A/HRC/44/61 34. According to overflight data, 14 air strikes were carried out on Kafr Nouran town, near Atarib, on 9 February alone, compelling almost everybody to leave. At least 14 civilians were killed and nine others injured, whereas, by the end of the day, Kafr Nouran was all but razed to the ground. Two civilians were reportedly killed in an air strike while collecting their belongings in preparation to leave Kafr Nouran. Information obtained by the Commission suggests that around 25 armed-group fighters, including from Falaq al-Sham and Hay’at Tahrir al-Sham, were present in Kafr Nouran town in January and early February. The Commission was not able to assess the presence of military objectives in Kafr Nouran at the time of the attack. 35. In another attack on nearby Ibbin Saman town, at around 2 a.m. on 10 February, proGovernment forces launched two consecutive air strikes in a span of three minutes against civilian-inhabited areas in western Ibbin Saman, near an intersection connecting the town to Idlib Governorate. As rescuers rushed to the scene, pro-Government forces conducted a second attack injuring several first responders. A few minutes later, another air strike, reportedly from a different aircraft, struck the outskirts of the town where a large number of residents, primarily women and children, had fled to earlier. Approximately 15 residential houses were destroyed as a result, and at least 15 civilians were killed, including three women and eight children aged 1 to 5 years. Another eight people were injured, including two women, three boys and two girls. Nearly 25,000 civilians left following the attack. C. Attacks affecting medical facilities 36. Consistent with a pattern previously documented by the Commission, 26 proGovernment forces reportedly struck 25 medical facilities in Idlib and western Aleppo between November 2019 and February 2020. 37. Ten such incidents in Idlib were investigated by the Commission. 38. Four medical facilities were damaged between 4 and 6 November in Jisr al-Shughur, Kafr Nubl and Ariha. 27 Among them was the Ikhlas maternity and paediatric hospital in Shinan, south of Ariha, which is the only maternity hospital in the area. On 6 November, at around 1.30 a.m., pro-Government forces carried out two air strikes that destroyed the facility and injured at least two medical workers. Later that day, at around 4.15 p.m., a series of air strikes conducted by pro-Government forces struck the de-conflicted surgical “cave” hospital in Kafr Nubl,28 by then the only facility servicing the area, damaging its western entrance and vital medical equipment. Doctors interviewed by the Commission described how, following the attacks on medical facilities in Kafr Nubl and Shinan, the number of staff reduced significantly while vital equipment was moved to hospitals in northern Idlib. 39. On 8 January, the central hospital in Ma’arrat al-Nu’man – by then the only hospital able to provide basic care in the area – was hit in a ground attack by Government forces that caused extensive damage to the facility. Most of the staff left soon thereafter owing to fears of further attacks. The Commission notes that interview accounts obtained from witnesses to the attack are consistent with the use of the BM-21 Grad multiple-barrelled rocket launcher system, reportedly from the area of Government-controlled Khan Sheikhoun, located 13 km south and within the range of this weapon. 40. On 29 January, after taking over Ma’arrat al-Nu’man and Kafr Nubl, three consecutive air strikes on residential areas in northern Ariha disabled the last medical facility servicing southern Idlib. The Commission has reasonable grounds to believe that the strikes were carried out by aircraft of the Russian Federation (see annex III). At least 14 civilians, 26 27 28 8 A/HRC/28/69, annex II, paras. 2–8; A/HRC/30/48, paras. 34–35; A/HRC/31/68, para. 77; and A/HRC/43/57, paras. 22–23, and annex II, paras. 1–8. A/HRC/43/57, paras. 28–29. Kafr Nubl “cave” hospital was hit previously. See A/HRC/42/51, annex II, paras. 1–3; and “Summary of the Secretary-General of the report of the United Nations Headquarters Board of Inquiry into certain incidents in northwest Syria since 17 September 2018 involving facilities on the United Nations deconfliction list and United Nations supported facilities”.