Vehicle hit by shrapnel while on its way to rescue wounded from Turkish airstrike

An ambulance on its way to rescue people wounded in a Turkish airstrike has been damaged in a bombing, in the latest of what Kurdish groups say is a pattern of attacks against medical staff in north-eastern Syria.

The ambulance, which had red markings indicating it was a medical vehicle, was heading to villages north of the town of Tal Tamr on Saturday afternoon when it was struck by shrapnel from a weapon that exploded close by. The two paramedics inside were injured in the blast.

“The ambulance was targeted with heavy weapons,” said Cadus, an independent German aid group and joint operator of the vehicle. “At the time of the attack our ambulance was not operating at the frontline.”

Quick guide What is happening in north-eastern Syria? Show Hide Who is in control in north-eastern Syria? Until Turkey launched its offensive there on 9 October, the region was controlled by the Syrian Democratic Forces (SDF), which comprises militia groups representing a range of ethnicities, though its backbone is Kurdish. Since the Turkish incursion, the SDF has lost much of its territory and appears to be losing its grip on key cities. On 13 October, Kurdish leaders agreed to allow Syrian regime forces to enter some cities to protect them from being captured by Turkey and its allies. The deal effectively hands over control of huge swathes of the region to Damascus. That leaves north-eastern Syria divided between Syrian regime forces, Syrian opposition militia and their Turkish allies, and areas still held by the SDF – for now. On 17 October Turkish president, Recep Tayyip Erdoğan, agreed with US vice-president Mike Pence, to suspend Ankara’s operation for five days in order to allow Kurdish troops to withdraw. The following week, on 22 October, Erdoğan and his Russian counterpart, Vladimir Putin agreed on the parameters of the proposed Turkish “safe zone” in Syria. How did the SDF come to control the region? Before the SDF was formed in 2015, the Kurds had created their own militias who mobilised during the Syrian civil war to defend Kurdish cities and villages and carve out what they hoped would eventually at least become a semi-autonomous province. In late 2014, the Kurds were struggling to fend off an Islamic State siege of Kobane, a major city under their control. With US support, including arms and airstrikes, the Kurds managed to beat back Isis and went on to win a string of victories against the radical militant group. Along the way the fighters absorbed non-Kurdish groups, changed their name to the SDF and grew to include 60,000 soldiers. Why does Turkey oppose the Kurds? For years, Turkey has watched the growing ties between the US and SDF with alarm. Significant numbers of the Kurds in the SDF were also members of the People’s Protection Units (YPG), an offshoot of the Kurdistan Workers’ party (PKK) that has fought an insurgency against the Turkish state for more than 35 years in which as many as 40,000 people have died. The PKK initially called for independence and now demands greater autonomy for Kurds inside Turkey. Turkey claims the PKK has continued to wage war on the Turkish state, even as it has assisted in the fight against Isis. The PKK is listed as a terrorist group by Turkey, the US, the UK, Nato and others and this has proved awkward for the US and its allies, who have chosen to downplay the SDF’s links to the PKK, preferring to focus on their shared objective of defeating Isis. What are Turkey’s objectives on its southern border? Turkey aims firstly to push the SDF away from its border, creating a 20-mile (32km) buffer zone that would have been jointly patrolled by Turkish and US troops until Trump’s recent announcement that American soldiers would withdraw from the region. Erdoğan has also said he would seek to relocate more than 1 million Syrian refugees in this “safe zone”, both removing them from his country (where their presence has started to create a backlash) and complicating the demographic mix in what he fears could become an autonomous Kurdish state on his border. How would a Turkish incursion impact on Isis? Nearly 11,000 Isis fighters, including almost 2,000 foreigners, and tens of thousands of their wives and children, are being held in detention camps and hastily fortified prisons across north-eastern Syria. SDF leaders have warned they cannot guarantee the security of these prisoners if they are forced to redeploy their forces to the frontlines of a war against Turkey. They also fear Isis could use the chaos of war to mount attacks to free their fighters or reclaim territory.

On 11 October, it was reported that at least five detained Isis fighters had escaped a prison in the region. Two days later, 750 foreign women affiliated to Isis and their children managed to break out of a secure annex in the Ain Issa camp for displaced people, according to SDF officials. It is unclear which detention sites the SDF still controls and the status of the prisoners inside. Michael Safi

Aram Hamidi, a Kurdish paramedic in the vehicle, said it had been hit by Turkish fire. “Our ambulance was struck and destroyed,” he said in a video interview released by the Rojava Information Center, a media collective working in the area.

“Both I and my colleague who was driving were injured … I was wounded by shrapnel. I still have a piece in my jaw, and all my teeth are broken.”

Photographs of the ambulance – also operated by the Kurdish Red Crescent, a humanitarian organisation not affiliated with the International Committee of the Red Cross – showed cracked windows and bloodstains on the seats.

A series of agreements between Ankara, Moscow and Washington halted a Turkish invasion of north-eastern Syria earlier this month, but fighting continues on the frontiers of territory under Turkey’s control.

Kurdish groups say medical personnel have been targeted throughout the Turkish operation in the area and continue to be vulnerable. The Rojava Information Center estimates that five medical personnel have been killed since the invasion began last month. Three were abducted and executed and two died in drone strikes. A further seven at least have been injured, it said.

Kurds call on US to block Turkish military drones from Syrian air space Read more

Sebastian Jünemann, the chief executive of Cadus, said it was unclear whether the ambulance had been hit by a drone or artillery fire, and that it was hard to tell if had been deliberately targeted. He said Cadus coordinated its movements with the UN’s civil-military coordination centre.

“We have been targeted by Isis in Mosul but never by a state actor like Turkey for example,” Jünemann said. “In Mosul we took certain security measures … but in this situation the actor is a Nato member so we are assured that we are secure. Normally we should be safe.”

Kurdish groups accuse Turkish forces and their militia allies of attacking Kurdish Red Crescent medical infrastructure, including the repeated targeting of a hospital in the city of Ras al-Ayn, and an artillery shell that landed near a medical convoy a week ago, killing a member of the Free Burma Rangers, an independent humanitarian group.

The Turkish government has consistently denied it deliberately targets medical vehicles or facilities. The Turkish foreign ministry has been contacted for comment.