The United States expressed on Tuesday its alarm by Syrian regime and Russian air strikes on northwestern Syria, saying they were a “reckless escalation” of violence.
“Indiscriminate attacks on civilians and public infrastructure such as schools, markets and hospitals is a reckless escalation of the conflict and is unacceptable,” said State Department spokeswoman Morgan Ortagus.
“The violence must end,” she said.
Regime air strikes, backed by Russia, have focused on the south of Idlib province and nearby parts of Hama, uprooting nearly 250,000 people.
The bombing has killed 229 civilians and injured 727 others, according to the UOSSM medical charity.
In the latest escalation, at least 21 civilians were killed as the regime intensified its bombardment of Idlib, said the Syrian Observatory for Human Rights.
Nine children were among the 21 killed in regime fire on several towns in Idlib province and the countryside of neighboring Aleppo, it added.
Strikes on a busy street in the village of Kafr Halab, on the western edge of Aleppo province, killed at least nine civilians.
An AFP photographer said the bodies of the victims were torn apart and several stores lining the side of the road were destroyed.
The street was crowded with people out and about before breaking the daytime fast observed by Muslims during the holy month of Ramadan.
A hospital in the Idlib town of Kafranbel was also hit by artillery shells, said David Swanson, a spokesman for the UN humanitarian office.
"The facility is reportedly out of service due to severe structural damage," he told AFP.
The hospital's administrative director Majed al-Akraa confirmed the attack.
"The hospital is completely out of service," he said.
The region is supposed to be protected from a massive regime offensive by a September buffer zone deal, but the opposition bastion has come under increasing bombardment by the regime and its ally Russia since late April.
The Observatory says nearly 280 civilians have been killed in the spike in violence since then.
More than 200,000 civilians have already been displaced by the upsurge of violence, according to the United Nations.
The UN has warned an all-out offensive on the region would lead to a humanitarian catastrophe for its nearly three million residents.
At least 20 health facilities have been hit by the escalation -- 19 of which remain out of service, the UN has said.
