Donald Rumsfeld says the American attack on Baghdad is "as targeted an air campaign as has ever existed" but he should not try telling that to five-year-old Doha Suheil. She looked at me yesterday morning, drip feed attached to her nose, a deep frown over her small face as she tried vainly to move the left side of her body. The cruise missile that exploded close to her home in the Radwaniyeh suburb of Baghdad blasted shrapnel into her tiny legs ­ they were bound up with gauze ­ and, far more seriously, into her spine. Now she has lost all movement in her left leg.

Her mother bends over the bed and straightens her right leg which the little girl thrashes around outside the blanket. Somehow, Doha's mother thinks that if her child's two legs lie straight beside each other, her daughter will recover from her paralysis. She was the first of 101 patients brought to the Al-Mustansaniya College Hospital after America's blitz on the city began on Friday night. Seven other members of her family were wounded in the same cruise missile bombardment; the youngest, a one-year-old baby, was being breastfed by her mother at the time.

There is something sick, obscene about these hospital visits. We bomb. They suffer. Then we turn up and take pictures of their wounded children. The Iraqi minister of health decides to hold an insufferable press conference outside the wards to emphasise the "bestial" nature of the American attack. The Americans say that they don't intend to hurt children. And Doha Suheil looks at me and the doctors for reassurance, as if she will awake from this nightmare and move her left leg and feel no more pain.

So let's forget, for a moment, the cheap propaganda of the regime and the equally cheap moralising of Messrs Rumsfeld and Bush, and take a trip around the Al-Mustansaniya College Hospital. For the reality of war is ultimately not about military victory and defeat, or the lies about "coalition forces" which our "embedded" journalists are now peddling about an invasion involving only the Americans, the British and a handful of Australians. War, even when it has international legitimacy ­ which this war does not ­ is primarily about suffering.

Take 50-year-old Amel Hassan, a peasant woman with tattoos on her arms and legs but who now lies on her hospital bed with massive purple bruises on her shoulders ­ they are now twice their original size ­ who was on her way to visit her daughter when the first American missile struck Baghdad. "I was just getting out of the taxi when there was a big explosion and I fell down and found my blood everywhere," she told me. "It was on my arms, my legs, my chest." Amel Hassan still has multiple shrapnel wounds in her chest.

Her five-year-old daughter Wahed lies in the next bed, whimpering with pain. She had climbed out of the taxi first and was almost at her aunt's front door when the explosion cut her down. Her feet are still bleeding although the blood has clotted around her toes and is staunched by the bandages on her ankles and lower legs. Two little boys are in the next room. Sade Selim is 11; his brother Omar is 14. Both have shrapnel wounds to their legs and chest.

Isra Riad is in the third room with almost identical injuries, in her case shrapnel wounds to the legs as she ran in terror from her house into her garden as the blitz began. Imam Ali is 23 and has multiple shrapnel wounds in her abdomen and lower bowel. Najla Hussein Abbas still tries to cover her head with a black scarf but she cannot hide the purple wounds to her legs. Multiple shrapnel wounds. After a while, "multiple shrapnel wounds" sounds like a natural disease which, I suppose ­ among a people who have suffered more than 20 years of war ­ it is.

And all this, I asked myself yesterday, was all this for 11 September 2001? All this was to "strike back" at our attackers, albeit that Doha Suheil, Wahed Hassan and Imam Ali have nothing ­ absolutely nothing ­ to do with those crimes against humanity, any more than has the awful Saddam? Who decided, I wonder, that these children, these young women, should suffer for 11 September?

Wars repeat themselves. Always, when "we" come to visit those we have bombed, we have the same question. In Libya in 1986, I remember how American reporters would repeatedly cross-question the wounded: had they perhaps been hit by shrapnel from their own anti-aircraft fire? Again, in 1991, "we" asked the Iraqi wounded the same question. And yesterday, a doctor found himself asked by a British radio reporter – yes, you've guessed it – "Do you think, doctor, that some of these people could have been hit by Iraqi anti-aircraft fire?"

