Rubble, glass and blood stains: Aftermath of Karabakh hospital bombing

Shattered window panes, doors ripped off their hinges and a caved-in roof is all that remains of one building in the military hospital complex in the mountainous Nagorno-Karabakh region after recent shelling.

The medical facility was struck this week as part of fierce clashes between Armenian separatists and Azerbaijan forces over the disputed province that erupted late last month.

Witnesses said rockets and cluster bombs hit the hospital near the mostly-abandoned northeast village of Martakert late on Wednesday, ripping through buildings and leaving behind deep craters.

They said the strikes hit just as some wounded soldiers were arriving from the frontlines some 10 kilometres (6 miles).

Gevorg Tadevosyan, who left his work as a doctor in the Armenian capital Yerevan to join the fighting, walks through the main hospital building gesturing to blasted out windows and blood stains on the walls.

"The warning siren started. Some managed to run to the basement, but those who were outside were wounded," said the 31-year-old, wearing camouflage and with a Kalashnikov assault rifle slung over his shoulder.

A blaze that ignited in the shelling left behind the burnt-out shells of several cars and vans in the hospital parking lot, now coated in a layer of dust and dotted with chunks of rubble and glass shards.

Two blood-stained stretchers were left outside, AFP journalists at the hospital witnessed.

"Everyone was wounded," recounted Victor Minasyan, surveying the damage the day after the strike.

"Luckily, I avoided serious injuries," he said, despite visible blood stains on the white bandage around his head.

The 36-year-old driver said he was helping to carry in the newly arrived wounded soldiers when the explosions hit, sending his sense of reality spiralling.

"When I regained consciousness, someone was screaming there, another over there," he said.

It was impossible to say how many people were injured in the attack or the number of soldiers being treated in the facility when it was struck, he added.

After the bombardment "we quickly transferred the wounded elsewhere", says Tadevosyan, the doctor and military volunteer who felt compelled to return to his village to defend it when fighting started.

A day later, the abandoned complex was eerily quiet, with just a few cots remaining in emptied wards and several mattresses left on the basement floor.

AFP journalists heard distant echoes of artillery near the hospital, with heavier explosions later sounding from the direction of Azerbaijan.

Karlen Aghabekyan, who lives in one of the small villages near the hospital, described Wednesday's attack as the worst yet since fighting started nearly three weeks ago.

While showing the damage inflicted on his neighbour's house several hundred metres from the hospital, the 56-year-old estimated that one cluster bomb that hit the area led to dozens more explosions.

"First the house burned down, then the fire spread to the nearby shed," he said, shaking his head.

Wearing a beige waistcoat, and carrying an ageing Kalashnikov machine gun, he concedes: "We couldn't put it out".

Several wooden beams were still smouldering in the yard of his neighbour's house, and Aghabekyan paused wearily after locking the gates as explosions sounded in the distance.

"It was the most intensive bombardment we have had in the village," he said.