BEIRUT — Syrian government forces and their Russian allies stepped up attacks on rebel-held areas on Monday, killing at least 23 civilians east of Damascus and striking at hospitals and residential buildings in the northwestern Idlib province, opposition activists reported.
The assault on Idlib, the last rebel-held province in Syria, has intensified in recent weeks but reached a new ferocity after militants shot down a Russian Su-25 near the town of Saraqeb over the weekend.
Russia has waged a punishing aerial campaign against Syria's armed opposition since intervening in the civil war on the side of its ally, President Bashar Assad, in 2015.
The al-Qaida-linked Levant Liberation Committee, which is the strongest militant group in Idlib, said its fighters downed the Russian jet and killed its pilot after he ejected from the plane and landed on the ground. Russia's Defense Ministry confirmed the downing, saying preliminary information indicated the plane was shot by a portable ground-to-air missile in an area held by al-Qaida militants.
Government forces have also stepped up operations against rebel-held suburbs near Damascus known as eastern Ghouta.
Opposition activists said government airstrikes killed at least 23 civilians in the area on Monday. The Syrian Observatory for Human Rights said waves of airstrikes hit at least five neighborhoods in the eastern Ghouta, the only remaining rebel stronghold near the capital, Damascus. The town of Arbeen was struck by 15 airstrikes, and airstrikes killed six people in Hazeh.
The activist-run Ghouta Media Center also reported that 23 were killed. The Observatory says at least 70 have been wounded and that the number of casualties is likely to climb as rescue operations are underway. Among those killed was a rescue worker from the first-responders group known as the White Helmets. The two groups say he died on duty in Arbeen.
An estimated 400,000 people live in eastern Ghouta, which is besieged by government forces.
In Idlib, a hospital in the town of Kafranbel was bombed early Monday, according to the activist-run Edlib Media Center and the Observatory. Another hospital, in Maaret al-Numan, was struck three times late Sunday and put out of service, according to the Syrian American Medical Society, which runs the facility. An apartment building in the city of Idlib, the provincial capital, was also destroyed, said the Observatory.
"It's just punishment," said Wissam Zarqa, a media activist in Idlib. "When you are targeting hospitals, targeting Idlib city, it's just to say 'I am here, and I can hurt you.'"
Last Tuesday, a hospital supported by Doctors Without Borders in Saraqeb was damaged in an airstrike that killed five people, according to the international aid group.
On Sunday, a search-and-rescue group and a medical charity reported that several people suffered breathing difficulties after a suspected chlorine gas attack on Saraqeb, days after the Trump administration accused Assad's government of producing and using "new kinds of weapons" to deliver poisonous gases. Damascus denied the White House's charges, and The Associated Press could not independently verify the reports of a chlorine gas attack.Comment on this story
A U.N. investigative commission said in 2016 that the Syrian government was behind at least three chlorine gas attacks during the seven-year civil war, but activists and monitoring groups claim there have been more.
The Syrian Civil Defense, also known as the White Helmets, said three of its rescuers and six other people suffered breathing problems. The Syrian American Medical Society said its hospitals in Idlib treated 11 patients for chlorine gas poisoning.
Associated Press writer Sarah El Deeb in Beirut contributed to this report.