Chaos and horror at a Kyiv hospital as the city is hit with heaviest bombardment in months

KYIV, Ukraine — The sky was crystal clear as Oksana Femeniuk took her daughter to Ukraine's largest children's hospital for routine dialysis.

Around 10 a.m, air-raid sirens blared. Sixteen-year old Solomiia was undergoing the treatment that required her to sit still for up to five hours and could not be interrupted. Her mother had to flee to the hospital's basement shelter without her.

Hurtling toward them at 700-800 kilometers (435-497 miles) per hour was a Russian Kh-101 cruise missile, according to Ukraine's security service, the United Nations and open-source investigators. Using painstaking trial and error, Russia has modified the weapon over the last year to defeat Ukraine's air defense systems by flying at low altititude and hugging terrain, according to military analysts.

Minutes later the world turned black. Neither the patient nor her mother would remember the moment the missile struck. But they remember the chaos that ensued after regaining consciousness: Femeniuk thought she would choke from the fumes. Solomiia woke to find the ceiling crumpled over her small body.

In an operating room in the next building, pediatric surgeon Oleh Holubchenko had been preparing to operate on an infant with a congenital facial defect. Covered in shrapnel wounds, he realized that the blast wave had catapulted him to the other side of the operating room.

The toll of Russia's heaviest bombardment of Kyiv in almost four months — one of the deadliest of the war — shows the devastating human cost of Russia's improved targeting tactics.

The hospital's director general, Volodymyr Zhovnir, stood at the scene of the explosion, eclipsed by the towering building with shattered windows. No children died, thank God, he said, but they lost a dear colleague, Dr. Svitlana Lukianchuk.

Solomiia was born with chronic renal failure, making hemodialysis part of her life.

After the full-scale invasion, Femeniuk left her three children and husband behind in the small village near Rivne, in western Ukraine, to live in the capital so the girl could access the treatment she needs.

Leaving her daughter during the air raid was a difficult decision. But the 34-year old mother had to project strength, she said. Her daughter was being brave by staying, knowing she could not interrupt her treatment. Femeniuk could not reveal to her daughter that she was actually terrified.

As the air-raid siren blared, the girl was on her phone watching videos. Given how long dialysis can take, she tends to get bored.

She awoke to find the ceiling in front of her eyes and the head doctor tending to her covered in blood and on her knees.

''The first thing I thought about was my mom, if she is alive or not. Then I thought: ‘Am I alive or not?''' she said, her fingers painted with small flowers, fidgeting as she spoke. Mother and daughter recounted their experience from the Kyiv City Children's Clinical Hospital, where Solomiia was transferred.

In the shelter, the exit was blocked and the fire blazing outside soon invaded the small space. Femeniuk called her husband, telling him she didn't know if she would survive and she didn't know if Solomiia was still alive.

Eventually, those taking shelter managed to push their way out and to their horror they realized that the very building they had been in, that some of their children had been in, was hit. Femeniuk began picking up pieces of rubble in panic, calling out her daughter's name. Then she saw the nurse who had been assisting them, covered in blood.

Solomiia had been evacuated after the blast, the nurse said. She was safe.

Meanwhile, in the operating room, it took Holubchenko fifteen minutes to realize that he was covered in shrapnel wounds. The doctor was too busy evacuating patients, starting with the 5-month old whose surgery was eventually completed elsewhere.

In the hospital ward, he looked out to the street from a shattered window.

''There used to be a wall here,'' he said.

When he went outside and realized the toxicology building had collapsed, his mind reverted to the times he would have consultations with patients there and check-ups. Now half the building was caved in.

But he didn't dwell on the thought for long and joined a line of volunteers, health workers and emergency crews removing debris, piece by piece.

''Everyone wanted to do something,'' he said.

Russia denied responsibility for the hospital strike, insisting it doesn't attack civilian targets in Ukraine despite abundant evidence to the contrary, including AP reporting. Moscow insisted it was a Ukrainian air defense missile that struck the hospital.

Artem Starosiek, the founder of the Ukainian group Molfar, which analyzes events based on open-source evidence, said there were overwhelming signs of Russia's culpability. The missile used in the attack bears the characteristics of the Kh-101, he said, pointing to the shape of the body, tail and location of the wings, he said.

That it was a clear blue day also played an important role, he said. Launching the modified missile during a sunny day is optimal for the weapon's optoelectronic system to recognize the target correctly, he said.

''The force of the warhead's explosion is important; an air-defense missile could not have caused such consequences,'' he said.

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