A view shows the damage at a hospital in a rebel-held town of Atareb in northwestern Syria, March 21, 2021. REUTERS/Khalil Ashawi

Russian jets hit a gas facility, a cement factory and several towns and cities in northwestern Syria near the Turkish border on Sunday, as Syrian army artillery killed seven civilians and injured 14 medics in an attack on a hospital in the area, witnesses and rebel sources said.

The sources said a Russian surface-to-surface missile also hit the town of Qah while Russian air strikes came close to densely populated refugee camps along the border with Turkey.

A gas facility was hit near Sarmada city in Idlib province and dozens of trailers carrying goods in a parking lot near the border crossing of Bab al Hawa were set aflame in the latest attack on fuel facilities that serve an economic lifeline for a region that is home to more than four million people.

Western intelligence sources say Russia was behind a ballistic missile strike earlier this month that set ablaze dozens of local oil refineries near the towns of al-Bab and Jarablus further east in a rebel-held area where Turkey holds sway and has a significant military presence.

The spokesman for the National Army, a Turkish-backed rebel alliance in the northwest, said Russia, which backs the government in Damascus, sought to destabilize the last rebel stronghold in Syria and disrupt commercial activity but the strikes did not signal an imminent major assault against Idlib.

“The Russian aerial strikes are continuing. Ballistic missiles have also hit areas close to civilian centers,” Major Youssef Hamoud told Reuters. “They seek to sow chaos and confusion,” he added.

Turkey’s Defenze Ministry said a missile launched by Syrian government forces had struck Qah and a truck and trailer park near Sarmada, injuring seven civilians.

It said a statement had been sent to Russia asking for the attacks to stop immediately and Turkish troops had been alerted.

There was no immediate comment from Moscow.

A woman and a child were among the seven civilians killed when mortar rounds hit the hospital in the city of Atareb. The Syrian army later shelled rebel-held Ariha town.

The Turkish Defense Ministry said earlier that five people were killed and 10 injured in an artillery attack by Damascus-backed forces on the hospital, one of dozens of hospitals hit by a Russian-led bombing campaign last year.

Videos received by Reuters from two witnesses showed a ward damaged and civil defense rescuers carrying bloodstained patients outside. Reuters could not verify their authenticity.

Fighting between Syrian army forces and rebels has subsided since a deal a year ago ended a Russian-led bombing campaign that had displaced over a million people in the region which borders Turkey after months of fighting that killed several thousand civilians.

Residents say although there have been no major hostilities, the calm is occasionally ruptured by Russian strikes on rebel outposts and by Iranian and Syrian-backed militias shelling towns and cities in the enclave.

Syria and Russia say they only target militant Islamists and deny any indiscriminate shelling of civilian areas or deliberate attacks on hospitals and infrastructure.