UPDATE (18 Feb 2016) — The death toll has risen to 25 people, with 11 people wounded.

The hospital was hit four times in two attacks within a few minutes of each other. Nine MSF-supported staff have been confirmed killed, 10 have been wounded. Sixteen people, including patients, caretakers and visitors, have been killed, one of whom was a child. One other person has been recorded wounded.

UPDATE (16 Feb 2016) — When the attack occurred 25 members of staff were in the hospital; five staff members have been confirmed killed; three were recovered from the rubble with injuries; two remain missing. The other 15 staff in the hospital at the time survived. Five patients, including one child, and a caregiver were also killed in the attack.

The current death toll of 11 is likely to rise, as staff inside were not aware of how many patients where in the structure when it was attacked. “When the hospital was hit, it was the time of the changeover from the night to the day shift, and the patient count had not been carried out,” says MSF’s head of mission Massimiliano Rebaudengo.

Rescue workers are still looking through the rubble and starting to clean up the area. “We do not know if the facility will reopen in another location,” said Masimiliano.

MSF supports more than 150 structures inside Syria, and this support can range from regular resupply of medical material to full support, where MSF pays for salaries and all the running costs of the hospital.

15 Feb 2016, Gaziantep — At least seven eleven people were killed*, and at least eight are missing, presumed dead, after a Médecins Sans Frontières (MSF) -supported hospital in Idlib province in northern Syria was destroyed in an attack on Monday morning.

The hospital in Ma’arat Al Numan was hit by four missiles in two attacks within a few minutes of each other, according to staff from the hospital. Around 15 other houses and structures located in populated zones were struck in the area, including reports of another non-MSF-supported hospital during Monday morning.

“The destruction on the MSF supported facility appears to be a deliberate attack on a health structure”, denounces Massimiliano Rebaudengo, MSF’s Head of Mission.

Five patients were killed, as well as one caretaker. In addition, a hospital guard was killed and eight members of staff are missing, presumed dead. Other patients are still missing, but their numbers are currently unknown.

“The destruction of the hospital leaves the local population of around 40,000 people without access to medical services in an active zone of conflict,” Massimiliano said.

There were also reports on Monday morning of another two hospitals in Azaz city being attacked. These facilities were not supported by MSF.

The 30-bed hospital in Ma’arat Al Numan had 54 staff, two operating theatres, an outpatient department and an emergency room. The outpatient department treated around 1500 people a month, the ER carried out an average of 1,100 consultations a month, and around 140 operations a month, mainly orthopaedic and general surgery, were carried out in the operating theatres.

MSF has been supporting this hospital since September 2015 and covered all the needs of the facility including provision of medical supplies and running costs.

In December 2015 MSF supported the reconstruction of the hospital after it had been forced to move from the previous location after being attacked three times.

Fighting also intensified in Azaz district about 100 kms away from Ma’arat Al Numan on Monday morning, and MSF’s Al Salamah hospital has so far received 10 war wounded patients. A mother and child hospital (not supported by MSF) has also been bombed in Azaz city, the hospital is organizing the setup of its pediatric operating theatre into MSF's Al Salamah hospital.