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If bombing a children's hospital isn't crossing a red line -- what is?

Editor's Note: (Michael Bociurkiw (@WorldAffairsPro) is a global affairs analyst. He is a senior fellow at the Atlantic Council and a former spokesperson for the Organization for Security and Cooperation in Europe. He is a regular contributor to CNN Opinion. The opinions expressed in this commentary are his own. View more opinion at CNN.)

Lviv, Ukraine(CNN) In wartime, the mind plays strange tricks. On Wednesday evening in Lviv, I was jolted awake by what I thought were nearby explosions. Instead, news alerts on my phone lit up with the unimaginable horror unfolding in the southern Ukrainian port city of Mariupol.

Michael Bociurkiw

A bomb had struck a hospital, destroying the maternity and children's wards. Grainy images and video showed an Armageddon-like scene: vehicles on fire, the outside grounds singed and a crater large enough to accommodate two men head to toe. A dazed, bloodstained, pregnant woman was being led out by rescue workers.

Three people died in the strike and more than a dozen were injured -- among them children, women and doctors. I think back to 2014, when another missile strike, that time fired by Russian-backed separatists in Donetsk, struck buildings and playgrounds in Mariupol, killing at least 30 people and injuring 102. The faces of the traumatized children we visited afterwards, flash through my mind again.

I've worked in many complex humanitarian emergencies before, but this is different for me. These are my people being injured and killed. I watch as large swaths of the land of my ancestors, introduced to me in childhood through Ukrainian folk songs and poems as a bucolic land of freedom fighters and brave dissidents, is being transformed into killing fields. No wonder my dreams keep me in a captive state of despair.

Two weeks into the war, scenes of carnage like that of the Mariupol hospital have become part of the daily horror for Ukrainians that can't be switched off.

And as of Wednesday, the United Nations said that the civilian death toll after 13 days of violence in Ukraine stood at 516. Of these, 37 are children. More than 900 people are reported wounded.

Ukrainian emergency workers carry an injured pregnant woman from the damaged maternity hospital in Mariupol, Ukraine, on Wednesday.

The situation in Ukraine is growing increasingly dire and Western countries need to do more instead of waiting for conditions to continue deteriorating. While the US and NATO should be careful to avoid escalating the war, world leaders should also be preparing for worst-case scenarios and setting non-negotiables to rein Putin in. The indiscriminate shelling of what are meant to be safe havens for women and children needs to be established as a red line no thuggish regime should be allowed to cross.

Russian forces have already bombed what were meant to be protected humanitarian corridors and launched strikes at one of Europe's largest nuclear power plants in Zaporizhzhia, according to Ukrainian officials. They also used banned weapons such as cluster bombs, NATO Secretary General Jans Stoltenberg said Friday. After all this, I have to ask: what more do Putin's forces need to do to jolt the world's conscience into action? And if Ukrainian officials' report of the bombing of a maternity and children's hospital doesn't do it -- is there any red line that could?

We have seen before, moments in war that cut through to people beyond a nation's ravaged borders. Images so awful that they sear into the global public consciousness -- and sometimes even force action from lawmakers. Like the image of drowned toddler, 3-year-old Alan Kurdi after he was photographed face down on a Turkish beach in 2015, that triggered worldwide anguish and condemnation. And helped prompt then-Chancellor Angela Merkel to open Germany's doors to a million Syrian refugees.

What of the images emerging from Mariupol in 2022? On Thursday, the International Committee of the Red Cross warned that "hundreds of thousands of people have no food, water, heat, electricity, or medical care." But perhaps the world has become numb to Putin's familiar tactics: demoralize a population by killing and wounding ordinary people, a strategy also used in Syria and Chechnya. While there is a multinational effort to provide weapons to Ukraine, Western leaders still seem to be repeating the same bullet points of condemnation, sanctions, embargoes and broad platitudes instead of setting down new red lines for the Kremlin.

In France, government spokesperson Gabriel Attal called Wednesday's strike "inhumane," "unjustifiable" and "cowardly." Not to be outdone, Canadian Deputy Prime Minister Chrystia Freeland, who is in Europe with her boss Justin Trudeau who has come under criticism for waiting to send lethal weaponry to Ukraine, said: "We have a very good understanding of what the Ukrainians need."

But speak to ordinary Ukrainians and they are quickly coming to the conclusion that what they need is more than words. There is a sense here that they are in this fight alone -- forget about NATO delivering zakryty nebo (closed air space) or even facilitating the transfer of Polish MiG fighter jets to the Ukrainian Armed Forces. Many say to me: 'We are willing to die for our country but why are we paying the ultimate price with the lives of our men, women and even children, in order to protect European security?'

The desperation has come to the point where one Kyiv mother, Oksana, who endured a harrowing 47-hour journey to a safe haven in western Ukraine texted me for help in evacuating her only son to the West. She wrote: "I am very horrified and I am in despair right now. I have no peace. I cry every hour of every day. I am very tired. I have lost the meaning of life. I beg you for help."

An Odessa mother, Katerina, tells me that while offers of western resettlement by countries such as Canada and the United Kingdom are welcome, it just isn't a viable option for her. "I held on all these days and today I can't stop crying. There is chaos in my head and I don't know how to live on. This is my home. I look around me and don't know how I can leave it all ... all my friends are at war now. If I leave, I will betray them ... like I gave up and don't believe in them."

John Shmorhun of the Ukrainian Education Platform, which helps resettle vulnerable women and children in safe havens in western Ukraine, told me that with violence escalating, desperate families in the east are being forced to make heart-wrenching decisions to send their young children on risky evacuation convoys to the West. Some two weeks into the war, the scale of the dislocation is immense.

The path out of this is unclear. Even though sanctions and embargoes are biting Russia -- to the point that the oligarchs in Mr Putin's circle may be forced to vacation in places like North Korea or the resort built by the Chinese on artificial islands in the contested South China Sea -- history shows Putin is not one to keep his promises on any substantive issue. In some cases, his regime is deliberately lying, in order to buy him time do the exact opposite.

Russian forces have repeatedly struck civilian escape corridors, according to Ukrainian officials, in what appears to be an effort to terrorize and obliterate Ukrainian civilians.

Indeed, in response to the strike on the Mariupol hospital, Russian Foreign Ministry spokesperson Maria Zakharova claimed — without providing evidence — that Ukrainian forces had "equipped combat positions" within the hospital.

Western leaders will only be spurred into action -- and help unify Europe on dealing with Russia -- when they realize that once Putin achieves his military goals in Ukraine, he will go further. Indeed many in neighboring countries are nervously watching his next move.

Putin has no apparent exit ramp now and seems to be daring NATO to enter the war with such statements that sanctions are equivalent to a declaration of war. As Latvian Defense Minister Artis Pabriks points out, "If ... the Kremlin would like to fight a war against NATO or Europe, they could always find a reason."

Hence, officials at NATO should at least psychologically prepare for a direct confrontation with Putin. Preparing for the worst is preferable to being forced to do so later on Putin's terms.

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