BEIRUT — Doctors and nurses at a pediatric hospital in eastern Aleppo scrambled Friday to evacuate babies in incubators to safety from underground shelters after the facility in the besieged Syrian city was bombed for the second time this week.

Medics and aid workers also reported a suspected attack involving toxic gas in a district on the western edge of the rebel-held area. At least 12 people, including children, were treated for breathing difficulties, said Adham Sahloul of the Syrian American Medical Society, which supports health facilities in Aleppo.

Claims of toxic gas attacks are common in Syria, and reports by international inspectors have held the government responsible for using chemicals in attacks on civilians, which Damascus denies.

Friday was the fourth day of renewed assaults by Syrian warplanes on eastern Aleppo districts, a rebel-held enclave of 275,000 people. The onslaught began Tuesday, when Syria's ally Russia announced its own offensive on the northern rebel-controlled Idlib province and Homs province in central Syria.

Friday's airstrikes in Aleppo hit a complex of four hospitals that had been attacked two days earlier. The latest strikes forced the pediatric hospital and a facility to stop operating.

"Now it is being bombed. ... I am sorry. ... I have to go to transfer the children," the head of the pediatric hospital wrote in a text message to The Associated Press. The doctor identified himself only by his first name of Hatem because he fears for reprisals against his family.

The incubators already had been moved underground for safety, but with bombs falling all around the facility, hospital workers had to rush them to a safer place despite the danger.

"As we drove out with the ambulance, warplanes were firing and artillery were shelling," he wrote. "But thank God we were not hurt."

The cameras of Al-Jazeera, which was broadcasting from the facility as the airstrikes occurred, went dark for a moment. When video resumed, dust was swirling and debris was strewn in the corridors.

Nurses scurried to get babies to safety, and one was seen carrying a blanket-wrapped infant. She then hugged and comforted another nurse who was sobbing as she picked up a baby.

Another hospital in a different Aleppo was bombed Thursday night, the doctor told AP. The entrance was set on fire but no one was hurt.

Government bombings have targeted with medical facilities, including the children's hospital and a nearby clinic that has one of the few remaining intensive care units in eastern Aleppo, the Observatory said.

Many hospitals and clinics in the besieged area have moved their operations underground after months of relentless bombardment. The World Health Organization said that in 2016, it recorded 126 attacks on health facilities, a common tactic over the five years of Syria's civil war. Russia and the Syrian government deny targeting hospitals.

Ibrahim al-Haj, a member of the Syria Civil rescue unit in Aleppo, said the city "is a mess." The group of rescuers and first responders said they are struggling to put out fires set off by the bombings in at least 10 areas. </s> BEIRUT (AP) — Intensive bombings pummeled Syria’s rebel-held eastern neighborhoods of the city of Aleppo on Friday, residents and rescuers said, hitting an area housing several hospitals and sending the chief of a pediatrics clinic in a frantic search for a place to move his young patients.

Earlier Friday, airstrikes on a village in the rural Aleppo province killed seven members of the same family, including four children, opposition activists said.

The attacks mark the fourth day of renewed assault by Syrian government warplanes on eastern Aleppo districts, a rebel-held enclave of 275,000 people. The onslaught began with a Russian announcement of its own offensive on the northern rebel-controlled Idlib province and the central Homs province.

So far, more than 100 people have been killed across northern Syria since Tuesday.

A physician who identified himself as Dr. Hatem, the head of the only pediatric hospital remaining in besieged rebel-held part of Aleppo, said his facility has been targeted once more on Friday, causing damages to its exterior. The hospital was also hit during a wave of airstrikes on the complex housing four hospitals on Wednesday.

“Now it is being bombed … I am sorry … I have to go to transfer the children” to a safe area, he said in a text message. He uses his first name fearing for his family’s safety.

Another Aleppo hospital in a different neighborhood also came under intense bombing late Thursday, he said, though no one was wounded.

Many hospitals and clinics in the besieged area have moved their operations underground after months of relentless bombings and airstrikes.

The city of Aleppo, once Syria’s commercial hub, has been divided since 2012, with the eastern half in rebel hands and the western half controlled by government forces.

Ibrahim al-Haj, a member of the Syria Civil Defense rescuers in Aleppo said the city “is a mess.” The group of rescuers and first responders said they were struggling to put out fires set off by the bombings in at least 10 different areas of eastern Aleppo.

