the death toll was 50.

Doctors Without Borders, the international medical charity, said the air strikes destroyed one of the hospitals it supports, killing at least seven, wounding eight and leaving an unknown number of patients buried in rubble.

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The hospital, in the town of Maarat al-Noaman, in insurgent-held Idlib province, was hit by four missiles in two sets of attacks within a few minutes of each other, the charity said, citing reports by hospital staff members.

A wounded Syrian man is carried to a hospital in Kilis, Turkey. An air strike in the northern Syrian province of Idlib destroyed a makeshift clinic supported by an international aid group on Monday. Photo: AP

"This appears to be a deliberate attack on a health structure, and we condemn this attack in the strongestpossible terms," Doctors Without Borders head of Syrian mission Massimiliano Rebaudengo said about Monday's strike on the charity's affiliate. Deliberate attacks on medical facilities are forbidden under international law.

The hospital had 30 beds, 54 staff, two operating rooms, clinics and an emergency room, and its destruction leaves 40,000 people without medical care, the charity said.

Syrians fleeing a government offensive and Russian air strikes try to cross the border into Turkey this month. Photo: Getty Images

Anti-government activists and residents said warplanes also attacked three other hospitals on Monday. Three people were killed and six wounded in one, the National Hospital, which is also in Maarat al-Noaman. And in Azaz, a major prize in the fierce battles unfolding in Aleppo province, two hospitals were hit, at least one of them