Preparing for a ground offensive into the rebel-controlled Idlib governate, Russia is once again launching air strikes on hospitals in western Syria.

The Union of Medical Care and Relief Organizations notes that since April 28, four hospitals in the Idlib and Hama governates have been struck by air and mortar strikes. UOSSM cannot identify who is responsible for the air strikes, but I am very confident it was the Russian air force.

So, why are the Russians bombing hospitals? It's not for the sake of being brutal per se. It's because Russian strategy views civilian harm as a mechanism for compelling adversaries to compromise. Put simply, Russian President Vladimir Putin believes that if his forces kill enough civilians and create enough imagery of that suffering, it will induce a speedy cease-fire. That's why the hospitals targeted are all in major rebel-held areas or along rebel supply routes. Alongside Syrian President Bashar Assad, the Russians want to seize Idlib. While Putin signed an Idlib cease-fire agreement with Turkish President Recep Tayyip Erdoğan in 2018, that deal was never going to last. Since January, Putin has wanted to act.

Equally important here is how civilian suffering will foster international calls for a cease-fire. Putin knows that the European Union and the United Nations will surrender to Russian demands in order to stop civilian loss of life. He also knows those interests are unwilling to pressure Russia as an alternate means of ending its aggression. As such, Putin views destroyed hospitals and aid convoys as a way to get international buy-in for any cease fire. Putin can then use that cease-fire to present himself as a reasonable leader while also buying time until he's ready for his next offensive. Thus, a pattern of encroaching offensives followed by cease-fires is Putin's favorite.

The Obama administration never understood this Russian mode of operation. That's why Obama kept falling for Russia's revolving-door policy of escalation-cease-fire. Hopefully, the Trump administration is smarter about this. Recognizing that Erdoğan will be furious over this offensive (Erdoğan sees himself as Sunni Islam's global political leader), Trump should persuade the Turkish leader to return to America's corner and abandon his purchase of Russian military equipment.

Trump should also warn Russia that any major offensive will result in new sanctions on its economy.