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A Russian airstrike on a maternity and children’s hospital in Mariupol killed civilians on Wednesday. The attack came despite the recent agreement to pause warfare in certain areas to allow civilians to flee through humanitarian corridors. 

The direct strike killed three people, including one child, and left at least 17 people injured, including doctors, nurses, young patients, and women waiting to give birth. Mariupol, a city in southeastern Ukraine, has been besieged by Russian forces for days; hospitals like the one targeted in the strike had been using their basements as simultaneous shelters and wards

The Mariupol city council told the BBC the strike had caused “colossal damage.” Deputy Mayor Serhiy Orlov also expressed disbelief to the news outlet, saying “we don’t understand how it’s possible in modern life to bomb a children’s hospital. People cannot believe that it’s true.”

“Direct strike of Russian troops at the maternity hospital.  People, children are under the wreckage, ” tweeted Ukrainian President Volodymyr Zelenskyy alongside a video from inside the wreckage of the hospital. The footage shows debris and broken glass, with bits of wall and roof falling in on itself. 

[Related: Ukraine’s answer to Russian tanks involves a classic tactic: metal ‘hedgehogs’]

In a video address spoken in Russian, Zelensky labeled the attack a war crime. Speaking at a press conference in Warsaw, Poland, Vice President Kamala Harris also expressed support for an international war crimes investigation of Russia, citing the bombing of the hospital. The United Nations Human Rights Council has already approved an investigation. The rules of war, per the Geneva Convention, state that “the sick and wounded have a right to be cared for, regardless of whose side they are on,” and “medical workers, medical vehicles and hospitals dedicated to humanitarian work can not be attacked.”

Russian Foreign Minister Sergey Lavrov said that any outcry about civilian casualties are “pathetic shrieks,” according to reporting by the AP. He claimed that the Mariupol hospital was a base for far-right radical fighters, but there’s no evidence to support that: Photos and videos in the aftermath of the airstrike show medical staff, pregnant women, and children on site.

The World Health Organization has confirmed 18 attacks on health care facilities in Ukraine since the war began on February 24.

Electricity, water, and sewage lines have been cut in Mariupol, so “it’s like medieval times,” Orlov told NPR. People are melting snow for water and cooking over open fires. Orlov added that about 1,200 civilians in Mariupol have died in the past two weeks, and that the city has been forced to use mass graves to dispose of the bodies.