Hospitals in Aleppo, Syria’s second city, are referred to by code numbers rather than the names they once held before the war. This is in the hope of making it less easy for Syrian government forces to identify and target hospitals when listening in to medical staff speaking on the radio.It doesn’t seem to help.“A bunker buster bomb landed in front of the entrance (to M10 Hospital) killing three maintenance workers and injuring a nurse and ambulance driver,” a press statement from the Syrian American Medical Society (SAMS), a non-profit organization that supports medical care in Syria, said last week. M10 was Aleppo’s biggest trauma hospital, located in the Opposition-held eastern half of the city. The men were repairing damage from a barrel bomb attack that killed four people two days earlier when they died.It is the fourth time M10 was struck in a week, with the latest bombing knocking the facility completely out of action, the SAMS’ statement said.So widespread and systematic are the repeated airstrikes against medical facilities that many observers monitoring Syria are convinced that the strikes are part of a targeted campaign and not collateral or accidental damage. Under the rules of war deliberate attacks of this nature could constitute war crimes. “Instead of helping get lifesaving aid to civilians, Russia and (Syrian President Bashar) Assad are bombing the humanitarian convoys, hospitals and first responders who are trying desperately to keep people alive," Samantha Power, the United States Ambassador to the United Nations, said recently to a UN Security Council emergency meeting. Near simultaneous attacks on different hospitals, repeated strikes, and the use of “double-taps” – where a second bomb is dropped on the same location several minutes after a first strike in order to hit first responders – have been cited as evidence for these claims.The brutalities unleashed by the regime of Bashar Assad on its own population are long and well documented, but in order for Russia to conduct strikes on medical facilities there would need to be a long-term strategic objective. Otherwise the risk of prosecution, diplomatic censure and bad publicity would not rationalize such actions.A cold logic of attrition is the thinking behind the attacks, observers are arguing. “The (Syrian) government understands that when you kill a doctor… it’s not just the loss of that individual’s life but it can be the loss of all the lives that the doctor could have saved,” Widney Brown, director of programs at the US-based Physicians for Human Rights, told The Media Line. Killing doctors in rebel-held territory reduces the number of their fighters that can be treated for injuries sustained in combat, the logic goes. Each doctor’s death has a permanent impact as there are no new doctors available to replace those killed, Brown, who documents strikes on health care facilities and staff as part of her work with the non-profit, said. The number of doctors working in Syria has decreased due to sniper and bombing attacks and through detention by government forces, Brown explained. Others have simply fled the country fearing for their lives and the lives of their families.But the logic goes beyond simply obstructing the Syrian Opposition’s access to medical care. Attacks on facilities are an attempt to make life for civilians in rebel held areas of Aleppo so hellish that they flee the area, Tim Eaton, research fellow for the Middle East and North Africa at London’s Chatham House think tank, told The Media Line. Civilians everywhere need doctors and in a warzone this is triply true. The “cold hearted pragmatism” is to bomb all facilities in an area which are critical for civilians to live in order to drive them out and to allow government forces to take control, Eaton said.This is a strategy learned by the Russian military during its conquest of Grozny in 2000 during the unsuccessful Chechen independence drive, the analyst suggested. “If you look since the Russian intervention (in Syria) last year, the Grozny-style tactic of depopulation has taken sway since that point,” he explained. Following the fighting and siege warfare in Grozny, which claimed the lives of thousands, the UN described the capital as the most destroyed city on the planet. While acknowledging the similarities in the “scorched earth policy” in Aleppo to the devastation wrought in the Chechen capital, Brown suggested that the policy was not a shift introduced by Russian military planners. The Russian intervention “brought much greater fire power… but the targeting policy was always on civilians, that hasn’t changed,” she explained.As well as force, the Syrian government is attempting to persuade citizens to leave Opposition-held territory. “The Assad government has said it will allow civilians to evacuate the area of Aleppo by creating a humanitarian passage,” Derek Averre, a scholar in Russian foreign and security policy at the University of Birmingham, told The Media Line, adding, “this allows the government to retake the area and leaves the opposition nowhere to go.”But there’s one other reason, analysts suggest, that the Syrian government and its Russian allies are choosing to attack hospitals and doctors: Because they can.“The underlying element of this is that if you trace back the conflict, what has been proven to the regime is that they can undertake such attacks without sanction,” Eaton acknowledged. A lack of action by the international community has allowed the violence in Syria to escalate to this level, Dr. Ousama Abo El Ezz, SAMS’s Aleppo Field Coordinator said. “M10 was not destroyed by bombs. It was destroyed because of the silence and inaction of the international community that knows what's happening in Aleppo,” he said, in the non-profit’s recent press release. This silence is not something that can continue any longer, Brown opined, arguing that prosecutions were necessary due to the severity of the crimes committed during fighting in Syria. Physicians for Human Rights “really wants to see a prosecution of this (as) a war crime (and) because it’s widespread and systematic this is also a crime against humanity,” the director said.