Kyiv, Ukraine – Earth-shattering blasts shook Oleksandra’s apartment building on Monday morning, sending dagger-like shards of glass flying around.

Hours later, she is still shaking, but it is not the damage to her two-bedroom apartment that shocked her.

“We can always have the windows replaced,” she told Al Jazeera, clutching a cigarette and sitting next to her elderly father on a bench near the building in central Kyiv.

It was the damage done to Okhmatdyt, Ukraine’s largest children’s hospital, a sprawling complex that is just metres away from her apartment.

Thousands of children, including those with cancer, undergo treatment at the hospital every year.

A Russian hypersonic missile struck the complex on Monday morning, hitting a two-storey toxicology department where children undergo dialysis, officials said.

The building’s roof collapsed, killing at least two hospital workers. One victim is understood to have been a doctor. At least 16 people were wounded, including seven children, officials said.

“I am feeling so down,” Oleksandra said, pointing at the hospital as it was still surrounded by a cloud of dust as bulldozers removed the debris.

“They saved my son there two years ago, and now I see this,” she said as dozens of volunteers rushed around, handing out bottled water, food and fruit to the children from pick-up trucks and buses.

“They are children, just little ones. We see them every day. Some have cancer,” she said.

The hospital attack was part of a Russian barrage.

Moscow launched three dozen missiles on several Ukrainian cities. At the time of writing, at least 36 people were reported to have been killed and 125 wounded, but the toll is expected to rise.

“There are still some children trapped under the debris,” a rescue worker told Al Jazeera four hours after the strike.

But a police officer signalled him to stop talking and told this reporter: “Everyone is alive and well. Please stay away.”

Russia denies responsibility

Russia habitually denies targeting civilian infrastructure. It claimed the hospital was hit by a Ukrainian air defence missile.

“The statements by the regime in Kyiv about Russia’s allegedly deliberate missile strike on civilian sites are absolutely unreal,” the Russian Ministry of Defence said in a statement.

“Multiple photos and video footage from Kyiv undoubtedly confirm the fact of destruction due to the fall of a Ukrainian air defence missile launched within the city limits,” it said.

But military analysts are adamant that the attack on Okhmatdyt was deliberate.

They used the “whole spectre” of missiles backed by Iranian-made Shaheed drones and “struck during daytime to exert moral and psychological pressure”, said Lieutenant General Ihor Romanenko, former deputy head of the General Staff of the Ukrainian Armed Forces.

“They struck Okhmatdyt to hit a nerve, so that Ukrainians, Kyivans get emotional and pressure their” leaders to agree with a Kremlin-proposed plan that would force Ukraine to recognise Moscow-occupied parts of Ukraine and Crimea as parts of Russia, he told Al Jazeera.

Ukrainians who have lived through years of bombardment agree that the assault was no mistake.

“Those were hits, not midair collisions” with air defence missiles, said Serhiy, a construction engineer who witnessed hits on the Artyom military plant, which is about a kilometre away (0.6 miles) from the Okhmatdyt hospital.

“The intervals between them were equal – one, two, three, four. I have seen and heard enough of them,” Serhiy told Al Jazeera. He is a native of the eastern city of Donetsk, which was taken over by separatists in 2014.

Like many Ukrainians, he is used to the strikes and the war in general.

“I have no feelings left,” he said.

He was not able to attend his mother’s funeral in Donetsk last year because a trip to the separatist-held city would have become a “one-way ticket”, he said.

The Artyom plant once produced missiles and other weaponry for Ukraine’s air forces.

It has been hit multiple times since the full-scale Russian invasion began in 2022, even though most of its manufacturing has been relocated and only a handful of staffers worked in the building.

“I should have run,” one of them told Al Jazeera on condition of anonymity, sitting in the shadow of an Orthodox Christian chapel across the street from the plant.

“Everything was flying around – sketches, papers, things,” he said, pointing at the building where firefighters were putting out a fire that was sending up two huge plumes of black smoke that were seen all over Kyiv.

He said at least one of his colleagues was killed.

Russia’s missiles ‘harder to identify and destroy’

Minutes later, a second air raid alert sent rescue workers, police officers and civilians to an underground passage.

Even though advanced Western air defence systems protect Kyiv from most of the Russian missiles and drones, Moscow keeps “improving” its bombardment tactics, Ukraine’s air force spokesman said.

Russia’s missiles are “harder to identify and destroy,” Yuri Ihnat wrote on Facebook.

He said that on Monday, the missiles were flying at “super-low altitudes” of merely 50 metres (165ft) above ground to avoid detection and interception.

For many in Ukraine, the hospital bombing epitomises Russia’s ruthlessness. Civilian sites, including schools, hospitals, railway stations and bomb shelters, have been struck throughout the war, now in its third year.

“We must hold Russia accountable for its acts of terror and [Russian President Vladimir] Putin for ordering the strikes,” Ukrainian President Volodymyr Zelenskyy said in a post on X.

“Every time there are attempts to discuss peace with [Putin], Russia responds with attacks on homes and hospitals,” he said, adding that Kyiv is initiating an emergency meeting of the United Nations Security Council to discuss the bombing.