Prelude

A Russian military police platoon (29 servicemen) deployed as part of the de-escalation observation forces in the Idlib de-escalation zone was on the night of 18 September encircled and trapped by rebels, including Jabhat al-Nusra, as a result of their offensive against the Syrian troops positioned north and northeast of Hama; the encirclement was breached by Russian forces several hours later by the early hours of 19 September in a special operation leaving three servicemen of the Special Operations Forces were wounded in the rescue operation. The Russian ministry stated that according to their intelligence, the rebels′ ″offensive was initiated by the US special agencies in order to stop the successful advance of the Syrian Arab Army to the east from Deir ez-Zor″.^[20][21][22]

Tahrir al-Sham-led attack

On 19 September, members of Tahrir al-Sham, alongside the TIP and militants aligned to the FSA, launched an offensive on pro-government and Russian Armed Forces positions overseeing the process of the de-escalation of the zone in the province of Idlib following an agreement with Turkey and Iran in negotiations in Astana in May 2017.^[3][23][24] Reports of the ensuing fighting were contradictory.^[24] The rebels initially captured four villages,^[25] but after back-and-forth fighting^[26] during which the villages changed hands several times,^[27][28][29] government forces recaptured all of the villages by 22 September.^[1] Russia stated it had killed 850 rebel fighters by 21 September.^[30] In contrast, SOHR reported that 66 rebels and 38 soldiers were killed during the offensive,^[15] as well as more than 40 civilians over two days in nearly 500 air-strikes on about 40 towns and villages in retaliation for the rebel offensive.^[31] There were also rebel claims of government and Russian airstrikes on civilian targets in Idlib, including medical facilities.^[24] The Russian Air Force and Russian Navy conducted air and cruise missile strikes against HTS targets, reportedly including a large military camp.^[32][33] The US State Department accused Syria and Russia, besides bombing civilian targets, of also targeting medical facilities.^[34] One of the three allegedly bombed hospitals^[35] was the al-Rahma clinic in Khan Shaykhun, which treated victims of the chemical attack there in April.^[36]

Syrian Army counter-attack and air-strikes

On 23 September, Russian air-strikes targeted rebels in Idlib and Hama governorates, including a Faylaq al-Sham headquarters in the area of Tal Mardiqh in Idlib province, killing more than 50 rebels. There were multiple other Russian airstrikes in Hama and Idlib, including on Khan Sheikhoun, Jisr al-Shaqour, Saraqeb and Kafr Sajna.^[37][38][39] Around 40 people were reported killed in airstrikes on 24 September.^[40]

Concurrently, the Syrian Arab Army launched a counter-offensive in the northern part of the Hama, capturing two villages.^[41] However, a strong rebel counter-attack in the evening forced government troops to retreat. The next morning, government forces once again attacked the villages, supported by Russian combat helicopters.^[2] On 25 September, the Army made a new attempt to capture the two villages.^[42] However, two days later, government forces withdrew from their positions around the villages.^[43]

Airstrikes by the government and its allies continued over the following days. On 25 September, Syria Civil Defence claimed that airstrikes resulted in over 40 deaths in Idlib.^[44] On 26 September, there were reports of a fifth hospital in rebel territory targeted, the Sham 4 hospital in Kafr Nabl, Idlib.^[45] On 27 September, another 43 deaths were reported in towns in Idlib, including Khan Shaykhun and Jisr al-Shughur, as a result of the campaign.^[46] On the same day, Russian Defense Ministry's spokesman Major General Igor Konashenkov stated that 5 HTS commanders and 32 militants were killed in a special operation executed by the Russian SOF in coordination with the Russian Air Force which delivered a surgical missile strike on the location of the meeting attended by the HTS field commanders south of Idlib. The commanders were believed to be behind an attack on the group of Russian military police back on September 18.^{[citation needed]} By 28 September, Syria Civial Defence had reported more than 152 civilian dead in the bombing campaign and that six hospitals had now been targeted, displacing urban residents into rural areas.^[47] The bombing campaign was halted on the night of 29 September.^[18]