As another airstrike rained down in Syria, Fadi Al Dairi knew that those inside Kfr Nobol Hospital, operated by the British NGO 'Hand in Hand,' would soon be targeted.
The story of Kfr Nobol Hospital is no different from other health facilities inside Syria that have paid a heavy price in the conflict.
The hospital in Idlib province, operated by the British NGO Hand in Hand, has been targeted by airstrikes multiple times throughout the war, like so many other medical facilities in Syria. In the past, our hospital survived with minor damage that could normally be fixed within days and would not hinder our ability to provide services. This is partially because, before Russia entered the war in Syria, with its sophisticated weaponry and spot on the U.N. Security Council, things were slightly better.
This time, however, it was different. On Monday (February 5, 2018), airstrikes were so intense that we immediately moved our operations underground. But it seems that the weapons used that day were intended to reach staff underground; thermobaric, or so-called guided bombs, can penetrate many levels of concrete, for a maximum level of destruction.
Four airstrikes by Russian fighter jets ensured that the hospital is now completely out of service. It was the only surgical hospital within a 30-mile (50km) radius.
It took 41 minutes. Forty-one minutes of hell is what I would call it, where all I could think of was the number of those at risk and their families.
10:01 a.m.: As the Syria country director for Hand in Hand, I am based in Turkey, and on the day of the attack I was in my office in Gaziantep with the senior team managers.
The first airstrike missed the actual building and hit the concrete fence outside, about 80 feet (25m) away. It set fire to the "guards' room. At this point, we knew we would be targeted. We knew our time had come, and that this time they intended to finish the job. Patients and staff were moved to shelter in a "safe underground space" but equipment could not be moved.
10:06 a.m.: The team saw the second attack, and it was getting closer to the building.
10:14 a.m.: The third attack took place, hitting the second floor.
10:18 a.m.: We received a warning through our Safety & Security WhatsApp group of an imminent fourth attack.
10:20 a.m.: The fourth and final attack hit. The missile made devastating damage to the structure and penetrated through three levels of concrete.
10:21 a.m.: We received a message advising us that the attacks were over. We assume it's because fighter jets can only carry four missiles.
10:26 a.m.: Evacuation began from the dialysis unit, which performed 2,133 services in 2017. It is next to the emergency room, where 15,588 lives were saved in 2017.
10:42 a.m.: We received confirmation from the hospital manager that none of the team are injured.
I could relax. I took a deep breath and only then did I begin to think about how to open the hospital again. We were adamant that the bombing was not going to stop us from delivering emergency aid. We still did not know the full scale of the destruction.
Forty minutes later, the field medical manager arrived at the hospital to inspect the damage. He and his team started to send images showing the scale of the destruction.
It was only then that we realized the building had been totally destroyed. It would cost $650,000 to repair the building and $300,000 for the equipment. But thinking of the cost could not rattle me, as I had found out all medical personnel and patients were safe and sound in the designated safe space.
The next day was different.
I tried to remain calm despite feeling helpless, but I was filled with feelings of guilt. These were my employees and I am not there to support them. I tried to hide these feelings and appear strong in front of our senior management team. They did not realize what I was going through, so I may have been successful.
At some point I thought to myself, why am I doing it? Why do I have to go through this?
Then I thought about how many lives this hospital has saved during its existence. I reminded myself of the 83,845 services provided in 2017. I knew it was worth it, and resolved to double that number in 2018.
After all, there is nothing I can do but become more determined to continue my work with my colleagues to find funds that will allow us to reopen the facility again and resume operations.
We will not give in to this cruel war. Life is a big lesson we learn from and build on. You win with strong will.