The Britain-based Syrian Observatory for Human Rights says the strike that killed the seven from one family took place in southwestern Aleppo. Syrian Civil Defense posted photographs online showing children’s bodies covered with dust and blood. </s> BEIRUT — Intensive bombings pummeled Syria's rebel-held eastern neighborhoods of the city of Aleppo on Friday, residents and rescuers said, hitting an area housing several hospitals and sending the chief of a pediatrics clinic in a frantic search for a place to move his young patients.

Earlier Friday, airstrikes on a village in the rural Aleppo province killed seven members of the same family, including four children, opposition activists said.

The attacks mark the fourth day of renewed assault by Syrian government warplanes on eastern Aleppo districts, a rebel-held enclave of 275,000 people. The onslaught began with a Russian announcement of its own offensive on the northern rebel-controlled Idlib province and the central Homs province.

So far, more than 100 people have been killed across northern Syria since Tuesday.

A physician who identified himself as Dr. Hatem, the head of the only pediatric hospital remaining in besieged rebel-held part of Aleppo, said his facility has been targeted once more on Friday, causing damages to its exterior. The hospital was also hit during a wave of airstrikes on the complex housing four hospitals on Wednesday.

"Now it is being bombed ... I am sorry ... I have to go to transfer the children" to a safe area, he said in a text message. He uses his first name fearing for his family's safety.

Another Aleppo hospital in a different neighborhood also came under intense bombing late Thursday, he said, though no one was wounded.

Many hospitals and clinics in the besieged area have moved their operations underground after months of relentless bombings and airstrikes.

The city of Aleppo, once Syria's commercial hub, has been divided since 2012, with the eastern half in rebel hands and the western half controlled by government forces.

Ibrahim al-Haj, a member of the Syria Civil Defense rescuers in Aleppo said the city "is a mess." The group of rescuers and first responders said they were struggling to put out fires set off by the bombings in at least 10 different areas of eastern Aleppo.

The Britain-based Syrian Observatory for Human Rights says the strike that killed the seven from one family took place in southwestern Aleppo. Syrian Civil Defense posted photographs online showing children's bodies covered with dust and blood. </s> Media playback is unsupported on your device Media caption Dr Abu Rajan shows cameras around the bombed M10 hospital in rebel-held Aleppo

Russian and Syrian air raids on the rebel-held eastern half of the city of Aleppo have forced the closure of the largest hospital in the area and killed two people, a medical charity says.

The Syrian American Medical Society, which supports the hospital, said it had been struck by barrel bombs.

There are also reports of Russian-backed Syrian government forces hitting Aleppo's historic Old City.

Clashes between government troops and rebels are occurring in several areas.

Russian and Syrian air forces resumed attacks on the rebel-held east of the city after a partial truce lapsed on 19 September. Government forces have also launched a ground offensive against the rebels.

Image copyright Reuters Image caption Hospitals in the east of Aleppo have been razed to the ground

Image caption Two people people were killed and about 10 reported injured at the hospital

The mounting civilian death toll has sparked international protests. The US says Russia is driving moderate rebels into the arms of jihadists.

Once Syria's commercial and industrial hub, Aleppo has been divided roughly in two since 2012.

The UN says at least 400 civilians, including many children, have been killed in the city this week as a result of Russian and Syrian government attacks.

Media playback is unsupported on your device Media caption Aleppo: Key battleground in Syria's civil war

Media playback is unsupported on your device Media caption Drone footage shows children playing football among Aleppo's ruins

On Saturday, air raids hit Aleppo's main trauma M10 hospital for the third time in a matter of days, medical workers say.

"The hospital is now out of service completely," radiologist Mohammad Abu Rajab was quoted by Reuters as saying.

"There's destruction to walls, infrastructure, equipment and generators. There are no more guards or staff left. It's complete darkness."

Hospital manager Dr Abu Rajan told local media that about 10 people at the hospital had been injured after it was hit by barrel bombs - improvised devices dropped from helicopters - cluster munitions, and a chlorine bomb.

Two patients were killed, while others have now been transferred to alternative facilities, the Syrian American Medical Society said.

A spokesman for US President Barack Obama condemned the bombing, which he said showed "total disregard" for medical professionals and patients.

"Reports of yet another hospital being destroyed further demonstrates the total disregard for the lives of medical professionals and their patients who need critical care because of the Assad regime and Russia's relentless campaign against the Syrian people."

