A year on from a devastating assault on the main hospital in the Syrian city of Afrin, a new Airwars visual investigation has pieced together key features of the attack.

At least 19 people were reportedly killed in two strikes on the Al-Shifa hospital on June 12th, 2021 in what was the single deadliest incident tracked by Airwars in Syria during 2021.

Hospital attacks in Syria are sadly common, with both the Syrian government and allied Russian forces striking dozens of them since the civil war began in 2011. The US-led Coalition against the so-called Islamic State, Turkey and Kurdish groups have also all been accused of targeting medical facilities.

But the Al-Shifa hospital strike was unusual in that the survivors didn’t all identify the same culprit. Some accused the Syrian regime, others the Russians, while others still blamed the US-backed Syrian Democratic Forces or allied Kurdish militias. Some even claimed Turkey was responsible for an attack in a city under its influence.

By bringing together satellite imagery, CCTV footage, witness testimony and expert analysis, Airwars created a comprehensive visual assessment of the strike. We were seeking to understand what munition was used and where the rocket was fired from.

While the investigation was not able to definitively conclude which party was responsible, it did define a seven-kilometre wide region from where the rockets were likely launched. In that area the Syrian regime, SDF and Russians all operated.

“We hope that by publishing this investigation on the anniversary of this horrific attack, we will spark a new conversation about the brazen targeting of a hospital,” Emily Tripp, Airwars’ Director, said.

“This case is one of far too many in Syria’s long civil war where families are left seeking answers about who killed their loved ones.”

The full visual investigation is available here.

The context

Afrin is a geopolitically significant city – located at the forefront between multiple belligerents in the 11-year Syrian civil war.

The city is close to the Turkish border and is currently under the control of Turkish-backed groups that operate under the broad title of the Syrian National Army (SNA).

Turkey has fought significant conflicts with Kurdish groups, including the SDF – the closest ally of the United States in Syria. The SDF controls much of the territory to the east of Afrin.

At the time of the strike the Syrian government and its Russian backers also had military capabilities in the region, controlling territory to the southeast of Afrin, while also being known to operate in the east. Russian and Syrian government forces have been the most common strikers of hospitals during the civil war.

Al-Shifa hospital is located in the west of the city and is reportedly close to multiple Turkish government and SNA buildings. The hospital is partly run by the Syrian American Medical Society (SAMS).

At the time of the attack Turkish president Erodogan accused the SDF, who in turn accused Syrian government forces. Allegations were also made against Russian forces and even Turkey itself.

The strikes

Most investigations of this type begin by analysing the remnants of the missiles at the scene. However, according to medical sources on the ground, Turkish-backed authorities removed all shrapnel and other physical evidence from the hospital in the hours after the attack, and also prevented activists and media from accessing the site for several hours. Without these vital clues, we drew on other forms of evidence that might give us an idea of where the projectiles might have been launched from.

Airwars compiled all available visual evidence, including drone footage, CCTV recordings provided by SAMS, social media posts, photographs and satellite imagery. We also gathered witness testimony, including speaking to survivors. Using this information we produced a 3D model of the hospital, mapping the impact locations.

The first strike hit the alleyway of the emergency department at 6.55pm – CCTV footage captured the explosion before cutting out shortly after as the electricity failed. The strike caused significant damage to buildings on both sides of the alleyway and reportedly killed, among others, a woman giving birth.

A screenshot from Airwars’ 3D model of the Afrin attack

“It was terrifying. It felt like an earthquake,” medic Mohammed al-Aghawani, who was injured in the attack, told Airwars. “At first I didn’t understand what had happened – whether I was alive or dead.”

The second strike, occurring a few seconds later, hit the main building and damaged the physiotherapy, paediatrics, ENT and surgical clinics. Photographs of the second impact location show a metal rafter broken and bent in half by the projectile as it penetrated the wall.

