Extensive evidence gathered and analyzed over months proves that Russian warplanes bombed four Syrian hospitals in the span of 12 hours in May as part of Moscow’s effort to keep Syrian President Bashar Assad in power, the New York Times reported Sunday.

“Recklessly or intentionally bombing hospitals is a war crime, but proving culpability amid a complex civil war is extremely difficult, and until now, Syrian medical workers and human rights groups lacked proof,” the US paper wrote in its report.

The report cited eyewitness accounts and tens of thousands of flight observations, cross-referenced with thousands of previously unpublished Russian Air Force internal radio transmissions, which were decoded over several weeks, as well as videos of three of the four strikes.

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It found that in all cases, the times logged by witnesses on the ground corresponded with pilot communications saying they had completed their mission. In at least two of the cases, the munitions used were precision bombs not possessed by Syria but held by Russia.

All the hospitals in the southern Idlib province bombed in the May 5-6 campaign — Nabad al Hayat Surgical Hospital, Kafr Nabl Surgical Hospital, Kafr Zita Cave Hospital and Al Amal Orthopedic Hospital — had added their locations to a United Nations-sponsored deconfliction list, which was sent to Russia and others to prevent them from being targeted.

Instead, healthcare workers in Syria believe the sites became a target list for Moscow, which isn’t likely to face international punishments over the raids.

“Russia’s position as a permanent member of the United Nations Security Council has shielded it from scrutiny and made United Nations agencies reluctant to accuse the Russian Air Force of responsibility,” the report said.

It quoted Susannah Sirkin, director of policy at Physicians for Human Rights, as saying that “the attacks on health in Syria, as well as the indiscriminate bombing of civilian facilities, are definitely war crimes, and they should be prosecuted at the level of the International Criminal Court in The Hague.”

Moscow refused to comment on the bombings, merely referencing earlier statements claiming the Russian Air Force only targets “accurately researched targets.”

Since May 5, the report said, at least two dozen medical facilities in rebel-held areas have similarly been struck. Syrian medical staff were quoted as expecting those attacks on civilian targets to continue in the absence of ways to hold Russia to account.