KYIV, Ukraine (AP) 鈥 The sky was crystal clear as Oksana Femeniuk took her daughter to Ukraine鈥檚 largest children鈥檚 hospital for routine dialysis.
Around 10 a.m, . Sixteen-year old Solomiia was undergoing the treatment that required her to sit still for up to five hours and could not be interrupted. Her mother had to flee to the hospital's basement shelter without her.
Hurtling toward them at 700-800 kilometers (435-497 miles) per hour was a Russian Kh-101 cruise missile, according to Ukraine鈥檚 security service, the United Nations and open-source investigators. Using painstaking trial and error, Russia has modified the weapon over the last year to defeat Ukraine鈥檚 air defense systems by flying at low altititude and hugging terrain, according to military analysts.
Minutes later the world turned black. Neither the patient nor her mother would remember the moment the missile struck. But they remember the chaos that ensued after regaining consciousness: Femeniuk thought she would choke from the fumes. Solomiia woke to find the ceiling crumpled over her small body.
In an operating room in the next building, pediatric surgeon Oleh Holubchenko had been preparing to operate on an infant with a congenital facial defect. Covered in shrapnel wounds, he realized that the blast wave had catapulted him to the other side of the operating room.
The toll of Russia鈥檚 heaviest bombardment of Kyiv in almost four months 鈥 one of the deadliest of the war 鈥 shows the devastating human cost of Russia鈥檚 improved targeting tactics.
The hospital鈥檚 director general, Volodymyr Zhovnir, stood at the scene of the explosion, eclipsed by the towering building with shattered windows. No children died, thank God, he said, but they lost a dear colleague, Dr. Svitlana Lukianchuk.
Lukianchuk was hurrying along the children and parents from the toxicology building, which would later be destroyed, to the shelter. She returned to empty out more rooms. And then, the explosion, Femeniuk remembers.
Solomiia was born with chronic renal failure, making hemodialysis part of her life.
After the full-scale invasion, Femeniuk left her three children and husband behind in the small village near Rivne, in western Ukraine, to live in the capital so the girl could access the treatment she needs.
Leaving her daughter during the air raid was a difficult decision. But the 34-year old mother had to project strength, she said. Her daughter was being brave by staying, knowing she could not interrupt her treatment. Femeniuk could not reveal to her daughter that she was actually terrified.
As the air-raid siren blared, the girl was on her phone watching videos. Given how long dialysis can take, she tends to get bored.
She awoke to find the ceiling in front of her eyes and the head doctor tending to her covered in blood and on her knees.
The girl's first impulse was to put her hands up to the ceiling to keep tons of concrete and debris from crushing her small body. She was trapped with a few other patients and hospital staff, and they were safely pulled out of the rubble.
鈥淭he first thing I thought about was my mom, if she is alive or not. Then I thought: 鈥楢m I alive or not?鈥欌 she said, her fingers painted with small flowers, fidgeting as she spoke. Mother and daughter recounted their experience from the Kyiv City Children鈥檚 Clinical Hospital, where Solomiia was transferred.
In the shelter, the exit was blocked and the fire blazing outside soon invaded the small space. Femeniuk called her husband, telling him she didn鈥檛 know if she would survive and she didn鈥檛 know if Solomiia was still alive.
Eventually, those taking shelter managed to push their way out and to their horror they realized that the very building they had been in, that some of their children had been in, was hit. Femeniuk began picking up pieces of rubble in panic, calling out her daughter鈥檚 name. Then she saw the nurse who had been assisting them, covered in blood.
Solomiia had been evacuated after the blast, the nurse said. She was safe.
Meanwhile, in the operating room, it took Holubchenko fifteen minutes to realize that he was covered in shrapnel wounds. The doctor was too busy evacuating patients, starting with the 5-month old whose surgery was eventually completed elsewhere.
鈥淢y colleagues and I who were in the operating room received shrapnel wounds to the body, the face, back, arms and legs,鈥 he said. 鈥淭here are glass windows in the operating room, the doors. All of it was just blown off, all destroyed.鈥
In the hospital ward, he looked out to the street from a shattered window.
鈥淭here used to be a wall here,鈥 he said.
When he went outside and realized the toxicology building had collapsed, his mind reverted to the times he would have consultations with patients there and check-ups. Now half the building was caved in.
But he didn鈥檛 dwell on the thought for long and joined a line of volunteers, health workers and emergency crews removing debris, piece by piece.
鈥淓veryone wanted to do something,鈥 he said.
The assault hit seven of the city鈥檚 10 districts. The strike on the Okhmatdyt children鈥檚 hospital, where 627 children were being cared for at the time, drew ire from Ukrainian officials and the international community. Two adults were killed, including a female doctor, and 50 were injured.
Russia denied responsibility for the hospital strike, insisting it doesn鈥檛 attack civilian targets in Ukraine despite abundant evidence to the contrary, including AP reporting. Moscow insisted it was a Ukrainian air defense missile that struck the hospital.
Artem Starosiek, the founder of the Ukainian group Molfar, which analyzes events based on open-source evidence, said there were overwhelming signs of Russia鈥檚 culpability. The missile used in the attack bears the characteristics of the Kh-101, he said, pointing to the shape of the body, tail and location of the wings, he said.
That it was a clear blue day also played an important role, he said. Launching the modified missile during a sunny day is optimal for the weapon鈥檚 optoelectronic system to recognize the target correctly, he said.
鈥淭he force of the warhead鈥檚 explosion is important; an air-defense missile could not have caused such consequences,鈥 he said.
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Associated Press journalist Volodymyr Yurchuk contributed.
