The United Nations said on Friday at least 18 health centers have been attacked in the past three weeks in northwestern Syria, prompting a confrontation between western powers and Russia and Syria at the Security Council over who is to blame.

While the area is nominally protected by a Russian-Turkish deal agreed in September to avert a new battle, Syrian President Bashar al-Assad’s forces — backed by Russians — have launched an offensive on the last major insurgent stronghold. Some three million civilians are at risk, the United Nations said.

“Since we know that Russia and Syria are the only countries that fly planes in the area, is the answer … the Russian and Syrian air forces?” Britain’s U.N. Ambassador Karen Pierce said to the 15-member council on where the blame lay.

Acting U.S. Ambassador to the United Nations Jonathan Cohen said Russia and Syria were responsible for the attacks on the health centers. He said it was “most alarming” that several of the centers attacked were on a list created by Russia and the United Nations in an attempt to protect them.

Pierce said it would be “absolutely grotesque” if health facilities that provided their locations were “finding themselves being the authors of their own destruction because of deliberated targeting by the regime.”

Russian U.N. Ambassador Vassily Nebenzia said the Syrian and Russian forces were not targeting civilians or civilian infrastructure and questioned the sources used by the United Nations to verify attacks on health centers.

“We categorically reject accusations of violations of international humanitarian law,” Nebenzia told the council. “Our goal is the terrorists.”

An array of insurgents have a foothold in northwestern Syria – Idlib province and a belt of territory around it. The most powerful is the jihadist Tahrir al-Sham, the latest incarnation of the former Nusra Front which was part of al Qaeda until 2016.

U.N. aid chief Mark Lowcock told the Security Council he did not know who was responsible, but “at least some of these attacks are clearly organized by people with access to sophisticated weapons including a modern air force and so called smart or precision weapons.”

Lowcock said 49 health centers had partially or totally suspended activities, some for fear of being attacked, while 17 schools have been damaged or destroyed and many more closed. He said that in the past three weeks up to 160 people have been killed and at least 180,000 people displaced.

U.N. political affairs chief Rosemary DiCarlo warned the Security Council: “If the escalation continues and the offensive pushes forward, we risk catastrophic humanitarian fallout and threats to international peace and security.”

 
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