KYIV, Ukraine — A major Russian missile attack across Ukraine on Monday killed at least 31 people and injured 154, officials said, with one striking a large children’s hospital in the capital of Kyiv, where emergency crews searched the rubble for victims.

The daytime barrage targeted five Ukrainian cities with more than 40 missiles of different types hitting apartment buildings and public infrastructure, President Volodymyr Zelenskyy said on social media. Ukraine’s air force said it intercepted 30 missiles.

Strikes in Kryvyi Rih, Zelenskyy’s birthplace in central Ukraine, killed 10 people and injured 47 in what the head of city administration, Oleksandr Vilkul, said was a massive missile attack. Seven people were killed in Kyiv, authorities said.

“It is very important that the world should not be silent about it now and that everyone should see what Russia is and what it is doing,” Zelenskyy said on social media.

Western leaders who have backed Ukraine will hold a three-day NATO summit in Washington beginning Tuesday to look at how they can reassure Kyiv of the alliance’s unwavering support and offer Ukrainians hope that their country can come through Europe’s biggest conflict since World War II.

Zelenskyy said during a visit to Poland he hopes the summit will provide more air defense systems for Ukraine.

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Children’s Hospital in Kyiv Hit

At the Okhmatdyt children’s hospital in Kyiv, rescuers searched for victims under the rubble of a partially collapsed, two-story wing of the facility. Mayor Vitali Klitschko said at least 16 people, seven of them children, were injured.

On the hospital’s main 10-story building, windows and doors were blown out and walls were blackened. Blood spattered the floor in one room. The intensive care unit, operating theaters and oncology departments all were damaged, officials said.

Rescuers searched for children and medical workers in the rubble. Volunteers formed a line, passing bricks and other debris to each other. Smoke still rose from the building, and volunteers and emergency crews worked in protective masks.

The attack forced the evacuation of the hospital and its temporary closure. Some mothers carried their children away on their backs, while others waited in the courtyard with their children as calls to doctors’ phones rang unanswered.

A few hours after the initial strike, another air raid siren sent many of them hurrying to the hospital’s shelter. Led by a flashlight through the shelter’s dark corridors, mothers carried their bandaged children in their arms and medical workers carried them on gurneys. Volunteers handed out candy to try to calm the children.

Marina Ploskonos said her 4-year-old son had spinal surgery Friday.

“My child is terrified,” she said. “This shouldn’t be happening, it’s a children’s hospital,” she said, bursting into tears.

Ukraine’s Security Service said it found wreckage from a Russian Kh-101 cruise missile at the site and had opened proceedings on war crime charges. The Kh-101 is an air-launched missile that flies low to avoid detection by radar. Ukraine said it shot down 11 of 13 Kh-101 missiles launched Monday.

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Czech President Petr Pavel said the hospital attack was “inexcusable” and that he expected to see at the NATO summit a consensus that Russia was “the biggest threat for which we must be thoroughly prepared.”

The U.N. humanitarian coordinator for Ukraine, Denise Brown, said striking children was “unconscionable.”

“Under international humanitarian law, hospitals have special protection,” she said in a statement.

Russia’s Defense Ministry said the strikes targeted Ukrainian defense plants and military air bases and were successful. It denied aiming at any civilian facilities and claimed without evidence that pictures from Kyiv indicated the damage was caused by a Ukrainian air defense missile.

Since early in the war that is well into its third year, Russian officials have regularly claimed that Moscow’s forces never attack civilian infrastructure in Ukraine, despite what officials in Kyiv say as well as Associated Press reporting.

Col. Yurii Ignat of the Ukrainian air force said Russia has been improving the effectiveness of its airstrikes, equipping its missiles with enhancements including so-called heat traps that deflect air defense systems.

In Monday’s attack, the cruise missiles flew at low altitudes — up to 50 meters (160 feet) off the ground — making them harder to hit, he said in comments sent to AP.

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Elsewhere in Kyiv, where seven of the city’s 10 districts saw the heaviest Russian bombardment of the capital in almost four months, the strikes killed seven people and injured 25, officials said.

About three hours after the first strikes, more missiles hit Kyiv and partially destroyed a private medical center. Four people were killed there, Ukraine’s Emergency Service said.

In the capital’s Shevchenkivskyi district, a three-story section of a residential building was destroyed. Emergency crews searched for casualties, and AP reporters saw them remove three bodies.

The powerful blast wave scorched nearby buildings, shattered windows and flung a dog into a neighboring yard, resident Halina Sichievka said.

“Now we don’t have anything in our apartment, no windows, no doors, nothing. Nothing at all,” the 28-year-old said.

The Kinzhal hypersonic missiles used in the attack are among the most advanced Russian weapons, Ukraine’s air force said, flying at 10 times the speed of sound and making it hard to intercept.

City buildings shook from the blasts. Three electricity substations were damaged or destroyed in two districts of Kyiv, energy company DTEK said.