Russia's Defense Ministry dismissed activist reports that it had carried out the strikes in a rebel-held area of Idlib province. The United Nations considers the area one of the most dangerous regions in the world.
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Russia on Monday denied claims that it carried out air strikes on a public market in northwestern Syria that killed at least 37 people.
The UK-based Syrian Observatory for Human Rights, a war monitor, and opposition activists said Russia bombed the town of Maaret al-Numan in Idlib province. The strikes reportedly injured at least 30 people.
"This the largest massacre to take place since the offensive started in April," Observatory head Rami Abdel Rahman told the DPA news agency.
The war monitor added that 105 people had been injured in the bombing in the city of Maaret al-Numann, and that more were feared still under the rubble.
Russia's Defense Ministry dismissed the reports as "fake."
"The Russian air force was not carrying out any missions in this part of Syria," it said in a statement.
Russian warplanes have been supporting forces loyal to Syrian President Bashar Assad in their fight to retake rebel-held areas of Idlib and Hama. The provinces are the last rebel strongholds left in the war-torn country.
Who's fighting in the Syria conflict?
Syria's civil war erupted out of the Arab Spring protests that swept much of the Middle East and North Africa in 2011. The conflict has since drawn in multiple warring factions from around the world.
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War with no end
Syria has been engulfed in a devastating civil war since 2011 after Syrian President Bashar Assad lost control over large parts of the country to multiple revolutionary groups. The conflict has since drawn in foreign powers and brought misery and death to Syrians.
Image: picture alliance/abaca/A. Al-Bushy
The dictator
Syria's army, officially known as the Syrian Arab Army (SAA), is loyal to Syrian President Bashar al-Assad and is fighting to restore the president's rule over the entire country. The SAA has been fighting alongside a number of pro-Assad militias such as the National Defense Force and has cooperated with military advisors from Russia and Iran, which back Assad.
Turkey, which is also part of the US-led coalition against IS, has actively supported rebels opposed to Assad. It has a tense relationship with its American allies over US cooperation with Kurdish fighters, who Ankara says are linked to the Kurdistan Workers' Party (PKK) fighting in Turkey. Turkey has launched multiple military offensives targeting Kurdish militias.
Image: picture-alliance/AP Photo/L. Pitarakis
The eastern guardian
The Kremlin has proven to be a powerful friend to Assad. Russian air power and ground troops officially joined the fight in September 2015 after years of supplying the Syrian army. Moscow has come under fire from the international community for the high number of civilian casualties during its airstrikes. However, Russia's intervention turned the tide in war in favor of Assad.
Image: picture-alliance/dpa/Tass/M. Metzel
The western allies
A US-led coalition of more than 50 countries, including Germany, began targeting IS and other terrorist targets with airstrikes in late 2014. The anti-IS coalition has dealt major setbacks to the militant group. The US has more than a thousand special forces in the country backing the Syrian Democratic Forces.
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The rebels
The Free Syrian Army grew out of protests against the Assad regime that eventually turned violent. Along with other non-jihadist rebel groups, it seeks the ouster of President Assad and democratic elections. After suffering a number of defeats, many of its members defected to hardline militant groups. It garnered some support from the US and Turkey, but its strength has been greatly diminished.
Image: Reuters
The resistance
Fighting between Syrian Kurds and Islamists has become its own conflict. The US-led coalition against the "Islamic State" has backed the Syrian Democratic Forces, an alliance of Kurdish and Arab militias. The Kurdish YPG militia is the main component of the SDF. The Kurds have had a tacit understanding with Assad.
Image: Getty Images/A. Sik
The new jihadists
"Islamic State" (IS) took advantage of regional chaos to capture vast swathes of territory in Iraq and Syria in 2014. Seeking to establish its own "caliphate," IS has become infamous for its fundamentalist brand of Islam and its mass atrocities. IS is on the brink of defeat after the US and Russia led separate military campaigns against the militant group.
Image: picture alliance/AP Photo
The old jihadists
IS is not the only terrorist group that has ravaged Syria. A number of jihadist militant groups are fighting in the conflict, warring against various rebel factions and the Assad regime. One of the main jihadist factions is Hay'at Tahrir al-Sham, which controls most of Idlib province and has ties with al-Qaeda.
Image: picture-alliance/AP Photo/Nusra Front on Twitter
The Persian shadow
Iran has supported Syria, its only Arab ally, for decades. Eager to maintain its ally, Tehran has provided Damascus with strategic assistance, military training and ground troops when the conflict emerged in 2011. The Iran-backed Lebanese Shiite militant group Hezbollah also supports the Assad regime, fighting alongside Iranian forces and paramilitary groups in the country.
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Idlib region is home to 3 million people and is meant to be protected by an international truce deal. However, it has come under increased aerial attack by the Syrian regime and Russia in recent months.
Idlib "has fast become one of most dangerous places in the world for civilians and aid workers today; a crisis within a crisis," said David Swanson of the United Nations Office for the Coordination of Humanitarian Affairs.
"This violence must stop and it must stop now," he added.
The recent uptick in violence has resulted in the deaths of more than 650 civilians as well as destroying or knocking out of service in excess of 20 health facilities.