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INVESTIGATIONS

Airstrikes on the Al Kinanah and Al Ferdous Hospitals

March 16, 2021

An investigation into the bombing of Al Kinanah and Al Ferdous Hospitals in Daret Azza

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Incident Summary

  • Place of Incident: Aleppo: Daret Azza
  • Location Hit: Al Kinanah and Al Ferdous Hospitals
  • Date: 17 February 2020
  • Time: Around 12:00 PM
  • Killed and Injured: One was injured at Al Ferdous Hospital
  • Type of Attack: Two airstrikes
  • Munitions Used: N/A
  • Potentially Responsibly: The Syrian or Russian Air Force was most likely responsibly for the airstrikes

Introduction

Both the Al Kinanah and Al Ferdous Hospitals are located in Daret Azza in the western countryside of Aleppo. As the only children and surgical hospitals in the entire western countryside of Aleppo, the two facilities provided essential medical services to the area’s residents. The two hospitals have been targeted previously several times, most recently in February of last year. This latest attack on the hospitals pushed them out of service, depriving the western countryside of essential medical care.

Methodology

Syrian Archive conducted an investigation into the incident, consisting of two components:

  1. Securing, analysing, and verifying 35 videos and images uploaded to social media networks purportedly showing the incident;

  2. Analysing satellite imagery showing the locations after the incident as well as flight observation data revealing the planes over the towns at the purported time of the strikes.

The combined analysis of these sources has culminated in the present investigation report. Complementing each other, they provide information regarding the incident’s date and time, location, casualties, and extent of damage.

Examining all information available on the strike, the investigations team developed an understanding of the incident and potential perpetrators.

For more details on Syrian Archive’s methodology, please see our site.

About Al Kinanah Hospital

The sign for Al Kinanah Hospital A screenshot from a video clip posted by Al Jazeera Mubashir showing the sign for Al Kinanah Hospital after the attack.

Al Kinanah Hospital is located adjacent to Al Ferdous Hospital in Daret Azza in the western countryside of Aleppo. The hospital was established on September 18, 2012 by 6 Egyptian doctors and 59 volunteers from the area with support from the Egyptian Medical Syndicate and The Humanitarian Relief Committee. The year of its establishment, the hospital began providing medical services to visitors at a rate of 6 operations per day. A response to the increased needs for specific medical services, Al Kinanah is the oldest surgical hospital in the area. When it opened in 2012, the hospital included two operating rooms, an outpatient clinic, a pharmacy, a laboratory, and a number of hospital rooms. The year after it opened, the hospital expanded adding an ambulance unit and a group of additional clinics including: an inpatient clinic, an orthopedic clinic, and a general surgery clinic.

Before being pushed out of service, the hospital provided medical services to around 50,000 patients at a rate of 10,000 visits per month. The most important of the hospital’s departments were the general, vascular, internal, orthopedic, pediatric, and ENT departments.

About Al Ferdous Hospital

The sign for Al Ferdous Hospital A photo posted by the SAMS Facebook page of the Al Ferdous Hospital sign after the attack.

The Al Ferdous Hospital for Obstetrics and Gynecology, supported by Syria Relief and Development (SRD), was established in Daret Azza in 2015, adjacent to Al Kinanah Hospital. According to SRD’s Facebook page, the hospital serves around 4,500 beneficiaries per month providing an estimated 7,000 medical services a month. The hospital provides it services free of charge to residents of Daret Azza and those displaced in the area as well as visitors from elsewhere in the region.

Within the hospital is a pediatric department, a gynecology department, a malnutrition unit and treatment center, an intensive care unit, a laboratory, and a pharmacy. The hospital is vital for patients in the area as it provides obstetrics operations and houses incubators for infants. Additionally in its outpatient clinics, Al Ferdous hosts a dialysis department, initially supported by a chapter of the Society for the Revival of Islamic Heritage organization, where it provides its clients with an approximate total of 550 dialysis sessions per month. Although funded shortly after its establishment, as shown in a tour of the hospital posted on YouTube by the Health Care Organization, financial support for the hospital discontinued and ended a few months after its establishment. During its years of operation, the hospital continually suffered from a lack of support. Later after the hospital’s establishment, its dialysis department was supported by the Syrian American Medical Society (SAMS).

A picture of a child receiving medical services at Al Ferdous Hospital A picture posted on Facebook by SRD of the medical services provided at the hospital

Previous Attacks on Al Kinanah Hospital

The February 2020 attack on the facility—the subject of this investigation—is not the first attack on Al Kinanah Hospital. The medical facility has been subject to several previous attacks. The first of which was on December 18, 2014. Pages on social media circulated pictures of a car bomb, which allegedly exploded near the hospital. Posts online reported casualties from the explosion that Syrian Archive was unable to verify. Shahba Press Agency uploaded a video onto YouTube showing remnants of the car bomb near the hospital.

Pictures posted onto Facebook showing the remnants of a car bomb that exploded near Al Kinanah Hospital.