Should we laugh or cry at this? Should we always blame "them" for their own wounds? Certainly we should ask why those cruise missiles exploded where they did, at least 320 in Baghdad alone, courtesy of the USS Kitty Hawk.

Isra Riad came from Sayadiyeh where there is a big military barracks. Najla Abbas's home is in Risalleh where there are villas belonging to Saddam's family. The two small Selim brothers live in Shirta Khamse where there is a store house for military vehicles. But that's the whole problem. Targets are scattered across the city. The poor – and all the wounded I saw yesterday were poor – live in cheap, sometimes wooden houses that collapse under blast damage.

It is the same old story. If we make war – however much we blather on about our care for civilians – we are going to kill and maim the innocent.

Dr Habib Al-Hezai, whose FRCS was gained at Edinburgh University, counted 101 patients of the total 207 wounded in the raids in his hospital alone, of whom 85 were civilians – 20 of them women and six of them children – and 16 soldiers. A young man and a child of 12 had died under surgery. No one will say how many soldiers were killed during the actual attack.

Driving across Baghdad yesterday was an eerie experience. The targets were indeed carefully selected even though their destruction inevitably struck the innocent. There was one presidential palace I saw with 40ft high statues of the Arab warrior Salaheddin in each corner – the face of each was, of course, that of Saddam – and, neatly in between, a great black hole gouged into the façade of the building. The ministry of air weapons production was pulverised, a massive heap of pre-stressed concrete and rubble.

But outside, at the gate, there were two sandbag emplacements with smartly dressed Iraqi soldiers, rifles over the parapet, still ready to defend their ministry from the enemy which had already destroyed it.

The morning traffic built up on the roads beside the Tigris. No driver looked too hard at the Republican Palace on the other side of the river nor the smouldering ministry of armaments procurement. They burned for 12 hours after the first missile strikes. It was as if burning palaces and blazing ministries and piles of smoking rubble were a normal part of daily Baghdad life. But then again, no one under the present regime would want to spend too long looking at such things, would they?

And Iraqis have noticed what all this means. In 1991, the Americans struck the refineries, the electricity grid, the water pipes, communications. But yesterday, Baghdad could still function. The landline telephones worked; the internet operated; the electrical power was at full capacity; the bridges over the Tigris remained unbombed. Because, of course, when – "if" is still a sensitive phrase these days – the Americans get here, they will need a working communications system, electricity, transport. What has been spared is not a gift to the Iraqi people: it is for the benefit of Iraq's supposed new masters.

The Iraq daily newspaper emerged yesterday with an edition of just four pages, a clutch of articles on the "steadfastness" of the nation – steadfastness in Arabic is soummoud, the same name as the missile that Iraq partially destroyed before Bush forced the UN inspectors to leave by going to war – and a headline which read "President: Victory will come [sic] in Iraqi hands".

Again, there has been no attempt by the US to destroy the television facilities because they presumably want to use them on arrival. During the bombing on Friday night, an Iraqi general appeared live on television to reassure the nation of victory. As he spoke, the blast waves from cruise missile explosions blew in the curtains behind him and shook the television camera.

So where does all this lead us? In the early hours of yesterday morning, I looked across the Tigris at the funeral pyre of the Republican Palace and the colonnaded ministry beside it. There were beacons of fire across Baghdad and the sky was lowering with smoke, the buttressed, rampart-like palace – sheets of flame soaring from its walls – looked like a medieval castle ablaze; Tsesiphon destroyed, Mesopotamia at the moment of its destruction as it has been seen for many times over so many thousands of years.

Xenophon struck south of here, Alexander to the north. The Mongols sacked Baghdad. The caliphs came. And then the Ottomans and then the British. All departed. Now come the Americans. It's not about legitimacy. It's about something much more seductive, something Saddam himself understands all too well, a special kind of power, the same power that every conqueror of Iraq wished to demonstrate as he smashed his way into the land of this ancient civilisation.

Yesterday afternoon the Iraqis lit massive fires of oil around the city of Baghdad in the hope of misleading the guidance system of the cruise missiles. Smoke against computers. The air-raid sirens began to howl again just after 3.20pm London time, followed by the utterly predictable sound of explosions.