protect them from attack. The reason: Some fear Russia has been using that information to help Bashar Assad’s forces target them with airstrikes.

Their decision highlights the brutal lengths to which Assad and Russia have gone in recent weeks to break Syria’s last rebel stronghold, Idlib. And provides yet more proof that Assad has made doctors and their civilian patients a central target in his bloody war to hold onto power.

More than 20 hospitals in the region have been bombed by Russian and Syrian jets in May alone, according to Physicians for Human Rights. Human rights monitors, meanwhile, say Assad, with Russia’s help, is indiscriminately using internationally banned cluster munitions and barrel bombs on civilians there, leaving medical facilities and schools destroyed in their wake. The concerted attacks on medical facilities prompted a group of international doctors Sunday to call for an immediate U.N. investigation into how the sharing of the coordinates, rather than shielding the hospitals, resulted in their destruction.

The latest burst of violence has already killed 270 civilians and displaced an estimated 300,000, according to doctors working in the region. With little meaningful resistance being provided by the international community, human rights watchdogs and analysts fear that these attacks could mark the start of a wider onslaught that would plunge the province of 3 million inhabitants into a humanitarian catastrophe and further cement Assad's brutal grip on Syria after eight years of war.

The assault on the province resembles the initial stages of earlier drawn-out offensives to recapture rebel-held territories like Aleppo and Deraa, said Human Rights Watch’s Syria researcher Sara Kayyali. Warplanes have pounded roads across the region, in order to destroy infrastructure and choke the territory economically, while helicopters are pummeling towns with weapons including barrel bombs (oil drums filled with explosives and shrapnel).

“Residents are reporting hundreds of airstrikes a day, with massive displacement, and the use of banned weapons that we haven’t seen for the better part of two years,” Kayyali told VICE News.

As with the brutal sieges of Aleppo and eastern Ghouta, where countless war crimes were documented, Assad's conduct in Idlib has drawn international condemnation, but little else.

Observers say that years of toothless international opposition to Syria’s abuses have given the regime and its backers a sense of impunity in the later stages of the conflict. Russia and Syria are able to simply ignore their critics — just this week Moscow used its Security Council veto to block a statement condemning the campaign — and years of grinding violence in the conflict have meant the bloodshed no longer provokes the same global outrage it once did.

“The international community’s lack of attention to the attack on Idlib is a sign of widespread fatigue regarding the Syrian conflict, and of violence in Syria being seen as routine,” Lina Khatib, head of the Middle East and North Africa program at Chatham House, told VICE News.

The heavy jihadi presence in Idlib, much of which is controlled by the al Qaeda–affiliated group Hayat Tahrir al-Sham (HTS), is also a barrier to halting the violence. Their presence gives Russia and Syria, who insist they only target terrorists in the province, a convenient narrative for their indiscriminate aggression, and makes the international community less likely to intervene, said Ege Seçkin, principal analyst at IHS Markit’s Country Risk.

“We’re unlikely to see a meaningful international response sufficient to force the Syrian government and Russia to desist,” Seçkin told VICE News.

Given the regime’s demonstrated brutality and its stated desire to recapture the last rebel-held territory, analysts fear that the assault on Idlib may prove one of the bloodiest chapters of Syria’s eight-year war. The indiscriminate shelling has already sent thousands of desperate families fleeing to the Turkish border, and pulverized entire towns, says Kayyali, and there are signs the assault could spread across the province.

“There's little doubt that Russia and Assad are willing to indiscriminately bomb the province into submission, or even deliberately bomb civilian institutions,” Thomas Joscelyn, a senior fellow at the Foundation for Defense of Democracies, told VICE News.

More ominously, according to Seçkin, creating a humanitarian catastrophe through airstrikes on civilian populations could be central to Assad’s strategy to regain control of the area. Assad and his allies lack the military capacity to retake and hold the remaining rebel-held territories in the region, and may instead be seeking to create a humanitarian crisis to force the rebels and their Turkish backers into a negotiated political settlement on the regime’s terms, said Seçkin.

The desperate conditions in Idlib are most starkly captured by the plight of the region’s hospitals, where doctors have been forced to operate secret mobile and underground clinics — in basements or even caves — to attempt to avoid Russian and Syrian bombs. Doctors there described scenes of “patients fleeing bombed hospitals with IV drips still attached and choking on dust raised by the explosions.”

“Rather than being a place of healing and refuge, hospitals are now some of the most dangerous places for civilians to be,” they said in a recent open letter to the international community.

The sustained assault on medical facilities throughout the war has convinced many monitors that it is the result of a deliberate, systematic approach by the regime to target doctors and terrorize civilian populations. Physicians for Human Rights has documented 566 attacks on about 350 Syrian health facilities since the war began, killing more than 890 medical staff.

Human Rights Watch’s Kayyali said the failure to halt the relentless attacks on civilians and medical infrastructure marked a damning failure for the international community.

“The idea that eight years into the conflict, after so much documentation, you’re still seeing hospitals being bombed, you’re still seeing cluster munitions and barrel bombs being used against what is largely a civilian population — that means that something in the way the system responds to violations of international law is deeply, deeply flawed,” she said.

Cover: 27 May 2019, Syria, Ariha: A man hugs a child after he was rescued by the members of the Syrian Civil Defense (White Helmets), from the rubble of a building that was damaged in an airstrikeby the Syrian government forces. According to the White Helmets, at least six people were killed and 10 remain under rubble. Photo by: Anas Alkharboutli/picture-alliance/dpa/AP Images