A surge in airstrikes by the regime of Bashar al-Assad and his Russian allies, and the beginnings of a ground invasion against one of the few remaining rebel-held enclaves in Syria, has prompted concerns of an impending humanitarian catastrophe.
For the past two weeks sources on the ground in Syria's northwest Idlib province have reported an unprecedented increase in Russian and Syrian regime air sorties, claiming the aerial bombardment, the worst seen in eight years of internecine civil war in the area, are a prelude to a final assault.
According to the Office for the Coordination of Humanitarian Affairs (OCHA), 152,000 people were forced to flee rebel-held areas in northwest Syria between April 29 and May 5. The U.N. agency also reported that airstrikes on Idlib carried out by the Assad regime and its allies have targeted 12 medical centers, killing more than 80 civilians and wounding in excess of 300 individuals.
A surgeon working at Kafranbel surgical hospital in southwestern Idlib province told Newsweek he feared an unimaginable price would be paid by the area's civilians as the Assad regime and its allies launched their endgame against the rebel-held territory.
"Everything that is happening indicates that this is an all-out assault," the doctor, identified only as Dr. Ahmed for his safety, said over the phone from the embattled Syrian province. "Everything is leading to a final assault…. [Civilians] are trapped in this area, and they can't go. It is going to be a disaster if the regime launches a ground invasion to recapture the area. It will be a disaster; there will be massacres."
Ahmed's hospital, housed in a former cultural center in Kafranbel and driven into an underground basement by scores of airstrikes over the years, took four direct hits on May 5. The facility, which once serviced over 200,000 people, was put out of action by the strikes. The surgeon was inside the hospital at the time of the blasts with 30 other medical staff and 20 patients in critical condition.
The majority of the hospital's beds were filled with individuals with egregious shrapnel wounds, too badly injured to be moved when the air raids began. As the bombs fell on the hospital they found themselves targeted for the second time.
"Dust filled the room, and we used oxygen tanks to help the patients breathe. After the fourth hit, the White Helmets came in," Ahmed said, referring to the Syria Civil Defense volunteer organization of first responders operating in rebel-controlled Syria. "They rushed in, and they evacuated the staff and the patients.... They needed critical attention."
3- Four medical facilities were directly targeted and forced out of service today with Russian and regime's missiles, last one of them was Kafranbel's Hospital which was targeted and destroyed by Russian airstrikes in a systematic method to destroy all livelihoods in the area. pic.twitter.com/SES3DJt1Qi
— The White Helmets (@SyriaCivilDef) May 5, 2019
Images shared on social media on Sunday showed the White Helmets moving dust-covered patients from Kafranbel. In subsequent days, Syrian and Russian warplanes had not left the skies over Idlib.
On Wednesday, the U.K.-based Syrian Observatory for Human Rights said Assad's ground forces had captured rebel-held Kfar Nabudah, 15 miles north of Kafranbel. Nine soldiers from government forces were reportedly killed in the clashes. Eighteen rebel fighters were killed.
The renewed violence, which began at the end of April, is the most serious challenge to a regional ceasefire that in September 2018 created a demilitarized area maintained by Turkey and Russia.
Russia has repeatedly stated its intention to expunge terrorist forces from Syria. Idlib province is predominantly held by the Islamist militant group Tahrir al-Sham, formerly the Al-Qaeda affiliate in Syria, the Nusra Front.
Ahmed said that it is the civilians who suffer in Idlib. "If you look at the reality, you will see that the regime and Russia are only bombing civilian areas. Are there terrorists in our houses and in our hospitals?" he asked rhetorically.
Laila Kiki, the executive director of the Syria Campaign, who uses a pseudonym for security reasons, said in a statement that the current offensive would have unimaginable consequences if it were allowed to continue.
"The situation in Idlib is one of abject horror that recalls past atrocities in Ghouta, Homs and Aleppo," Kiki said. "Russia and Turkey agreed last year to a demilitarized zone in Idlib to protect civilians, but today we see Russia killing them and Turkey barring them.
"Both countries must urgently honor their commitment to the demilitarized zone and stop the bloodshed. International governments must push for an end to the regime and Russia's bombing. If the attacks are allowed to continue, the end result is unimaginable," Kiki said.