Image of the impact site (Via Syrian National Commission on Detainees)

From this we determined that the projectile would have arrived at an angle perpendicular to the bend of the bar. Plotting this onto a wider map, we concluded that the projectile must have come from a near due easterly direction.

The third strike

Hoping to narrow down the potential launch area further, we extended our 3D model to map a third impact location allegedly from the same volley of projectiles. Dr. Amin Qosho was at sitting at his kitchen table in his apartment home a few hundred metres away from the hospital. Around 7pm a projectile struck the building opposite his apartment. Instead of penetrating the wall, it hit the building’s reinforced elevator shaft, sending a large spread of shrapnel towards Qosho’s balcony and through his door, killing him instantly.

Using video footage and photographs of this impact location we were able to determine the relative height of the building struck and the building directly to the east. Building upon our previous determination that the projectile came from the east, we concluded that the angle of impact must have been high enough to clear the neighbouring building.

To narrow down our launch area further we investigated the munition used.

The type of weapon

While the Turkish-backed authorities removed all munitions remnants from the hospital itself, an image shared on social media that day showed a projectile found between Qosho’s home and the Al-Shifa hospital.

Images showing part of what appears to be remnants of a 122mm BM-21 rocket (spring-loaded fins) taken ~175m from the site of the Afrin hospital attack that killed over a dozen. Possibly from the first part of the double tap strike, hitting surrounding area

36.509510, 36.860433 pic.twitter.com/w8PAUvsTYU

— Alexander McKeever (@AKMcKeever) June 14, 2021

The projectile was identified as a 122mm, fired from a BM21 GRAD rocket launcher. This type of launcher was first developed by the Soviet Union in the 1960s but are now a very common – used by multiple sides in the Syrian war. Such launchers fire up to 40 projectiles in a single volley and are inherently inaccurate – designed for open battle fields not urban warfare.

While it was impossible to say with absolute certainty that the hospital and Qosho’s home were also hit by 122mm rockets, it is likely they were from the same volley of rockets.

Firing tables for GRAD rockets give a typical range of between 5 and 20 kilometres. However, using our model we determined that to clear the top of the building to the east, the rocket would have had to enter at a minimum of 23.4 degrees. This narrowed our potential launch area down further to between 12.3 and 20.5 kilometres.

Airwars modelling of the potential angles of impact

We shared all our visual evidence with a leading world expert in GRAD rockets, Ove Dullum. He agreed that the projectiles came from an easterly direction, adding that the fragment patterns from the impact indicated a low angle of impact, narrowly clearing the neighbouring building to the east.

Compiling his analysis with our own findings we estimate that the rockets were likely fired from the east and within the closer half of our range.

A still image of the estimated launch area, showing multiple groups operating there

Other investigations have found that the same type of rockets have been launched from the same area, including one by @obretix on a strike that hit the headquarters of a medical first responders organisation in Afrin six weeks after the attack on Al-Shifa hospital.

Conclusion

At the time of the incident, our estimated launch area was mostly under control of the SDF, America’s closest ally in Syria, along with allied militia groups. However control of this region is complicated. Reports in the weeks prior to the attack showed evidence of Russian and Syrian military forces operating within our estimated launch area.

On the 2nd of June, alleged Turkish artillery targeting SDF positions in Mara’anaz reportedly killed a Lieutenant in the Syrian militant, showing the presence and proximity of both the SDF and Regime forces in the area. Two days prior to the Al-Shifa attack, three soldiers from the Syrian military were reportedly injured by alleged Turkish bombardment on Menagh airbase, located within our potential launch area.

As such official designation of responsibility remains unclear. The SDF, Russians and Syrian Government all deny responsibility for this attack on a vital resource.

For the families of the victims and the survivors, the lack of accountability makes the suffering harder.

“I tried to check on the families of the martyrs – their psychological and financial situations are very bad,” Al-Aghawani said. “Personally, every few nights I dream of bombing.”

Airwars invites anyone with additional information to come forward.