July 10

Analysis of the Russian Missile Strike on the Okhmatdyt Hospital in Kyiv

On the morning of July 8, Russia launched a wave of missile strikes against cities across Ukraine (see our summary on strikes on civilian infrastructure for details of civilian casualties), with Kyiv being one of the primary targets. Missiles and fragments of intercepted missiles hit several city districts. Specifically, the Shevchenkivskyi district experienced missile strikes on the Artem military plant and Okhmatdyt, the largest children’s hospital in the country. Unlike other strikes conducted on July 8, and more broadly in the two and a half years since the beginning of the full-scale invasion, a video of relatively good quality captured the moment of impact. As a result, we had a rare opportunity to examine the specific circumstances of the incident.

Missile Identification

Based on the available recording, which captures the moment when the missile struck the toxicology department of the Okhmatdyt hospital, we can confidently identify the type of weapon used. Still frames clearly show the missile’s fins and its distinctive turbofan engine, located externally under its tail section. It is worth noting that the missiles used by Ukraine for air defense do not feature external engines. Thus, we can decisively exclude the version proposed by the Russian Ministry of Defense and certain propagandists that a Ukrainian interceptor missile struck the hospital. Moreover, the presence of an external turbofan engine also excludes all variants of cruise missiles used by the Armed Forces of Ukraine, such as Storm Shadow/SCALP-EG or R-360 Neptune.

Additionally, the Security Service of Ukraine (SBU) reported the recovery of missile fragments from the impact site, including parts of the nose cone (with its distinctive shape), engine casing, electronic countermeasure module (a recent wartime innovation) and wing deployment mechanism. Some of the fragments still had visible serial numbers, with the SBU identified as belonging to a Kh-101 cruise missile.

The missile’s shape, wing configuration, tail structure and external turbofan engine all lead us to conclude that it is indeed a Kh-101 missile. This conclusion is corroborated by missile expert Fabian Hoffmann, experts interviewed by the BBC, Bellingcat analysts and RFE/RL's Ukrainian Service. UN monitoring mission chief Danielle Bell likewise suggested that there is a high likelihood that the strike resulted from a direct hit on the hospital, rather than an air defense interception.

Air Defenses or Electronic Warfare

Eyewitness footage captured the final seconds of the missile’s flight before it struck the toxicology department of the hospital. The missile’s trajectory appears straight and stable, without any rotation or erratic movement. The missile shows no visible damage, did not disintegrate in mid-air, nor emit any significant amount of smoke, apart from the normal engine exhaust trail. Therefore, we can assert that there are no signs of external interference with the missile, effectively ruling out the hypothesis that the missile landed on the children’s hospital after being deflected off course by a Ukrainian air defense missile.

We also rule out the possibility of the missile being impacted by electronic warfare systems (jammers), as we are not aware of any cases where jammers have caused cruise missiles to deviate from their course. Furthermore, according to Ukrainian sources, during the war, Russia has upgraded its missiles. Specifically, the Kh-101 series missiles now feature a more sophisticated three-lens digital scene-matching area correlation (DSMAC) system. Another argument against the presence of effective electronic warfare systems in Kyiv at the time of the attack is the fact that several missiles also hit the Artem plant, evidently one of the planned targets, located just 1,300 meters [0.62 mi] from the hospital, without apparent error.

Let us also consider the direction of the missiles’ flight as they approached the target. Geolocation of the video showing the strike on the hospital indicates that the missile was flying from west to east. However, cruise missiles are designed to actively maneuver during flight along a programmed route. These routes are pre-planned based on the attack objectives and available information about areas with active enemy air defense to ensure that the missile flies as low as possible and avoids potential interception by ground-based air defenses. This is why a cruise missile can approach the target from any direction, regardless of the launch site.

Geolocation of the missiles that struck the Artem plant shows that they were also flying from west to east. This, along with the almost synchronous impact times, suggests that they belonged to the same group and were launched simultaneously from the same carriers.

As previously noted, the Ohmatdyt hospital is only 1,300 meters south of the Artem plant buildings. Therefore, with missiles flying from west to east, the Ohmatdyt hospital is not on the flight path to the plant. Its azimuth relative to the east-west axis is significantly different from that of the plant, meaning it is “out of the way” for the missiles. It is important to note that on the final phase of their trajectory, as they approach the target, cruise missiles no longer maneuver and fly in a straight line.


Taking into account all of the above, in our view, the possible versions of what occurred are:

  • a deliberate strike on the hospital;
  • an error in programming the flight path of a missile, causing the hospital building to become its target;
  • a technical malfunction of the missile itself, leading to its deviation from course.

Unfortunately, our ability to investigate the strike further is limited at this point. To establish the true circumstances of what happened, it would be necessary to interview all individuals involved in the preparation and launching of the missiles, examine the missile debris, and conduct other detailed inquiries, which we obviously cannot do.

It goes without saying that a deliberate strike on a healthcare facility, especially a children's hospital, is a grave war crime. However, Russia has repeatedly committed such crimes in the past, not only as part of the current invasion of Ukraine but also during the "Syrian campaign," as documented in our previous investigations.

It is also worth noting that if the events occurred according to one of the last two versions mentioned above, Russia is obligated under international law to investigate the causes of the incident and hold those responsible for criminal negligence accountable. Refusal to conduct a thorough investigation would constitute a separate offense committed by Russia.