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A/HRC/34/64 8 Bombardment of water stations forced the population in the east to drink water from boreholes, risking the contraction of waterborne diseases. 27. Launched on 23 September 2016, the aerial bombardment campaign of eastern Aleppo drastically increased civilian casualties. Approximately 300 people – including 96 children – were killed in the first four days of the offensive alone. By mid-October, a lack of resources and medical supplies forced doctors to amputate limbs, which might have otherwise been saved. 28. On 14 November, government artillery fire reportedly struck an orphanage providing shelter for 50 children in Salah al-Din district, injuring two boys aged 11 and 14 years. The children were subsequently moved to a basement, where they remained trapped for weeks. After several attempts, they were evacuated on 19 December. 29. Conditions significantly worsened in December, when all hospitals were bombed out of service. Residents were concentrated in ever-shrinking territory, where they lived under aerial attacks, and with insufficient food, water and heating. Without medical facilities, several families had no choice but to leave the bodies of their dead and injured relatives in the streets. Many suffer from trauma and guilt for having survived the violence. 2. Hospitals 30. Between July and November, air strikes repeatedly struck health-care facilities in eastern Aleppo, continuing the pattern observed in the first half of 2016 (A/HRC/33/55, paras. 44-49). By the time pro-Government forces recaptured the city in late December, no hospitals were left functioning. The majority of attacks were conducted in two waves: between late September and mid-October, and in mid-November. The attacks assessed below were carried out by either the Russian air force or the Syrian air force, or both. 31. Hospitals, ambulances and medical personnel are afforded special protection under international humanitarian law (see annex I, para. 36). While they may be made the object of attack when used for military purposes, such attacks require prior warning (ibid., para. 39). In the incidents investigated by the Commission, however, there was no indication of the presence of military targets or of warnings being issued prior to attack. The display of an emblem to signify a location’s protected status is not required in conflicts where hospitals are deliberately targeted (ibid.). 32. Repeated bombardments, lack of warnings and the absence of military presence in the vicinity of the health-care facilities strongly suggest the deliberate and systematic targeting of medical infrastructure as part of a strategy to compel surrender, amounting to the war crime of intentionally targeting protected objects (ibid., paras. 36-39). Furthermore, deliberate attacks against medical staff and ambulances amount to the war crimes of intentionally attacking medical personnel and transport (ibid., para. 39). 33. Located next to the Khalid Ibn Waleed mosque, the M10 hospital in al-Sakhour district served as the largest trauma hospital. Air strikes hit the hospital on four occasions between late September and mid-October, putting it out of service. On 28 September, at approximately 4 a.m., an air strike hit the vicinity of the M10, killing a 12-year-old boy and injuring his father. The air strike damaged the intensive care unit and destroyed the generators, fuel storage and water tanks. Witnesses described the use of barrel bombs, and a large crater believed to be the result of a bunker-buster bomb. A video of the aftermath reveals two unexploded ShOAB-0.5 sub-munitions, indicating the use of an air-delivered RBK-500 cluster bomb. 34. On 1 October, at around 11 a.m., a series of barrel bombs struck the M10, forcing more than 100 people, including patients and medical staff, to take refuge in the basement of the hospital. Two patients were killed and at least 13 others injured. The attack als