[1][19] In March 2017, rebels led by Hayat Tahrir al-Sham launched an unsuccessful offensive against the Syrian Armed Forces north of Hama.

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] 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.

[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.

There were multiple other Russian airstrikes in Hama and Idlib, including on Khan Sheikhoun, Jisr al-Shaqour, Saraqeb and Kafr Sajna.

[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.