Firefighters arrived at a Moscow drug clinic within minutes of getting an overnight emergency call.
They evacuated Hospital 17, in the south-west of the city, but were unable to help 45 people, already dead.
The all-women victims on the second floor of the clinic, which treats drug addicts, had been overcome by smoke.
The victims were trapped between the fire at one end of their corridor and a locked gate at the exit at the other end.
With daylight, people who knew the victims began coming to the hospital.
As the full horror of the fire dawned, people wept openly among the emergency vehicles.
Psychologists from the emergencies ministry tried to comfort the bereaved.
Many of the victims were women below the age of 35 being treated for addiction.
It was one of the worst fires in years to hit Moscow.
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