French Foreign Minister Jean-Marc Ayrault also condemned the bombing, saying the shelling of healthcare structures and personnel constituted war crimes - and the perpetrators would have to be held to account.

'Shelling heavily'

The Syrian army says it is gaining ground but the rebels deny this.

"They are shelling the Old City heavily after another failed attempt to gain ground," Abu Hamam, from the Failaq al-Sham group, was quoted as saying by Reuters news agency.

"They have lost several fighters and we are steadfast."

The Syrian Observatory for Human Rights, a UK-based monitoring group, also reported government barrel bomb and jet attacks on the Ghouta area outside Damascus on Saturday.

In another development, it said government forces were battling fighters from the Islamic State group in Homs region.

War of words

Washington and Moscow have continued to spar over Syria, with the US dismissing Russian accusations that it was protecting a jihadist group in its bid to oust Syrian President Bashar al-Assad.

Russian Foreign Minister Sergei Lavrov said the US had broken its promise to separate the powerful Jabhat Fateh al-Sham (formerly known as al-Nusra Front) and other extremist groups from more moderate rebels.

Media playback is unsupported on your device Media caption Russia's claim is "absurd", says state department spokesman Mark Toner

State department spokesman Mark Toner said the Russian allegations were "absurd".

He told reporters the US had not targeted al-Nusra for months because they had become "intermingled" with other groups and civilians.

Media playback is unsupported on your device Media caption Sergei Lavrov: "We believe the plan was to spare Nusra"

At least 250,000 people have been killed in the conflict since it began in March 2011 with the Observatory estimating the true number to be about 430,000.

More than 4.8 million people have fled abroad, and an estimated 6.5 million others have been displaced within the country, the UN says. </s> (CNN) Days of heavy airstrikes have left Syria's rebel-held eastern Aleppo without a single hospital operating at full capacity, the Syrian American Medical Society told CNN on Saturday.

A number of major trauma hospitals were knocked out of service during recent attacks, according to the medical society.

However, activists working in the city said up to five other hospitals in eastern neighborhoods are still functioning.

"For the first time, eastern Aleppo is out of hospitals operating at full capacity," said Dr. Mazen Kewara, director of the medical society's Turkey office. "There are remaining medical facilities, but they are not operating at full capacity."

One of those hit was a children's hospital, forcing staff to evacuate babies to safety.

Hospitals are desperately needed as an estimated 250,000 people remain trapped while the Syrian regime bombards the city's rebel-held east, which faces dwindling reserves of food, fuel and medical supplies.

On Saturday, at least 38 civilians were killed by the extensive bombardment of eastern Aleppo, according to the Syrian Civil Defense, a volunteer group also known as the White Helmets. The barrage included 250 airstrikes and more than 2,000 artillery rounds.

Powerful video footage that the activist group Aleppo Media Center posted online showed what it said was the immediate aftermath of a bombing at eastern Aleppo's M2 hospital on Friday evening.

A man covered with dust and blood is carried past a body toward a stairwell filled with rubble and splintered wood. Another bandaged, dust-covered patient follows holding what looks like his own IV drip. Patients confined to bed are given face masks to cope with the dust.

A man who appears to be a doctor tells the cameraman, "Everyone in the hospital got injured, even already injured patients have been injured again, God help us."

Another man who seems to be a doctor says the hospital was bombarded, and there has been a direct hit on the intensive care unit, which he says was full of patients, "(especially) those who were transferred from hospitals that have been struck today morning and yesterday evening."

He says staff have had to transfer patients to other hospitals when they don't even know if they are operational, adding "the material damage is so huge in the hospital, unbelievable horror among patients and the medical staff, the ambulances outside can't rescue patients, people can't rescue each other, people are afraid of coming to the hospitals."

The humanitarian group Doctors Without Borders condemned the airstrikes, saying entire hospitals, electric generators, emergency rooms and wards have been destroyed in eastern Aleppo in more than 30 attacks since July.

"It is not only MSF that condemns indiscriminate attacks on civilians or civilian infrastructure, including hospitals, but also humanitarian law," said Teresa Sancristoval, emergency coordinator for the group also known as Médecins Sans Frontières.

"The message is simple, and I don´t know how to say it any louder: Stop bombing hospitals."

In Washington, national security adviser Susan Rice said in a statement: "The United States condemns in the strongest terms these horrific attacks against medical infrastructure and humanitarian aid workers. There is no excuse for these heinous actions."

