AMMAN: A Daraa field hospital, one of the best-equipped medical facilities in opposition-held southern Syria, was a shuttered ruin on Monday after an airstrike killed and injured dozens of people the day before, leaving hospital administrators with the “fateful decision” to either rebuild for a third time or close down for good.

“Four consecutive, direct airstrikes” hit the Radwan field hospital and its surroundings in Jasim, a rebel-held town 40km north of the provincial capital of Daraa city, on Sunday, Abu Muhammad al-Hourani, a citizen journalist who witnessed the attack, told Syria Direct the following day. Al-Hourani lives in a neighboring Daraa town and was visiting Jasim on Sunday.

“Ten people were killed, including a pharmacist, an administrative nurse and four women and children,” al-Hourani told Syria Direct. “The residences surrounding the hospital were completely destroyed.”

The Radwan Hospital on Sunday. Photo courtesy of Nabaa Media Foundation.

An estimated 30 people were wounded in the airstrikes, Doctor Ehab al-Jalam, the director of the Radwan field hospital told Syria Direct on Sunday. Al-Jalam was in the hospital’s emergency department when either Russian or regime airstrikes struck on Sunday. Al-Jalam suffered minor injuries.

“The whole outside of the building was destroyed as well as the generators and the entire fourth floor,” said al-Jalam. While medical devices deeper inside the structure likely survived the bombing, “the ambulance network was completely destroyed.”

Sunday’s airstrikes are the third time the hospital has been targeted. Radwan was bombed twice in 2015, and subsequently changed locations both times. “We haven’t yet made a decision about rebuilding the hospital,” he said. “It could be repaired, or the doctors could move to other hospitals. It’s a fateful decision.”

Before Sunday’s attack, the Radwan field hospital was the only working hospital in Jasim, home to more than 50,000 people. It also provided care for “400,000 people from Daraa and the Quneitra countryside, as well as displaced people from western Outer Damascus,” said al-Jalam.

Residents at the scene of Sunday’s airstrikes. Image courtesy of Hossam Naser.

The doctor accused Russia of carrying out the attack, while some pro-opposition news sites and social media accounts have claimed the planes came from the Assad regime. Neither Syrian nor Russian state media has reported the bombing.

Videos and photographs posted online by Jasim residents shortly after the attacks appear to show extensive damage to the hospital—which is still standing—and the destruction of surrounding buildings. Pulverized stone and concrete coat surrounding streets and crumbling buildings with a layer of dust. Would-be rescuers are dots of color, moving across mounds of ash-colored rubble. Residents cover the bloodied body of a small child with pieces of cardboard. Twisted rebar protrudes from buildings. A disoriented man leans against a wall pockmarked by shrapnel. Outside of the damaged hospital, the roof of a parked ambulance has caved in.

“MSF-supported al-Redwan hospital located in Jasim town, Daraa in southern #Syria hit by airstrikes,” Doctors Without Borders tweeted on Sunday. “Al-Redwan hospital was the only functional public hospital in #Jasim town, a city of ~65000 people,” the medical non-profit said in an additional tweet, adding the hashtag “#NOTATarget.”

"We are also angry: Year upon year we have warned and mourned about civilian loss of life in Syria, and yet the situation goes from bad to worse," IRC president and CEO David Miliband said in a statement on Sunday.

As the best-equipped field hospital in northwest Daraa, staffed by more than 100 doctors, including all major specialties, Radwan provided a wide range of services before Sunday’s bombing.

Radwan staff received rebel fighters wounded in battles as well as residents injured in bombings. Surgeons delivered babies via Caesarean section. Diabetics went to Radwan to test their blood sugar. People with kidney failure came on a rotating basis for dialysis treatments. Cancer patients received palliative medications at no cost.

The hospital was founded by a group of mobile volunteers who worked to secretly provide medical care to wounded protesters and fighters so they wouldn’t have to go to hospitals and risk arrest.

When rebels took control of Jasim in 2013, “a small medical facility staffed by no more than five doctors” was established. In a matter of months, after receiving medical equipment and supplies from international organizations and money from individual donors, Radwan “became one of the largest hospitals in southern Syria,” said al-Jalam.

“Thousands of patients every month” used the hospital, said al-Jalam.

While nearby towns also have medical facilities, the loss of the largest, best-equipped hospital in northwestern Daraa—temporarily or permanently—means that every other hospital in the area is under additional pressure, said al-Jalam.

"The surrounding hospitals don’t have the capacity to absorb large numbers of the wounded like Radwan did.”