Air strikes killed 10 civilians near a bakery and a medical clinic in Syria’s rebel-held Idlib region on Thursday, as government forces kept up a ground offensive.

The Britain-based Syrian Observatory for Human Rights said Russian warplanes hit the Idlib province town of Ariha, but the Russian defence ministry said its “aviation did not carry out any combat tasks in this area of Syria.”

The government and its Russian allies have upped their deadly bombardment of Syria’s last major rebel bastion, slowly chipping away at it from the south.

Rebel-held territory has shrunk to just over half of Idlib province, along with slivers of neighbouring Aleppo and Latakia, following a series of government gains.

The saw Damascus loyalists retaking the strategic northwestern town of Maaret al-Numan on Wednesday.

Early on Thursday, Russian air strikes hit near a bakery and the Al-Shami clinic in Ariha which is now out of service, the Observatory said.

The monitor says it determines whose planes carried out strikes according to type, location, flight patterns and munitions.

A dust-covered doctor ran out of the clinic screaming following the strike, which partially damaged the facility’s walls, an AFP correspondent reported.

Nearby, three entire buildings had collapsed and several vehicles were reduced to mangled wrecks.

The wailing of women and children rang out as rescue workers searched for corpses beneath the rubble.

Toufic Saado, a paramedic, said he was inside the medical facility when three air strikes ravaged the area.

“The wounded were lying on the floor outside the medical centre,” he said.

Ground offensive
The latest deaths bring to 21 the number of civilians killed by Russian air strikes in Idlib since Wednesday, the Observatory said.

Earlier this month, Russia denied launching any combat operations in the region since a ceasefire it agreed with rebel supporter Turkey went into effect on January 12.

But the truce has since become a dead letter and the number of reported Russian raids has risen sharply in an area dominated by jihadists of the Hayat Tahrir al-Sham alliance.

Turkish President Recep Tayyip Erdogan accused Moscow on Wednesday of “not honouring” several deals intended to avert a broad military offensive in the area.

It was a rare critical remark from Erdogan, who has largely sought to keep good relations with Russian President Vladimir Putin since a 2016 rapprochement.

Thousands of Russian troops are deployed across Syria in support of the army, while a contingent of Russian private security personnel also operates on the ground.

Moscow’s military intervention in 2015, four years into the Syrian conflict, helped keep President Bashar al-Assad in power and started a long, bloody reconquest of territory lost to rebels in the early stages of the war.

Government forces pushed north from Maaret al-Numan, on Thursday towards the town of Saraqib, whose residents have mostly fled in the face of heavy bombardment.

The front line is now within five kilometres (three miles) of the town, the Observatory said.

Both Maarat al-Numan and Saraqib lie on the key M5 highway connecting the capital Damascus to second city Aleppo.

The road has been in the government’s sights as it seeks to revive a moribund economy ravaged by almost nine years of war.

Some 50 kilometres (30 miles) of the M5 remain outside regime control, the Britain-based Observatory said.

Exodus of civilians
Tens of thousands of civilians have fled the government’s advance, seeking safety closer to the Turkish border further north.

The violence in the northwest has displaced more than 388,000 civilians since December, the United Nations says.

At least 20,000 of them have moved in the past two days, UN undersecretary general for humanitarian affairs Mark Lowcock said on Wednesday.

“Unless the current hostilities stop, we will see an even greater humanitarian catastrophe,” he told the UN Security Council.

Aid groups have warned the latest violence is compounding one of the worst humanitarian disasters of the nine-year war.

Government forces, which now control around 70 percent of Syria, have repeatedly vowed to retake the entire country, including Idlib.

The civil war has killed more than 380,000 people and displaced more than half the country’s population since it erupted following the brutal repression of anti-government protests in 2011.

A volunteer firefighter battles a blaze after a night-time air strike on the Idlib province town of Ariha

3D map of Idlib province, detailing control of territory by fighting forces and the number of civilians killed or displaced, as of January 27, 2020

The air strikes devastated a whole residential block

Many residents gathered what was left of their belongings and prepared to flee to relative safety closer to the Turkish border