Russia said on Saturday it will step up airstrikes in Syria, escalating a military intervention that Moscow says is weakening ISIL but which Western powers claim is aimed at shoring up the regime of President Bashar al-Assad.
A senior Russian military officer said the country’s jets based in western Syria had carried out more than 60 sorties in 72 hours across Syria. "We will not only continue strikes... We will also increase their intensity," said Andrei Kartapolov from the Russian army General Staff.
Those remarks chime with reports that Russian warplanes have launched several raids in the Syrian province of Latakia near the Turkish border, including one that hit a hospital.
"Two rockets fell near the hospital. Barnas hospital suffered material damage only," Ahmad Haj Bakri, an activist in Latakia told Al Jazeera.
The hospital was run by Doctors Without Borders (MSF) before it was handed over to local medical groups more than a year ago.
An MSF official confirmed to Al Jazeera that the hospital was hit without assigning responsibility to any side.
"We understand that one of the rockets hit about 50 meters away from the hospital and damaged the building. The hospital was evacuated and no casualties reported," Yazan al-Saadi, a regional MSF communication officer, told Al Jazeera.
Russia's air campaign in Syria, where a U.S.-led air coalition and fighters on the ground from regional states are already entangled in a four-year-old civil war, has drawn strong criticism from the United States and its allies.
President Barack Obama warned President Vladimir Putin that he was defending a crumbling authoritarian ally in Assad and could be sucked into a "quagmire".
Questions have been raised over the extent that Russia is focusing raids on Islamic State in Iraq and the Levant (ISIL) targets.
Britain's Defense Minister Michael Fallon has said that only one in 20 Russian airstrikes in Syria were aimed at ISIL, which control large parts of eastern Syria and western Iraq.
Fallon accused Russia of dropping unguided munitions on civilian areas, and against Assad's Western and Gulf-backed enemies. Russia has denied any suggestion that it had bombed civilian areas and said that its raids are having an impact in countering ISIL.
"The strikes were carried out around the clock from the Hmeymim air base along the whole depth of the territory of Syria," Kartapolov said, referring to an airport near Syria's Mediterranean coast where Russian jets are based. "Over three days we were able to undermine the terrorists' infrastructure and significantly reduce their military potential."
The British-based Syrian Observatory for Human Rights said at least 39 civilians had been killed since the start of the Russian airstrikes on Wednesday. It said 14 fighters, mostly members of ISIL, had also been killed.
Russia said in the last 24 hours it had targeted a command post and underground weapons bunker near Raqqa, the eastern Syrian stronghold ISIL, as well as a weapons store in Maarat al-Numaan.
Maarat al-Numaan, in Syria's northern province of Idlib, is not known as an ISIL base. Most fighters in the area are from the al Qaeda-linked Nusra Front and other insurgent groups, according to the Syrian Observatory for Human Rights monitoring group.
A Syrian military source, quoted by state media, said Russian and Syrian planes destroyed a command center in Latamneh, in Hama province, where Western-backed rebels operate. They also hit a training camp and weapons depot in Maarat al-Numaan, and weapons and ammunitions stores in Jisr al-Shughour.
The Russian airstrikes have hit at least four rebel factions operating under the umbrella of the Free Syrian Army which had received significant military support from states that oppose Assad, rebel fighters said this week.
Rescue workers in opposition-held areas in western Syria say the Russian strikes have killed at least several dozen civilians, including children.
In the town of Ihsim, northwest of Maarat al-Numaan, 11 people were killed in two raids, the rescue workers said. Nine of the dead were from one family. The Observatory put the casualties at 12 people killed or wounded.
A fighter operating in the Al-Ghab region in northwest Syria reported several air strikes there. "Russian warplanes hit a number of areas in the Ghab plain. They are hitting all the factions fighting Assad. The only casualties are civilians," said Abu el Baraa al Hamawi, from Ajnaad al-Sham rebel group.
Al Jazeera and wire services. Additional reporting by Basma Atassi.