An activist with the Aleppo Media Center told CNN on Saturday that up to five hospitals are now operating in the northern Syrian City.

The group said there were minor injuries to patients and staff at the M1 surgical hospital after artillery shelling and airstrikes that caused major fires Friday.

At a second facility, the al-Hakim children's hospital, the group told CNN that medical crew and children were evacuated with no injuries and that all babies survived the attacks.

The UK-based monitoring group the Syrian Observatory for Human Rights said Saturday that some hospitals struck in recent airstrikes were out of service for a time but are now operating to some extent.

Syria's grinding five-year conflict has devastated the city, divided between government-controlled areas in the west and rebel positions in the east.

Moscow has sought to distance itself from the latest blitz, with Deputy Foreign Minister Sergey Ryabkov saying this week that the Russian air force had not carried out the Aleppo strikes, according to state-run news agency Tass. </s> BEIRUT — Doctors and nurses at a pediatric hospital in eastern Aleppo scrambled Friday to evacuate babies in incubators to safety from underground shelters after the facility in the besieged Syrian city was bombed for the second time this week.

Medics and aid workers also reported a suspected attack involving toxic gas in a district on the western edge of the rebel-held area. At least 12 people, including children, were treated for breathing difficulties, said Adham Sahloul of the Syrian American Medical Society, which supports health facilities in Aleppo.

Claims of toxic gas attacks are common in Syria, and reports by international inspectors have held the government responsible for using chemicals in attacks on civilians, which Damascus denies.

Airstrikes also hit a village in rural areas Aleppo province, killing seven members of a family, including four children, opposition activists said.

Friday was the fourth day of renewed assaults by Syrian warplanes on eastern Aleppo districts, a rebel-held enclave of 275,000 people. The onslaught began Tuesday, when Syria's ally Russia announced its own offensive on the northern rebel-controlled Idlib province and Homs province in central Syria.

Since then, more than 100 people have been killed across northern Syria.

Friday's airstrikes in Aleppo hit a complex of four hospitals that had been attacked two days earlier. The latest strikes forced the pediatric hospital and a neighboring facility to stop operating.

"Now it is being bombed. ... I am sorry. ... I have to go to transfer the children," the head of the pediatric hospital wrote in a text message to The Associated Press. The doctor identified himself only by his first name of Hatem because he fears for reprisals against his family.

The incubators already had been moved underground for safety, but with bombs falling all around the facility, hospital workers had to rush them to a safer place despite the danger.

Hatem rushed 14 babies in incubators to another facility a 10-minute drive away while airstrikes continued, he said in a later message.

"As we drove out with the ambulance, warplanes were firing and artillery were shelling," he wrote. "But thank God we were not hurt."

Some of the survivors of the suspected gas attack were taken to the children's hospital.

The cameras of Al-Jazeera, which was broadcasting from the facility as the airstrikes occurred, went dark for a moment. When video resumed, dust was swirling and debris was strewn in the corridors.

Nurses scurried to get babies to safety, and one was seen carrying a blanket-wrapped infant. She then hugged and comforted another nurse who was sobbing as she picked up a baby.

Another hospital in a different Aleppo neighborhood was bombed Thursday night, the doctor told AP. The entrance was set on fire but no one was hurt.

Only four of seven hospitals are still operating in the district, Sahloul said.

The Britain-based Syrian Observatory for Human Rights said dozens of airstrikes, artillery and barrel bombs hit 18 different neighborhoods of eastern Aleppo.

Government bombings have targeted neighborhoods with medical facilities, including the children's hospital and a nearby clinic that has one of the few remaining intensive care units in eastern Aleppo, the Observatory said.

Many hospitals and clinics in the besieged area have moved their operations underground after months of relentless bombardment. The World Health Organization said that in 2016, it recorded 126 attacks on health facilities, a common tactic over the five years of Syria's civil war. Russia and the Syrian government deny targeting hospitals.

The city of Aleppo, once Syria's commercial hub, has been divided since 2012, with the eastern half in rebel hands and the western half controlled by government forces.

Ibrahim al-Haj, a member of the Syria Civil Defense rescue unit in Aleppo, said the city "is a mess." The group of rescuers and first responders said they are struggling to put out fires set off by the bombings in at least 10 areas.

The Observatory said at least four people were killed in the city's districts.

