An airstrike on a hospital in Yemen Tuesday killed seven people including four children, said a humanitarian group.

The global charity Save the Children, which supports the medical facility, is calling for a swift investigation into the incident and a suspension of arms sales to all parties to the conflict—including American arms-recipent Saudi Arabia.

“We are shocked and appalled by this outrageous attack,” said Carolyn Miles, President & CEO of Save the Children, in a statement. “Innocent children and health workers have lost their lives in what appears to been an indiscriminate attack on a hospital in a densely populated civilian area. Attacks like these are a breach of international law.”

“The Saudi-led coalition, which is backed by the United States, is the only party in the war using warplanes, mostly American and British-made fighter jets,” as the Washington Post noted. Moreover, “the United States helps the Saudi coalition warmakers choose their targets,” wrote peace activist and author Kathy Kelly.

According to Save the Children, the missile hit a gas station less than 50 yards from the Kitaf Hospital’s main entrance. Open for just 30 minutes when the bombing took place, the hospital was busy with staff and patients entering, said the aid group.

Miles said her agency is providing urgent aid to children who “have the right to be safe in their hospitals, schools, and homes. But time after time, we see a complete disregard by all warring parties in Yemen for the basic rules of war. Children must be protected. We must stop this war on children.”

The escalation in the conflict, which marked its four-year anniversary on Tuesday, has devastated infrastructure of the already impoverished country. It has been marked by attacks on civilian targets including medical facilities and a school bus, as well as accusations of war crimes. 

In a Twitter thread, Yemen researcher at human rights group Amnesty pointed out how medical facilities have been repeatedly attacked during the conflict, and said the latest strike “shows that after more than four years of devastating conflict, the coalition is unrepentant in its complete disregard for the laws of war.”

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