Blast Razes Russian Hospital

A suicide bomber driving a truck rigged with explosives blasted a Russian military hospital near separatist Chechnya on Friday, killing at least 29 people amid a fresh upsurge of violence in the region, authorities said.

Hundreds more were reported wounded, scores seriously, in the attack in Mozdok in the Russian republic of North Ossetia, an area used as a base for Russian forces fighting in Chechnya. Rescuers were still searching for about 13 people in the rubble, emergency officials said.

No one claimed responsibility for the attack, but suspicion immediately fell on Chechen rebels.

“A Kamaz truck rammed through the gate and exploded in the direct vicinity of the main building, killing and injuring dozens of patients and medical personnel,” Mozdok Vice Mayor Svetlana Lotiyeva said by telephone. “What used to be a hospital is now a terrifying sight that makes one’s hair stand on end.

“And it is hard to say what the final death toll will be.... All that’s left of the four-story building are two of its walls.”

The blast left a 15-foot-deep pit in the ground, Lotiyeva said.

About 300 people, mostly soldiers, were reported injured. Ninety-eight patients, plus medical personnel, were in the hospital at the time of the explosion, authorities said.

Many local residents suffered light injuries from shards of flying glass.

Authorities estimated the explosives used to be equivalent to a ton of TNT.

Separatist guerrillas attacked a Russian troop convoy in the Chechen city of Argun overnight Thursday, in an ambush that left a local policeman, a Russian soldier and five to 10 rebels dead. An additional 33 rebels were killed in three clashes Wednesday and Thursday in Chechnya that left at least two Russian soldiers dead, authorities said.

Friday’s attack fueled fears that war in Chechnya will spread through the Caucasus region.

“North Ossetia and Ingushetia are already on fire and destabilized. Dagestan is on the brink of exploding. The war in Chechnya is creeping all over the North Caucasus,” said Liliya Shevtsova, an analyst at the Moscow Carnegie Center. “This is an extremely alarming tendency.”

The latest fighting comes after a series of suicide bombings -- mainly carried out by women -- that have killed at least 123 people since May 12. Two of those attacks were in Chechnya, one was in North Ossetia, and one was at a rock concert in Moscow.

The intensified struggle coincides with the run-up to the presidential election set for Oct. 5 in Chechnya, a vote engineered by Russian President Vladimir V. Putin in an effort to entrench a pro-Moscow Chechen government with enough legitimacy to stand up against separatist forces. Akhmad Kadyrov, the current Kremlin-appointed head of the Chechen administration, is expected to be a leading candidate.

Guerrillas appear determined to disrupt the balloting. Putin -- trying to portray a situation of greater normality -- has repeatedly declared military victory and proclaimed that nothing is left but mopping-up operations against terrorists and bandits.

Putin rode to power with a tough stance on Chechnya. Now, as he faces a campaign for reelection next March, his interest lies in portraying his policies as largely successful.

Putin’s press service said Friday that he had expressed deep condolences to relatives of the dead. He also ordered an Emergency Situations Ministry plane to carry rescue workers and equipment to Mozdok and instructed Defense Minister Sergei B. Ivanov to head to the scene, the press service said.

Ella Pamfilova, chairwoman of a presidential human rights commission, told the Russian news agency Interfax that “obviously there are bandits and mercenaries behind this attack.”

“They are trying to disrupt the peace process in Chechnya, to disrupt the upcoming presidential and parliamentary elections in the republic, and to disrupt the possibility of a peaceful life,” she said. “Those who organized the terrorist act in Mozdok are monsters -- nothing can stop them, nor do they care for people’s lives. They are trying to look like separatists and liberators, but they are actually trying to profit from other people’s deaths.”

Chechens exercised self-rule after defeating Russian troops in a 1994-96 war, but Russian forces returned in 1999 and have been fighting pro-independence guerrillas ever since. International human rights groups have repeatedly said that abuses by Russian forces in Chechnya are one cause of the resentment and anger among Chechens that has fueled the conflict.

“What is happening in Chechnya really is a civil war, pure and simple,” Shevtsova said.

“The intensification of hostilities that can be seen lately in and around Chechnya is undoubtedly connected with the coming presidential elections in the republic,” she added. “By staging acts of terror like the one in Mozdok ... prominent field commanders are sending a message to the Kremlin: ‘You say everything is back to normal, you are thinking about holding elections in Chechnya, you think that the situation is stable? You are wrong! And we will get you not only here, but we will get you as far as Moscow.’ ”

Alexander I. Zhilin, an independent military analyst in Moscow, said political forces in Chechnya are so fragmented that bringing peace to the region has become more difficult than ever.

“There are too many opposing forces and too many opposing interests, and everyone wants to fish in these muddy waters,” he said. “If things continue to look as bad as they look now, President Putin will not have much left but to introduce direct presidential rule in Chechnya -- and rule with the help of tough measures.”

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Alexei V. Kuznetsov of The Times’ Moscow Bureau contributed to this report.