It also said the strike that killed the seven family members took place in southwestern Aleppo province. Syrian Civil Defense posted photos showing the bodies of children covered with dust and blood. </s> BEIRUT -- Doctors and nurses at a pediatric hospital in eastern Aleppo scrambled Friday to evacuate babies in incubators to safety from underground shelters after the facility in the besieged Syrian city was bombed for the second time this week.

Medics and aid workers also reported what was believed to be an attack involving toxic gas in a district on the western edge of the rebel-held area. At least 12 people, including children, were treated for breathing difficulties, said Adham Sahloul of the Syrian American Medical Society, which supports health facilities in Aleppo.

Claims of toxic-gas attacks are common in Syria, and reports by international inspectors have held the government responsible for using chemicals in attacks on civilians, which Damascus denies.

Airstrikes also hit a village in a rural area of Aleppo province, killing seven members of a family, including four children, opposition activists said.

Friday was the fourth day of renewed assaults by Syrian warplanes on eastern Aleppo districts, a rebel-held enclave of 275,000 people. The onslaught began Tuesday when Syria's ally Russia announced its own offensive on the northern rebel-controlled Idlib province and on the Homs province in central Syria.

Since then, more than 100 people have been killed across northern Syria.

Friday's airstrikes in Aleppo hit a complex of four hospitals that had been attacked two days earlier. The latest strikes forced the pediatric hospital and a neighboring facility to stop operating.

"Now it is being bombed. ... I am sorry. ... I have to go to transfer the children," the head of the pediatric hospital wrote in a text message. The doctor identified himself only by his first name of Hatem because he fears reprisals against his family.

The incubators already had been moved underground for safety, but with bombs falling all around the hospital, workers had to rush them to a safer place despite the danger.

Hatem rushed 14 babies in incubators to another facility a 10-minute drive away while airstrikes continued, he said in a later message.

"As we drove out with the ambulance, warplanes were firing and artillery were shelling," he wrote. "But thank God we were not hurt."

Some of the survivors of the suspected gas attack were taken to the children's hospital.

Images from Al-Jazeera, which was broadcasting from the facility as the airstrikes occurred, went dark for a moment. When video resumed, dust was swirling and debris was strewn in the corridors.

Nurses scurried to get babies to safety, and one was seen carrying a blanket-wrapped infant. She then hugged and comforted another nurse who was sobbing as she picked up a baby.

Another hospital in a different Aleppo neighborhood was bombed Thursday night, the doctor said. The entrance was set on fire, but no one was hurt.

Only four of seven hospitals are still operating in the district, Sahloul said.

The Britain-based Syrian Observatory for Human Rights said dozens of airstrikes, artillery and barrel bombs hit 18 different neighborhoods of eastern Aleppo.

Government bombings have targeted neighborhoods with medical facilities, including the children's hospital and a nearby clinic that has one of the few remaining intensive care units in eastern Aleppo, the Observatory said.

Many hospitals and clinics in the besieged area have moved their operations underground after months of relentless bombardment. The World Health Organization said that in 2016, it recorded 126 attacks on health facilities, a common tactic over the five years of Syria's civil war. Russia and the Syrian government deny targeting hospitals.

The city of Aleppo, once Syria's commercial hub, has been divided since 2012, with the eastern half in rebel hands and the western half controlled by government forces.

Ibrahim al-Haj, a member of the Syria Civil Defense rescue unit in Aleppo, said the city "is a mess." The group of rescuers and first responders said they are struggling to put out fires set off by the bombings in at least 10 areas.

The Observatory said at least four people were killed in the city's districts.

It also said the strike that killed the seven family members took place in southwestern Aleppo province. Syrian Civil Defense posted photos showing the bodies of children covered with dust and blood. </s> All hospitals in Syria’s besieged rebel-held eastern Aleppo are out of service after days of heavy air strikes, its health directorate and the World Health Organization (WHO) said, though a war monitor said some were still functioning.

White House national security adviser Susan Rice said the United States condemned “in the strongest terms” the latest air strikes against hospitals and urged Russia, an ally of Syrian President Bashar al-Assad, to take steps to halt the violence.

Intense air strikes have battered the eastern part of the city since Tuesday, when the Syrian army and its allies resumed operations after a pause lasting weeks. They launched ground attacks against insurgent positions on Friday.

The war monitor, the Britain-based Syrian Observatory for Human Rights, said 48 people, including at least five children, had been killed in eastern Aleppo on Saturday by dozens of air strikes and barrel bombs and dozens of artillery rounds.

