Activists monitoring Syria’s long-running civil war said Saturday that airstrikes had seriously damaged an underground medical center in Idlib province, just kilometers from the site of a deadly chemical attack that sparked international outrage and a U.S. cruise missile retaliation earlier this month.

The Syrian Observatory for Human Rights said airstrikes targeted a cave that housed the rebel-controlled Abdin medical facility, killing at least one person and wounding more than a dozen others. Another opposition website, Aleppo Today, said three medical staffers were presumed killed.

Witnesses said it was unclear whether Syrian warplanes or those from ally Russia had targeted the facility.

The medical charity Physicians for Human Rights said more than 400 airstrikes tied to Russian or Syrian government warplanes bombed more than 300 separate medical facilities between 2011 and the end of last year. Nearly 800 medical workers were killed.

The Abdin facility is just north of Khan Sheikhoun, the town hit in a chemical attack that killed about 100 civilians in a suspected government-ordered strike on April 4. U.S. President Donald Trump responded by ordering a cruise missile attack on an air base in western Syria.

Separately Saturday, monitors said warplanes thought to belong to the U.S.-led international coalition battling Islamic State extremists struck targets on the Euphrates River 40 kilometers upstream from IS’s de facto capital, Raqqa.

An observatory statement said the strikes near al-Tabqa city had killed at least five people and wounded an untold number of others.

U.S.-backed Kurdish fighters have been pushing northward toward Raqqa for weeks, cutting IS supply lines and capturing an air base near the Tabqa dam.

Those units advanced toward Raqqa as a largely Syrian Arab militia closed in on the extremist-held city from the west, north and east, ahead of an expected assault on the stronghold later this year.

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