A/HRC/37/72 were closed down, leaving thousands of children deprived of education. While schools may be made the object of attack when used for military purposes, such attacks require prior warning when the school is located in a densely populated civilian area, as would be the case for the incidents documented. In none of the following incidents, however, were warnings issued. 21. At around 10.40 a.m. on 16 October, a shell fell in a lane next to the Ghosn Zeitoun school in Kafr Batna. More than 150 children were gearing up to leave the school after attending classes, when an explosion was heard, later identified by interviewees as a shell likely fired from pro-Government forces’ positions. A female teacher and her 8-year-old daughter who were leaving school were killed by shrapnel, and the teacher’s 5-year-old son sustained injuries to one leg and his hands. Following the incident, the school reduced the number of shifts, operating only from 6 to 9 a.m. 22. On the morning of 31 October, at 10.30 a.m., a shell hit the playground of the Mohammad Nasser Ash’Osh primary school for boys in Jisreen. The school, attended by more than 400 pupils, is located in the centre of Jisreen, surrounded by residential buildings. There is a kindergarten across from the school. As with the incident on 16 October on the Ghosn Zeitoun school, students had just finished classes. The shell killed five boys aged eight to 11 years, and an elderly man who was selling candy close by. At least 26 other boys were injured, as well as one girl in the vicinity. Several of the injuries required immediate surgery, with one boy’s feet having been amputated. The school’s gate and one wall were destroyed. Following the incident, the school adopted an “emergency” schedule, holding only two classes a day. 23. In one single day, on 8 November, three schools were impacted by airstrikes in eastern Ghutah. The same school complex hosting the Ghosn Zeitoun school, previously hit on 16 October, was struck again though this time by an airstrike. At 1 p.m., an airstrike hit the pavement in front of Basma Amal school, also in Kafr Batna, causing severe damage to the classrooms. Shortly afterwards, at 2.30 p.m., an airstrike hit the Tamayoz kindergarten in Hammourieh. About 240 children attend the kindergarten, which is adjacent to a hospital. There were no casualties among pupils in any of the 8 November incidents, as the Education Directorate instructed all schools to close for security reasons just two days prior. B. Hospitals 24. Attacks on medical facilities are one of the longest running patterns of violations of the conflict in the Syrian Arab Republic. In besieged areas, hospitals often operate from damaged facilities that have been made the object of repeated attacks over years (see A/HRC/34/64, paras. 30–40), and without the most basic equipment and medication. Hospitals, clinics, and medical points are regularly attacked for attending to the wounded, as part of a strategy to erode the viability of civilian life in opposition-held areas. Attempts to protect the facilities by changing their names or moving underground have often proved unsuccessful (see A/HRC/36/55, paras. 62–66). Hundreds of medical workers have been killed and injured, and countless others have sought refuge abroad. Together, these factors have resulted in a severe weakening of the medical system countrywide, with devastating impact on besieged civilians, particularly vulnerable groups such as children, expectant mothers, the elderly, and those with chronic illnesses. During periods of intense bombardment, such as the one in eastern Ghutah on 8 November, the hundreds of casualties in need of care far exceed the capacity of hospitals to provide it, resulting in inadequate treatment and preventable deaths. 25. On 13 September, at 1.30 p.m., two artillery shells hit Al-Hekma hospital in Kafr Batna, with two more shells landing in its immediate vicinity. Al-Hekma hospital is the main trauma facility of the area. As the hospital had been hit several times in previous years, medical staff stopped using the building’s upper floors, which were more frequently impacted in the other attacks. The 13 September attack resulted in four people being injured, among them two patients, including a woman, and one hospital worker. The emergency and recovery rooms were also both damaged, as was hospital furniture including 24