That brings the number of people killed by the increased bombardment of Aleppo and the surrounding countryside over the past five days to about 180, including 97 in the city’s besieged eastern sector, the observatory added.

Warplanes, artillery and helicopters continued bombarding eastern Aleppo on Saturday, hitting many of its densely populated residential districts, the Observatory said. There were intense clashes in the Bustan al-Basha district, it added.

“This destruction of infrastructure essential to life leaves the besieged, resolute people, including all children and elderly men and women, without any health facilities offering life-saving treatment ... leaving them to die,” said Aleppo’s health directorate in a statement sent to Reuters late on Friday by an opposition official.

Elizabeth Hoff, the WHO representative in Syria, said on Saturday that a U.N.-led group of aid agencies based over the border in Turkey “confirmed today that all hospitals in eastern Aleppo are out of service”.

The monitoring group said some hospitals were still operating in besieged parts of Aleppo but said many residents were frightened to use them because of the heavy shelling.

Medical sources, residents and rebels in eastern Aleppo say hospitals have been damaged by air strikes and helicopter barrel bombs in recent days, including direct hits on the buildings.

“The United States again joins our partners ... in demanding the immediate cessation of these bombardments and calling on Russia to immediately deescalate violence and facilitate humanitarian aid and access for the Syrian people,” Rice said in a statement.

British Foreign Secretary Boris Johnson tweeted that reports of air strikes hitting civilians and hospitals in east Aleppo were “sickening” and called for a return to diplomacy.

However, with the United States awaiting the inauguration in late January of President-elect Donald Trump, who has been critical of Washington’s Syria policy without laying out detailed plans himself, diplomatic efforts appear stalled.

Staffan De Mistura, the special envoy of the U.N. secretary general, is likely to meet Syrian Foreign Minister Walid al-Moalem in Damascus on Sunday after recent talks in Turkey and Iran, another diplomat said.

“He will push on Aleppo, perhaps on a ceasefire, but on the political file there won’t be anything until (U.N. Secretary– General Ban Ki-moon’s successor Antonio) Guterres is in office, the diplomat said.

Both Russia and Assad’s government have denied deliberately targeting hospitals and other civilian infrastructure during the war, which began in 2011 and was joined by Russia’s air force in September 2015.

Russia unilaterally called a ceasefire in late October and said on Saturday it was now only striking against groups that are not also observing it. Rebel groups in Aleppo have all said they do not recognize the Russian ceasefire.

The charity Doctors Without Borders said in a message there had been more than 30 hits on hospitals in eastern Aleppo since early July. “Doctors are few and medical supplies are depleted, with no possibility of sending more supplies in,” it said.

Health and rescue workers have previously been able to bring damaged hospitals back into operation but a lack of supplies is making that harder.

The Syrian war pits Assad and his allies Russia, Iran and Shi’ite militias against Sunni rebels including groups supported by the United States, Turkey and the Gulf monarchies and also jihadist groups.

Aleppo, for years split between a rebel-held east and government-held western sector, has become the fiercest front.

An army offensive backed by a major aerial bombardment from late September to late October killed hundreds, according to the United Nations, and tightened the siege, leaving eastern Aleppo with little food, medicine or fuel.

A rebel counter-attack early this month involved shelling that killed dozens of civilians, the U.N. said, but it quickly petered out and the army and its allies, including Hezbollah and Iraqi militias, reversed all insurgent gains in about two weeks.

Syrian state television said on Tuesday the air force had targeted “terrorist strongholds and supply depots” in Aleppo. Russia has said its air force is only conducting air strikes in other parts of Syria. The Damascus government describes all the rebels fighting it as terrorists. </s> AMMAN (Reuters) - Russian warplanes and their Syrian government allies battered rebel-held areas in and around Aleppo on Saturday, and rebels and aid workers accused them of destroying one of the city’s main hospitals and killing at least two patients.

M10, the city’s main trauma hospital, in eastern Aleppo, was struck as the United States and its allies urged Russia, which is trying to crush resistance to Syrian President Bashar al-Assad, to halt the bombing and reach a diplomatic resolution.

Saturday’s air strikes focused on major supply lines into rebel-held areas of Aleppo - the Castello Road and Malah district and around the Handarat camp.

Fighting also raged in the city in the Suleiman al Halabi neighborhood, the front line to the north of Aleppo’s Old City and in the residential Bustan al Basha quarter.

