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People gather near a destroyed building said to be a Medecins Sans Frontieres (MSF) supported hospital in Marat al Numan, Idlib, Syria, February 15, 2016 Reuters/Social Media Website via Reuters

The death toll in Syria continues to mount as 50 civilians across a number of buildings in rebel-held towns were killed in airstrikes on Monday.

At least seven people were killed and eight staff reported missing when a Doctors Without Borders Hospital in Maaret al-Numan, Idlib province, was attacked by four missiles within minutes of each other. This is not the first time the aid organisation, also known as Médecins Sans Frontières (MSF), has had its centres destroyed by airstrikes.

“The destruction of the hospital leaves the local population of about 40,000 people without access to medical services in an active zone of conflict,” said Massimiliano Rebaudengo, MSF’s head of mission in Syria.

"This appears to be a deliberate attack on a health structure and we condemn this attack in the strongest possible terms.”

MSF France’s president Mego Terzian said he believed either the Syrian government or Russia were responsible for the attacks, although this was disputed by Syrian ambassador to Russia, Riyad Haddad, who in turn, pointed fingers at US Air Forces.

US Military had attacked a MSF hospital in Afghanistan by mistake in October 2015, killing 30 hospital staff and patients.

The MSF facility is one of several medical centres that were hit in Syria. UNICEF said four of its facilities were destroyed – one a child and maternal hospital where children were reportedly killed and scores evacuated.

"A third of hospitals and a quarter of schools in Syria – 5,000 – are no longer functioning,” said UNICEF executive director Anthony Lake in response to the attacks.

"Apart from compelling considerations of diplomacy and obligations under International Humanitarian Law, let us remember that these victims are children.

"Children."

In a separate incident in the town of Azaz near the Turkish border, 14 people were reportedly killed and 30 injured after a missile struck a children’s hospital.

ISSG commitments quickly forgotten

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Smoke rises from a location said to be a Medecins Sans Frontieres (MSF) supported hospital in Marat al Numan, Idlib, Syria. Reuters/Social Media Website via Reuters TV

The destruction in Syria comes just days after world leaders agreed to a gradual “cessation of hostilities” at the International Syria Support Group (ISSG) conference in Munich last week.

The truce, which does not apply to the fight against Daesh groups and other IS militants, is aimed at breaking the deadlock in Syria. However, UN spokesman Farhan Haq said the latest strikes “cast a shadow on the commitments” made at the Feb. 11 meeting.

But Syrian President Bashar al-Assad said in a televised address on Monday that a ceasefire did not mean putting away the weapons. The agreement, he said, was to stop terrorist groups from “strengthening their positions”.

During a press conference announcing the deal, Russian Foreign Minister Sergey Lavrov had also made it clear that Russia would not halt airstrikes, saying “the truce does not go for terrorists … The military operation against them will be continued.”

As Scott Lucas, Professor of International Politics at the University of Birmingham, points out, Russia has used the pretext of attacking IS to drive its campaign, and expanded this rationale to include all anti-Assad groups as part of the "terrorists" group. In fact, more than 80 percent of operations have been on opposition-held territory since the beginning of its strikes on September 30.

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Meanwhile, in what is increasingly sounding like a broken record - and a sign confirming that Western powers have no leverage in the Syrian conflict - the US government has once again called on all parties to cease attacks on civilians.

According to Reuters, US State Department spokesman John Kirby said the continuation of the attacks “flies in the face of the unanimous calls by the ISSG (International Syria Support Group), including in Munich, to avoid attacks on civilians and casts doubt on Russia’s willingness and/or ability to help bring to a stop the continued brutality of the Assad regime against its own people.

“We call again on all parties to cease attacks on civilians and take immediate steps to grant humanitarian access and the cessation of hostilities that the Syrian people desperately need.”