A/HRC/44/61 Annex III Satellite imagery, including in relation to specific incidents investigated A. 29 January, al-Shami hospital, Ariha town, Idlib governorate 1. On 29 January, at approximately 10:30 p.m., pro-government forces launched three airstrikes that struck a residential area in close proximity to al-Shami surgical hospital, killing the hospital’s director and severely damaging the emergency and x-ray units, in addition to the hospital’s laboratory and vital medical equipment (see section V. C.). Subsequent to this attack, the hospital was rendered non-operational, thus leaving civilians with no other operational medical facility in southern Idlib. 2. Approximately 12 residential homes located near the hospital, in addition to numerous commercial shops, a bakery, civilian vehicles and one ambulance, were also damaged. At least 14 civilians, including one doctor, 5 women and 5 children, were killed and dozens injured. Residents interviewed by the Commission recalled that following this attack, some 80.000 women, men and children fled Ariha. 3. Interviewees described that, earlier that day, doctors were busy treating the casualties from another attack that took place earlier on 29 January on Kafr Latt town. At around 10 a.m., as health personnel was providing care to the wounded, flight spotters reported that aircraft had been observed heading towards Ariha town. Fearing attacks, medical staff began evacuating the patients. Two ambulance vehicles were sent to al-Shami to collect the patients and transport them to other hospitals in the area. 4. Medical staff who witnessed the attack recalled how, at around 10:30 p.m., they heard the first airstrike that caused a loud explosion and shook the hospital. Windows and doors were shattered, while a civilian vehicle stationed nearby caught fire. As civilians sought shelter in the basement and under hospital beds, two consecutive airstrikes hit the hospital’s immediate vicinity and impacted nearby residential homes. The airstrikes caused significant damage to vital medical equipment inside the hospital, subsequently rendering it out of services. 5. Consistent with interview accounts, video footage, picture material and satellite imagery (see image below) showed large-scale destruction inside the facility and surrounding residential areas. The three points of impact were situated very close to each other and impacted the immediate vicinity of the hospital building on three sides, indicating a precise attack likely carried out by missiles, which appeared to have targeted the hospital. 6. The Commission notes that, during the time of the attack, there was no ground fighting and the front line was more than 10 kilometres away to the south-east. Interviewees consistently described the area as civilian, without military objectives located nearby. 7. Credible information obtained by the Commission, including flight spotters’ reports and overflight data, indicate that at least one Russian aircraft departed from Hmemim Air Base between 10:17 and 10:20 p.m., and was observed in the vicinity of Ariha town at 10:30 p.m. Witness statements subsequently confirmed that the airstrikes were launched out at 10:30 p.m., and were carried out in sequence within an interval of 10 minutes. 8. The Commission received no information suggesting that a Syrian aircraft was present in the area, or was part of a coordinated aerial operation, during the time of the attack. The Russian Ministry of Defence denied that a Russian aircraft had been involved in a combat mission in Ariha that resulted into the destruction of al-Shami hospital.1 1 See https://iz.ru/970319/2020-01-30/minoborony-oproverglo-udar-aviatcii-po-grazhdanskimobektam-v-sirii and https://tass.ru/armiya-i-opk/7643795. In note verbales addressed to the Russian Federation and the Syrian Arab Republic of 29 April and 5 June respectively, the Commission sought 23