OZDOK, Russia, Aug. 2, 2003 - Vera Khalitskaya's daughter-in-law, Yelena, lay buried today somewhere in the shattered wreckage of a military hospital here, along with perhaps 17 other people still missing, victims of the latest of the suicide bombings that have struck Russia over the spring and summer.

Her son, Vladimir, kept a vigil outside, fearing the worst, as cranes and backhoes clawed through the ruins of the hospital and soldiers formed bucket brigades atop a two-story heap of rubble. He said he was overwrought, in no position to speak. "Everything collapsed in one moment," said Mrs. Khalitskaya, who was watching Vladimir's and Yelena's 30-month-old son, Danil, at her home. "Our whole family."

On Friday, a suicide bomber drove a truck through a metal gate, swept past a heavily guarded checkpoint and detonated a bomb at the base of the hospital. Today, the toll of confirmed dead rose steadily, reaching 41 by tonight. At least 77 others were wounded, some of them gravely.

The attack increased the fear and anger across Russia, especially here in Mozdok, a city of 60,000 that has now endured two suicide attacks in less than two months. The city is just 35 miles from the Chechen border.

Friday's bombing - the eighth attack involving suicide bombers since mid-May and one of the deadliest - appeared to be part of a new campaign by Chechnya's separatist guerrillas to escalate the war and extend its violence beyond the southern republic's borders. The bombings - four in Chechnya itself, two in Moscow and two here - have killed more than 150 people and wounded scores more. They have continued in spite of - and some experts believe because of - a political effort begun by the Kremlin to end the war gradually; the effort has included a constitutional referendum that Chechens overwhelmingly approved in March.

Elections for a new president for the republic are now scheduled for Oct. 5, and President Vladimir V. Putin, making his first extensive remarks on the latest attack, said they would proceed. "The terrorists will be unable to impose their criminal will," he said in a telegram of condolence sent to the families of the victims, according to the Interfax news agency. "Their bloody, evil deeds will not stop the process of a political settlement and the restoration of normal peaceful life in Chechnya."

The bombings have also exposed the inability of Russian security forces to stop the attacks, though officials have reported thwarting some by seizing caches of explosive, including five "suicide belts" found on Moscow's outskirts last week.

Russia's defense minister, Sergei B. Ivanov, who visited the hospital's ruins today after being sent by Mr. Putin, suggested that troops guarding the hospital had violated security procedures, though he did not elaborate. A Russian intelligence official, standing outside the building, said the Russian Army's intelligence agency had warned of an attack in Mozdok on Aug. 1 or 2.

Tatyana V. Avilova, a nurse's aide who worked in a separate single-story clinic beside the hospital, said she had heard the truck plow through the gate and its engine roar as it accelerated toward the hospital before exploding. She said no guards had opened fire.

The force of the explosion - estimated to have been the equivalent of a ton of TNT - collapsed the ceiling above her, trapping doctors, nurses and patients alike. She had left the main hospital building only 10 minutes earlier.

What followed was chaos and helplessness. While soldiers helped rescue some of the wounded, there was little to do to save those trapped in the main hospital. Lt. Col. Aleksandr M. Koval, a spokesman for Russian Army forces based at the military outpost here, said today that only one survivor had been found in the wreckage alive.

The suicide attacks, practically unheard of just a year ago, are becoming a terrifying part of everyday life, and not only in Chechnya.

Thomas de Waal, an expert on Chechnya at the Institute for War and Peace Reporting in London, said in an interview today that the tactic appeared to reflect not only the radicalization of the Chechen rebels but also their fractionalization, with some groups adopting an extremist Islamic fundamentalism.

"As a mass phenomenon, this is definitely new," he said. "The idea of Chechen suicide bombers would have been unthinkable five or six years ago. It's transforming the war."

The radicalization of the tactics by some Chechen fighters appears to have only hardened the views of many Russians, from Mr. Putin to Colonel Koval, who called suicide bombers "scoundrels for whom there should be no place on earth."

In Mozdok, the latest bombing has stoked underlying suspicions of Chechens and has also raised fears that the suicide attacks mean that no place is safe, as well as a widely held resignation that there is little prospect that the war will end soon.

"Today it's here; tomorrow it's there; the day after tomorrow somewhere else," Anna M. Karapetyan, a pensioner, said today, articulating the anxiety felt by many here.

"Everyone is afraid," said Svetlana Bogachova, whose husband, Aleksandr, lay in bed at the city's main civilian hospital, his head wrapped in a crude gauze bandage. He was working in a cardboard factory next to the hospital. Two, perhaps three, of his colleagues died.

He said he was angry, but most of all, he said, "I feel helplessness."

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