On February 26, 2016, pages on social media circulated images and videos showing the alleged targeting of Al Kinanah Hospital with airstrikes that severely damaged the facility and caused a fire outside the hospital. The fire reportedly burned one of the hospital’s ambulances. The hospital’s Facebook page reported Russian warplanes as having targeted the hospital with a thermobaric (or vacuum) bomb that forced the facility temporarily out of service. This was confirmed by eyewitnesses of the attack.

 A post by the Facebook page for Al Kinanah Hospital about Russian warplanes targeting the facility with a thermobaric bomb.

Previous Attacks on Al Ferdous Hospital

While the February 2020 attack discussed in this investigation is the first direct targeting of Al Ferdous Hospital, the medical facility was subject to siege of a length Syrian Archive was unable to fully verify. Posts on Twitter and Facebook reported on January 1, 2019 that the hospital had been surrounded during fighting between the Nour Al Din Al Zanki Movement affiliated with The National Front for the Liberation of Syria and Hayat Tahrir Al Sham, after the latter gained control over Daret Azza. Throughout the siege, posts online called for help in the evacuation of newborns and patients trapped in the besieged hospital.

A tweet and Facebook post reporting on the siege of Al Ferdous Hospital that was a result of nearby fighting.

What Happened (and When)?

The damage to Al Kinanah Hospital A photo posted by the Facebook page for Al Kinanah Hospital in Daret Azza showing the damage to the hospital’s entrance directly after the airstrike.

Between 11:50 AM - 12:50 PM on February 17, 2020, warplanes targeted Al Ferdous Hospital. Ten minutes later after the attack on Al Ferdous, Al Kinanah Hospital was hit in two of eight airstrikes targeting Daret Azza, according to sources online. The attack severely damaged both facilities pushing them out of service and leaving the countryside of Aleppo without sufficient medical facilities.

Smoke from the bombing of Al Kinanah and Al Ferdous Hospitals A photo posted by Anas Al Maarawi showing smoke from the attack on Al Kinanah and Al Ferdous Hospitals.

The first tweets reporting on the attack were posted around 12:13 PM by Ahmed Rahal, Anas Al Maarawi, Macro Media Center (MMC), Jisr TV, and Syria TV. Users reported that both Al Kinanah and Al Ferdous Hospitals were out of service as a result of targeting by Russian warplanes. Shortly after these tweets, Anas Al Maarawi posted a video showing the moments inside Al Kinanah Hospital directly after the attack.

The Syrian Civil Defense YouTube channel also posted a video showing first responders arriving at the scene of the attack and searching for those stuck under rubble.

Chronolocating the shadows shown in the Civil Defense video Identified using the SunCalc tool, the shadows shown in the video uploaded by the Syrian Civil Defense correspond with the location of the sun in Daret Azza at 12:00 PM on February 17, 2020. This further corroborates reports by journalists and posts on social media of the incident occurring around noon on February 17.

In addition, later the day of the attack Orient News, Syria TV, Al Jazeera Mubashir, Shaam News Network, Al Araby TV, and the Facebook page of journalist Taim Alyusuf posted video reports confirming the airstrikes on the hospitals as well as showing the damage to both medical facilities.

The Free Aleppo Health Directorate and the Syrian American Medical Association - SAMS also confirmed on Facebook that airstrikes from Russian warplanes forced the two hospitals out of service.

Later, the Syrian Civil Defense on YouTube as well as the Hussein Khattab and Independent Doctors Association pages on Facebook posted videos and images of the airstrikes hitting the two hospitals.

Smoke from the bombing of Al Kinanah and Al Ferdous Hopsitals A screenshot from a video posted by the Syrian Civil Defense showing smoke from the bombing of the Al Kinanah and Al Ferdous Hospitals.

Geolocation of images showing the bombing of Al Kinanah and Al Ferdous Hospitals A geolocation of a video posted by the Syrian Civil Defense and a picture posted by Anas Al Maarawi that show smoke from the bombing of the Al Kinanah and Al Ferdous Hospitals.

Moreover, journalists Jamil Al Hassan and Yakeen Yaser Bido posted videos on Facebook showing the damage to both hospitals mentioning a displacement of civilians from Daret Azza as a result of the ongoing military campaign in the area. Journalist Fatima Haji Moussa additionally confirmed the displacement of civilians describing, in a video posted onto Facebook, a recent wave of 12,500 families displaced from the town.

Damage to the entrance of Al Kinanah Hospital A screenshot from a video posted on Facebook by journalist Yakeen Yaser Bido shows damage to the entrance of Al Kinanah Hospital.

The two strikes and their timing were further confirmed in a report on unlawful attacks and mass displacement in northwest Syria published by Amnesty International. In the report, the Amnesty International details that an initial airstrike hit Al Ferdous Hospital injuring a hospital staff member. The report additionally confirms that an attack hit Al Kinanah Hospital (300 meters away from Al Ferdous Hospital) ten minutes later, damaging the facility.

