Syrian government warplanes struck a busy market and an industrial area in Idlib on Wednesday, killing at least 19 people and wounding dozens more, opposition activists said.
The Union of Medical Care and Relief Organisations (UOSSM) said women and children were among those killed in the strikes which hit the Al Hal market on Wednesday, adding that at least 65 civilians were also injured.
Violence in the rebel-held province has continued despite a new cessation of hostilities agreement between Russia and Turkey, who support the opposite sides in the conflict.
Yahya Abu Al Yaman, a volunteer with the Syrian Civil Defence, a rescue group also known as the White Helmets, said most of the victims were in critical conditions.
The Syrian Civil Defence said one of its volunteers was killed in the strike.
UOSSM Chairman Hussam Al Fakir warned continued strikes on the city could trigger “a global refugee catastrophe”.
The Britain-based Syrian Observatory for Human Rights said the two areas were crowded with people when the warplanes struck.
The Observatory said air strikes were also reported in other parts of Idlib province, recording at least 42 Russian raids and 33 by government warplanes.
The government also dropped several barrel bombs from helicopters in rural parts of the province, according to the Observatory. The bombs are rudimentary and inaccurate projectiles that cause massive destruction.
Idlib is controlled by armed rebel groups, including Turkey-backed opposition groups and Al Qaeda-linked militants. It is also home to 3 million civilians.
The United Nations said at least 300,000 people were displaced by violence in the province last month.
UN spokesman Stephane Dujarric on Wednesday said the world body is increasingly concerned about the safety of those civilians.
“The UN urges all parties, and those with influence over those parties, to ensure the protection of civilians and civilian infrastructure, in line with their obligations under international humanitarian law,” he said in a statement.
The international body, which is responsible for delivering most of the aid to Idlib, has warned of the growing risk of a humanitarian catastrophe as people flee the fighting toward the Turkish border.