AMMAN: Civil Defense first responders are searching for survivors in the wreckage of a major hospital in southern Idlib on Sunday, one day after a purported Russian airstrike demolished the facility in the latest blow to an already devastated medical infrastructure.

On Saturday afternoon, up to six bunker buster missiles reportedly fired by Russian warplanes struck the Shaam Hospital, located in the rebel-held, southern Idlib village of Abdin, 10km west Khan Sheikhoun, the site of deadly chemical attack earlier this month.

Following the attack on the hospital, a fortified facility in an underground cave, the structure collapsed almost immediately, trapping patients and medical staff under rubble and stone

One member of the Civil Defense who responded to the scene told Syria Direct that the attack killed at least three doctors and four patients, but warned that the death toll may increase.

“Today, we’re trying to retrieve three bodies—a father, a mother and their daughter—who were present in the hospital at the moment it was targeted,” said the Civil Defense’s Ahmed al-Idlibi.

First responders at the scene of the Shaam Hospital bombing on Saturday. Photo courtesy of the Idlib Civil Defense.

Moments after the initial attack, a surface-launched rocket containing cluster munitions hit farmland surrounding the hospital, killing one man and injuring his son, the Idlib Civil Defense reported.

Neither Syrian nor Russian state media commented on the bombings. In an interview with Russia’s RIA Novosti and Sputnik news agencies in Damascus on Friday, Syrian President Bashar al-Assad did, however, accuse Western media of inflating the death toll from the six-year war “to use it as humanitarian pretext to intervene in Syria.”

Saturday’s attack marked the third time that the Shaam Hospital was bombed and partially destroyed in less than two months. After each of the previous attacks, hospital administrators rebuilt and relocated the facility, most recently attempting to shelter the building under seven meters of rock in the south Idlib countryside.

On Sunday, hospital administrators told Syria Direct that they are questioning whether it is worth rebuilding.

“We’re looking into new plans to transfer all health care work to the border areas if the warplanes don’t stop targeting medical facilities,” Dr. Abdullah al-Darwish, the head of Hama’s Healthcare Directorate, told Syria Direct on Sunday. “If even underground caves are targeted, why should the hospitals stay here?”

Since February 1, the Assad regime and its allies have attacked more than a dozen medical facilities across opposition-controlled areas of Idlib and Hama provinces, Syria Direct reported. The months-long wave of attacks—using both conventional and chemical weapons—has partially or completely destroyed at least seven major hospitals, two field hospitals, four specialized clinics and one medical warehouse.

Civil Defense workers transport an injured man following Saturday’s bombing. Photo courtesy of the Idlib Civil Defense.

Now, with the Shaam Hospital—previously the area’s main remaining medical facility—out of service, residents told Syria Direct they must travel up to 100km to receive medical care from the next closest facility located in the provincial capital of Idlib city.

“There are no other alternatives right now,” Dr. Maram a-Sheikh, the director of the Shaam Hospital, told Syria Direct on Sunday. “We always have backup plans, but of course it’s just not possible to guarantee the security of the new location.”

Already this year, Syrian, Russian and United States-led coalition airstrikes have killed hundreds of civilians across Idlib and Hama provinces. The increased bombings in the area come at a time where tens of thousands of rebel fighters and civilians are arriving to Idlib province, the result of a series of rebel surrenders and subsequent mass evacuation deals around the country.

“The international community has been silent amidst all these attacks on medical facilities,” said Dr. a-Sheikh of the Shaam Hospital.

"It’s reaching the point where bombing a hospital is just commonplace now,” he added. “It’s not even newsworthy anymore.”