In testimony gathered by Amnesty International and featured in the report, a doctor and a hospital administrative employee described around 40 workers and 20 patients in the hospitals at the time of the first strike. In their testimony, a doctor from Al Ferdous Hospital stated: “Around 11:50 AM we heard an explosion. The pressure broke doors and windows. A lot of dust filled the rooms… We immediately realized that the hospital was the target… The aftermath of the attack was horrible.”

The administrative worker at Al Kinanah told Amnesty International that: “We were shocked around 12:00 PM to hear an explosion. I stepped outside of my office and saw smoke… We were told that Al Ferdous hospital was targeted. I got scared… We all went down to a kind of basement; 70% of it is underground. Around 10 minutes later, our hospital was struck. We heard an explosion – walls shook, dust filled the room…” No one was injured in the attack.

The Damage to Al Kinanah and Al Ferdous Hospitals

The damage to the entrance of Al Kinanah Hospital A picture posted by the Facebook page Zeitoun Media showing the damage to the entrance of Al Kinanah Hospital.

Many sources documented the damage to Al Ferdous and Al Kinanah Hospitals. In addition to the videos mentioned earlier, Einab Baladi, Al Mohrar Media, Bawaba Aleppo, Macro Media Center (MMC), Zeitoun Media, and Free Aleppo Health Directorate posted photos showing the damage to both hospitals from the airstrikes.

The photos available online show rubble at the entrance of Al Kinanah Hospital as well as collapsed pieces of concrete, metal rebar from the hospital walls, debris from destroyed medical equipment, damaged patient stretchers, and scattered oxygen tanks. Rubble also covers areas inside the hospital where damage ranges between total and partial destruction of the facility. Pictures show damage to the walls and doors of hospital rooms and patient beds with the floor covered in rubble. Pictures also show damage to medicine and medical equipment in the hospital. This damage forced the facility completely out of service.

Pictures of the internal and external damage to Al Kinanah Hospital posted by Einab Baladi, Al Jazeera Mubashir, Shaam News Network, Macro Media Center (MMC), and Orient News.

As for Al Ferdous Hospital, airstrikes destroyed several departments including the operating room. The attack additionally put the dialysis department supported by SAMS out of service. A video posted by Syria Relief and Development, the organization that supports Al Ferdous, shows damage to some of the hospital’s departments and medical equipment.

Pictures posted by the Syrian American Medical Association - SAMS of the damage to the dialysis department at Al Ferdous Hospital

Flight Data Analysis

To further verify this incident, Syrian Archive cross-referenced information from open sources and pictures and videos taken by the investigations team with flight observation data from a spotter organization, which documents sightings of warplanes by partner observers in cities throughout Syria. These observers collect data about the aircrafts such as the type of plane and the direction the plane is flying. Although there may be misidentifications of aircraft in the flight data, additional information such as witness statements and social media posts can corroborate the identified aircraft and its course. Data for flights occurring briefly before, during, and after the time of the incident around 22:35 near Daret Azza was analyzed.

Flight observation data shows Su-24 aircraft, which are frequently used by both the Syrian government and Russian forces, taking off northwest from the T4 West Airbase in Homs (212 km south of Daret Azza) at 11:21 AM. Government light ground attack warplanes were also spotted taking off from the Quiris Military Airbase (66 km east of Daret Azza) at around 11:36 AM. Shortly after, at 11:34 AM, 11:41 AM, and 12:04 PM, Su-24 aircraft were spotted circling over Daret Azza. Additionally, government light ground attack warplanes were spotted circling over the town at 11:44 AM. Identified in previous investigations, the common practice of circling by war zone aircrafts featured in this data set generally indicates a target acquisition and/or preparation for an imminent strike. Su-24 aircraft and government light ground attack warplanes above Daret Azza around the estimated time of the incident confirms that the first airstrike occurred at around 11:55 AM and the second airstrike at 12:05 AM.

However, there is no information available indicating that one of the observed aircraft was directly involved in the strike detailed above. Nevertheless, the presence of Russian and Syrian warplanes above Daret Azza at or around the time of the strike further confirms the purported times—in open sources and witness testimonies—airstrikes hit Al Kinanah and Al Ferdous Hospitals. Considering that the aircrafts monitored above Darat Azza at the time of the strike are used by both the Russian and Syrian Air Forces, it is likely that the Russian or Syrian Air Force was responsible for the February 17, 2020 strikes.

Conclusion

Through the information detailed above, Syrian Archive confirmed that an air attack targeted both Al Ferdous Hospital and Al Kinanah Hospital at around 12:00 PM on Monday, February 17, 2020. The two airstrikes destroyed significant portions of both hospitals, forcing them out of service and depriving the western countryside of Aleppo of the last two medical facilities providing necessary care for area residents. Although Syrian Archive is unable to definitively identify the party responsible for the strikes, social media posts, witness testimony, and flight observation data points towards the Russian or Syrian Air Force as potentially responsible for the incident.

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