ODESA, Ukraine >> Ukraine’s largest children’s hospital was destroyed by a Russian missile today, shaking Kyiv, the capital, with images of bloodied and injured children, and sending hundreds racing to the scene to help clear twisted metal and smashed concrete in a desperate search for survivors.

The hospital strike was part of a barrage of bombings by Moscow across the country, including one of its deadliest assaults on Kyiv since the first months of the war. At least 38 people were killed across the country, including 27 in Kyiv. More than 100 people were injured. The Ukrainian air force said it shot down 30 out of the 38 missiles launched by Russia during the attack, which began in the midmorning.

“The attack was massive, combined with the use of aerial, ballistic and cruise missiles,” said Serhii Popko, the head of the Kyiv military administration. “The missiles flew at the capital in waves and from different directions.”

At the hospital, one doctor and another adult were killed and at least 10 more people were injured, including seven children, local officials said. At least three children were pulled from the rubble, Ukraine’s emergency services agency said.

Olha Melnyk, the mother of a child being treated in the oncology unit of the hospital — who was not there at the time — said she was in a state of shock.

“There were so many families like us, who had their own personal war with oncology already,” she said. “And you know, these children can’t go to the basement, because all the tubes and treatments. If they do this, there will be no healing at all, you can’t interrupt the healing session.”

The U.N. Security Council will hold an emergency meeting Tuesday to address the strikes. President Volodymyr Zelenskyy of Ukraine called for the meeting, saying President Vladimir Putin of Russia should be held accountable.

“To everything that they try to discuss with him about peace, Russia responds with strikes on houses and hospitals,” he said. “That is why we can only force Russia to make peace.”

Video of the attack taken by a Kyiv resident and verified by The New York Times showed a missile moving downward at high speed before striking the children’s hospital. Fabian Hoffman, a doctoral research fellow at the University of Oslo who specializes in missile technology, identified the weapon as a Russian Kh-101 cruise missile.

The type of the weapon and its trajectory suggested that Russia intentionally targeted the hospital, according to Hoffman. He said the trajectory of the missile “appears controlled,” and that it was likely programmed before launch.

Hoffman also noted that the missile was not struck by a Ukrainian air defense interceptor, and was “fully intact, with no visible damage to the fuselage.”

The Ukrainian Security Services recovered fragments of what it said was the missile that struck the hospital, also identifying it as a Kh-101 cruise missile.

The Ukrainian prosecutor’s office said seven of the casualties today were caused by missile debris that fell onto another medical facility, a women’s hospital in Kyiv.

The Ukrainian air force said today’s attacks were carried out in part by bombers operating from deep within Russian territory, where Ukraine is restricted from using Western weapons to strike. The strikes came a day before NATO leaders were scheduled to meet in Washington, where they were expected to announce new efforts to bolster Ukraine’s air defenses.

Zelenskyy, who was in Warsaw today to sign a new security pact with Poland, said the document “includes a provision for shooting down Russian missiles and drones in Ukraine’s airspace that are fired in the direction of Poland.” He said both sides were “committed to implementing it,” but he did not say when it would go into effect.

Russia has relentlessly bombed Ukraine in recent weeks, seeking to overwhelm its defenses with the sheer volume of attacks. While Kyiv has some of the most robust air defenses in the country — and thus has been largely protected from direct missile strikes — the city’s military administrator warned last month that Moscow has been testing new tactics to breach them.

Overall, the country’s air defenses are stretched thin, struggling to protect vital military assets, critical infrastructure and residential neighborhoods at the same time.

“The strike is a tragic reminder that it is not possible to have air defenses everywhere, that choices must be made about what will be defended and which are not,” said Thomas Karako, who directs the missile defense project at the Center for Strategic and International Studies in Washington.

“The protection of military assets tends to be prioritized,” Karako added, “which, unfortunately, plays into the hand of those who target civilians contrary to the most basic laws of armed conflict.”

At the hospital, Volodymyr Zhovnir, the director, said more than 600 children were being treated there when it was hit.

Doctors and others inside the hospital shared images of bloodstained hallways, collapsed ceilings and destroyed operating rooms.

Dr. Tymofii Dvorovyi, a surgeon, said he had managed to get his patients into the bomb shelter just before the strike. “I don’t know about other departments,” he said. “There were surgeons who were performing operations when the missile hit.”

After the explosion, he said, he saw scores of “badly injured” people staggering through the halls.

A two-story medical building next to the main hospital sustained the most extensive damage. Shortly after an explosion tore through it, a woman carrying a small child covered in dust and blood emerged near the entrance. More dazed and bloody staff, many carrying children, followed.

The explosion also blasted out the windows of the main hospital and sent shrapnel tearing into the building.

“Now, we are evacuating the patients to another hospital,” Dvorovyi said

Ukrainian Health Minister Viktor Lyashko said intensive care units, operating rooms and the oncology department had all sustained damage.

“Maybe Russians knew that families like us are an easy target,” said Melnyk, the mother whose child was being treated at the hospital. “I just can’t believe it’s happening.”

Today’s attacks began before dawn, when Russian bombers launched four X-101 cruise missiles and two Iskander-M ballistic missiles, the commander of the Ukrainian air force, Lt. Gen. Mykola Oleschuk, said in a statement. Three of the cruise missiles were shot down, he said, without offering details on those that evaded air defenses.

A few hours after that first strike, air alarms sounded across Ukraine as Russia launched the second, larger barrage, including the one that hit the hospital.

Three transformer substations were also destroyed in the barrage, according to DTEK, Ukraine’s largest private energy utility. All told, damage was reported in at least seven districts of the capital.

In an analysis provided to the Times after today’s attack, Janes, a British security intelligence firm, concluded: “Ukraine’s air defense network will have a harder time defending against saturation attacks until it is reinforced, or Ukraine gains the ability to consistently and accurately strike the assets Russia is using to launch these attacks.”

This article originally appeared in The New York Times.

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