Russian and regime airstrikes 'force hospital closures' in northwest Syria: MSF

The raids in the Idlib region and northern Hama have intensified since they began on September 19, and hospitals are closing either after being hit or for fear of being targeted, MSF said in a statement.

After several months of calm, rebel-controlled Idlib province has been the target of heavy airstrikes by the regime and its Russian allies following a rebel assault in Hama province.

The Britain-based Syrian Observatory for Human Rights said strikes continued across Idlib throughout Friday and into the night, killing at least 24 civilians including seven children and wounding dozens.

The monitor, which gathers information from sources on the ground in Syria, said the death toll could rise even further because the strikes were continuing.

MSF said the main hospital in Hama was struck at dawn on Tuesday, adding that no one was killed but the facility was shut down.

Three other hospitals have not been operational since being bombed on September 19, the charity said.

Two other important hospitals in the Jisr al-Shughur area were evacuated overnight on Wednesday for fear of new airstrikes.

As a result, other hospitals in the region have been overwhelmed with patients.

The key Hama Central/Sham hospital was the only one still able to carry out complex surgical operations as others have been damaged or evacuated.

Nearly 250 people have been taken to other MSF-backed hospitals and clinics in the Idlib region since September 20.

MSF teams have reported 61 deaths in the same period.

"The other hospitals are still operating but the staff live in daily fear of being bombed," MSF said.

More than half the patients are women and children under age 15.

"Hospitals are clearly not being spared from the bombings taking place in Idlib and it is scandalous," said MSF director of operations Brice de le Vingne.

"Fear is causing hospitals to close or reduce their services, which affects everyone -- the sick, the wounded, pregnant women, anyone who needs medical attention," he said.

Russian President Vladimir Putin and Turkish counterpart Recep Tayyip Erdogan on Thursday agreed to push for the creation of a "de-escalation" zone in Idlib.

The Syrian conflict began when the Baath regime, in power since 1963 and led by Assad, responded with military force to peaceful protests demanding democratic reforms during the Arab Spring wave of uprisings.

It triggered an armed rebellion fuelled by mass defections from the Syrian army.

According to independent monitors, hundreds of thousands of civilians have been killed in the war, mostly by the regime and its powerful allies. Millions more have been displaced both inside and outside of Syria.

The brutal tactics pursued mainly by the regime, which have included the use of chemical weapons, sieges, mass executions and torture against civilians have led to war crimes investigations into Assad's government.