Russian warplanes have struck a field hospital in north-western Syria killing 13 people, including two medical staff. The aerial bombings took place on Tuesday 20 October in the town of Sarmin, in the north-western province of Idlib, which has been regularly targeted by Russia's missiles since the beginning of its air raids on 30 September.

A physiotherapist, Hassan Taj al-Din, and a hospital guard from the clinic, which was run by the Syrian-American Medical Society (SAMS), were killed in the attack. Taj al-Din leaves behind his four-months pregnant wife.

The first Russian air-to-surface missiles hit 10 metres from the hospital, prompting medical personnel and civilians to rescue the injured. After 10 minutes, the second strike targeted the facility, killing 10 civilians, the two medical personnel and injuring 28 civilians. One of them is a SAMS staff member who is in a critical condition.

When I am in the hospital, I feel like

I am sitting on a bomb. It is only a matter of time until it explodes. Dr Mohamed Tennari,

director of Sarmin field hospital in Syria

Russia has been accused of targeting civilians and medical personnel in war-torn Syria. The double strategy to target civilians with a first air strike and then those who offer first emergency response with a second has been criticised by human rights groups.

"The field hospital is in the populated suburbs of Idlib, in an area which has never had military presence," SAMS member Kathleen Fallon told IBTimes UK. "Targeting medical staff is an aspect of collective punishment, to prevent the injured from being cured."

The 20 October attack "adds to the previous estimated eight Russian air strikes on hospitals in Syria, as well as the 313 attacks on medical facilities since the start of the conflict" SAMS said in a statement.

Dr Mohamed Tennari, who is director at the Sarmin field hospital, said the hospital has been targeted and hit by air strikes more than 18 times, by the Syrian government and by the Russians. "When I am in the hospital, I feel like I am sitting on a bomb. It is only a matter of time until it explodes. It is wrong − a hospital should not be the most dangerous place. I wish I could say that targeting a hospital in Syria is unique, but is not," he said in a statement.

The UK-based Syrian Observatory for Human Rights (SOHR) also confirmed that 13 people were killed in the Russian air strikes on Sarmin. Russia's defence ministry said that its armed forces had struck Sarmin, but did not mention the hospital.

"Civilians continue to face unimaginable violence in Syria. We call on the international community to use all means necessary to end attacks on civilians and to prevent the further targeting of healthcare facilities in Syria," said Dr Ahmad Tarakji, president of SAMS.

The Foundation, which has volunteer medical personnel treating victims and reporting on attacks in Syria, said Russian airstrikes in the area over the weekend targeted the only two hospitals in southern Aleppo, forcing both facilities to shut down and evacuate patients.

Russia maintains that it is targeting only the Islamic State (Isis) extremists and other Islamist groups in Syria, but it has come under fire for attacks on non-extremist groups and civilians. The Observatory documented at least 127 civilians killed out of 370 people who died in the aerial bombings.

Journalist and activist Maamun al-Khatib told AFP that Russian raids had struck two hospitals in the northern province of Aleppo in the past week. A UN official has said that recent fighting in Syria has displaced tens of thousands of people.