Latest bombardment comes as UN warns of catastrophe for three million caught in the crossfire in the besieged region.

More than 20 civilians were killed on Tuesday as the Syrian government continued its relentless bombardment against the last rebel stronghold in the country’s northwest.

The latest attacks came as the United Nations denounced world powers for doing nothing to halt the bloodshed and destruction.

A month of intensified bombing of the region by Syria and its ally Russia has killed 229 civilians and wounded 727 others, according to the Union of Medical Care and Relief Organizations (UOSSM) medical charity.

Nine children were among the 21 killed in government fire on several towns in Idlib province and the countryside of neighbouring Aleppo on Tuesday, said the UK-based Syrian Observatory for Human Rights war monitor.

Civil defence agency rescuers who work in opposition-held territory put the death toll at 24.

Attacks on a busy street in the village of Kafr Halab, on the western edge of Aleppo province, killed at least nine civilians, the Observatory said.

An AFP photographer confirmed seeing the bodies of victims. The street was crowded with people before breaking their daytime fast – observed by Muslims during the holy month of Ramadan – when it was attacked.

Idlib and parts of the neighbouring provinces of Aleppo, Hama and Latakia are under the control of Hay’et Tahrir al-Sham (HTS), formerly the Syrian al-Qaeda affiliate, which the Syrian government has vowed to destroy.

Caught in the crossfire

A hospital in the Idlib town of Kafranbel was also hit by artillery fire and out of commission, said David Swanson, a spokesman for the UN humanitarian office. At least 20 health facilities have been hit by the escalation – 19 of which remain out of service.

About 200,000 people have now fled the region for safety, according to the UN.

The deputy UN humanitarian chief warned further military operations in northwest threaten an estimated three million people caught in the crossfire.

Ursula Mueller told the Security Council on Tuesday that humanitarian operations in many areas where there are active hostilities have been suspended. She said that includes services previously supporting some 600,000 people.

Mueller, UN Secretary-General Antonio Guterres‘s top humanitarian affairs official, lambasted the Security Council for a history of inaction in Syria, questioning what it will do to prevent another catastrophe, this time in the northwest.

“Can’t this council take any concrete action when attacks on schools and hospitals have become a war tactic that no longer sparks outrage? Is there nothing to be said or done when indiscriminate barrel bombs are dropped in civilian areas?” Mueller said.

Scorched earth

The United States, meanwhile, said it continues to be alarmed by Syrian government and Russian air raids in northwest Syria and believes they are a “reckless escalation” of violence.

“Indiscriminate attacks on civilians and public infrastructure such as schools, markets and hospitals is a reckless escalation of the conflict and is unacceptable,” said State Department spokeswoman Morgan Ortagus. “The violence must end.”

New satellite imagery provided by DigitalGlobe Inc showed plumes of dark smoke rising from the countryside around al-Habeet village in Idlib and the small town of Kafr Nabuda in Hama.

The images showed patches of scorched earth, fields blackened by fire, and clusters of destroyed buildings. Some of the fires appeared to be still burning.

The Civil Defence in the northwest, a rescue service in opposition territory, said on Monday that government warplanes had been pounding crop fields in Idlib, setting them on fire.

Syrian state news agency SANA said on Tuesday that rebels had shelled villages in the northern Hama countryside, damaging houses and burning wheat fields.

The army onslaught in the northwest over the past month marks the most intense escalation between Syrian President Bashar al-Assad and his rebel enemies since last summer.