Overnight airstrikes reportedly carried out by the Russian air force hit civilian targets in rebel-held Idlib city in northwestern Syria, killing more than 60 civilians and putting two hospitals out of service.

More than 60 civilians were killed by overnight airstrikes Monday on the rebel-held city of Idlib in northwestern Syria, according to local reports and Turkey’s foreign ministry. The airstrikes targeted two hospitals in the city and put them completely out of service.

Rescue workers from Syria Civil Defense, known as the White Helmets, immediately rushed to the sites and began an intensive rescue operation for civilians stuck under the rubble.

The U.K.-based monitoring group, the Syrian Observatory for Human Rights, reported 23 deaths, including seven children, on Tuesday morning, but the death toll rose as more people were discovered under the rubble.

Ten consecutive airstrikes on Idlib were reported by the Observatory.

Oqba Barish, a lawyer from Saraqeb in western Idlib, told Syria Deeply that the airstrikes, which he believes were carried out by the Russian air force, targeted both the national and Ibn Sina hospitals.

“The airstrikes hit civilian targets,” he said. “Those two hospitals are out of service now, and they were nowhere near a military target.”

Farouk Kashkash, the national hospital’s director, told the Guardian the missiles struck in very close proximity to the hospital buildings.

“The staff have stopped working because of the imminent danger. We expect everything. What do you expect an enemy to do? They do everything, targeting hospitals, women and children. It is no longer strange,” he said.

“While they [rescue workers] were digging out bodies of dead and injured people, we could see military helicopters flying above us,” Barish said.

Later on Tuesday, the Idlib media center reported airstrikes on Saraqeb, as well as Maarat al-Numan in rural Idlib.

Among those killed by the airstrikes on the city was Safwan Daaboul, a member of a civil response volunteer team.

The Syria Civil Defense center in Idlib issued a statement on its social media channels saying that it was still continuing its search and rescue mission. “A little while ago we rescued an infant and a woman,” the statement said.

“The armed factions are all located in the ‘security block,’ which the government knows of,” said Barish.

In Kafranbel, activists and residents reported an airstrike that targeted the town with two missiles, injuring three people.

Samer al-Salloum, an activist from Kafranbel, spoke to Syria Deeply about the air raid. “Kafranbel remains one of the very few areas that no armed faction was able to gain control over,” he said. “There are no armed groups in Kafranbel, and definitely no Nusra Front presence,” he added, referring to a militant group affiliated with al-Qaida.

“Luckily, the first missile fell on the home of a civilian by the name of Omar al-Rahhal, and the second one landed on a water tank, which minimized the damages and spared casualties,” he said.

On Tuesday afternoon, the Russian defense ministry issued a statement denying accusations of its role in the airstrikes.

“Russian planes did not carry out any combat missions, to say nothing of any airstrikes, in the province of Idlib,” Igor Konashenkov, a Russian defense ministry spokesman, said in a statement.

The Turkish foreign ministry issued a statement following the attacks and called on the international community to act immediately against the “indefensible” crimes of the Syrian regime and its ally, Russia.

The Idlib civil administration announced the suspension of all its civil centers due to the severity of the aerial campaign, except for Syria Civil Defense and ambulances.

The Syrian regime, along with its allies, targeted and destroyed al-Quds hospital during an aerial campaign on rebel-held neighborhoods in Aleppo in late April, killing nearly 200 civilians, including 18 children and seven medical personnel.

The attack on Idlib was the deadliest since February, when the U.S.-Russia-brokered truce was implemented throughout the country. The truce excluded the Nusra Front.

Idlib, located 37 miles (59km) southwest of Aleppo, has been under rebel control, specifically that of the Nusra Front-affiliated Jaish al-Fatah (“Army of Conquest”), since last year, when the government lost the province in what is known as the Battle for Idlib.