Rebels and rescuers said at least seven missiles were dropped on the hospital, more commonly known as Sakhour, by both Russian jets and Syrian helicopters.

An American relief organization said two patients were killed and 13 injured in the attack, which was the second on the hospital in less than a week.

“The hospital is now out of service completely. There’s destruction to walls, infrastructure, equipment and generators. There are no more guards or staff left. It’s complete darkness,” said Mohammad Abu Rajab, a radiologist in the hospital.

Footage of the bombed hospital on social media showed extensive damage.

The attack drew immediate condemnation from France and Germany. French Foreign Minister Jean-Marc Ayrault said the shelling of healthcare structures and personnel in Aleppo amounted to war crimes, adding: “Their perpetrators will be held to account.”

“The bombing of Aleppo needs to finally stop! Whoever wants to fight terrorists does not attack hospitals!” German Foreign Minister Frank-Walter Steinmeier tweeted.

The U.S envoy to the United Nations last week called Russia’s actions in Syria “barbarism,” not counter-terrorism.

An official for U.S. President Barack Obama’s administration condemned the bombing, citing “total disregard” for medical professionals and those needing their help.

“Reports of yet another hospital being destroyed further demonstrates the total disregard for the lives of medical professionals and their patients who need critical care because of the Assad regime and Russia’s relentless campaign against the Syrian people.”

Rebels said Moscow and the Syrian army have for months been targeting power plants, hospitals and bakeries to force into surrender the nearly 250,000 believed trapped in the city.

Hundreds of people have been killed in indiscriminate bombing of residential areas and many hundreds more wounded, with little access to treatment in hospitals that lack basic supplies.

The army, aided by hundreds of Iranian-backed militias who have arrived in Aleppo, have backed up the air campaign with a ground offensive on several frontlines.

“The regime is spearheading an attack on all fronts and is trying to open more than one major front and of course there are a lot of amassing of troops mostly based in Handarat,” Abu Haidar, a commander in Fastaqim, one of the rebel groups inside Aleppo, said via internet messaging.

In a telephone conversation with U.S. Secretary of State John Kerry on Friday, Russian Foreign Minister Sergei Lavrov said Moscow was ready to consider more ways to normalize the situation in Aleppo, the ministry said.

A man walks on the rubble of damaged buildings after an airstrike on the rebel held al-Qaterji neighbourhood of Aleppo, Syria. REUTERS/Abdalrhman Ismail

But Lavrov criticized Washington’s failure to separate moderate rebel groups from those the Russians call terrorists, which had allowed forces led by the group formerly known as the Nusra front to violate the U.S.-Russian truce agreed on Sept. 9.

The United States made clear it would not, at least for now, carry through a threat made on Wednesday to halt the diplomacy if Russia did not take immediate steps to end the violence.

Moscow and Assad spurned the ceasefire to launch the new offensive, potentially the biggest and most decisive battle of the civil war, which is now in its sixth year.

BACK AND FORTH

An army source quoted in state media said its forces had made advances, which was denied by rebels.

A news commentary by the state-run Ikhbariyah said “high level coordination from the air and ground by Syrian and Russian warplanes” had allowed the two allies to “successful hit locations where terrorist groups had dug in.”

But rebels said Syrian troops backed by fresh reinforcements from Iranian-backed militias were struggling to make any gains in a ground offensive in a key frontline in the old city.

“They are shelling the old city heavily after another failed attempt to gain ground. They have lost several fighters and we are steadfast,” said Abu Hamam, a rebel from the Failaq al-Sham group.

The Syrian Observatory for Human Rights, a British-based group that monitors the war, reported heavy bombardment by government forces and “back and forth” fighting in the Suleiman al-Halabi neighborhood.

Rebels led by the main Islamist rebel group Ahrar al-Sham said on Saturday they had regained several areas in the Bustan al-Pasha district seized a day before, a strategic point that would allow the army to press into the heart of the rebel held eastern sector.

Slideshow (6 Images)

Russia joined the war exactly a year ago, tipping the balance of power in favor of Assad, who is also supported by Iranian ground forces and Shi’ite militia from Lebanon and Iraq.

The army said it would press its advantage after retaking last Thursday the strategic Handarat camp north of Aleppo that had already changed hands once since the start of the attack.
Media reports say a hospital in Aleppo neighborhood is bombed on night by the Syrian government.