Beirut: A series of air strikes Friday in opposition areas in Syria’s northern Aleppo province killed at least 18 people, including children and two hospital staffers, when the missiles hit an open market, a women and children’s hospital and a village, activists and rescue workers said.

Air strikes hit the only hospital for women and children in the town of Kafr Hamra before dawn Friday, killing two staffers including a nurse. The first-responders team of Syrian Civil Defense said it pulled 10 people alive from under the rubble.

Kafr Hamra is adjacent to the northern frontline in the deeply divided city of Aleppo, where government troops have sealed the main route into opposition areas, effectively trapping nearly 300,000 residents.

The opposition fighters launched a counteroffensive last week, breaching the siege from the southern front. That road remains under fire, and the UN has asked for a ceasefire to allow aid into the area.

Health facilities have been frequently targeted in the civil war in Syria. Aid groups have said the month of July was one of the worst since the war began in 2011, with some 43 facilities in opposition areas partially or totally destroyed.

Despite calls for cease-fire and a promise from Russia of a three-hour respite to allow in humanitarian aid, there has been no let up in the violence.

During the day Friday, air strikes hit a market area in the southwestern Aleppo Province town of Urem aAl Kubra, killing at least six people, according to the Britain-based Syrian Observatory for Human Rights, which monitors the war in Syria. Urem Al Kubra lies on the road linking Aleppo to the northern rebel-controlled province of Idlib, which has also witnessed intense bombings.

In the northern Aleppo countryside, at least 10 people were killed, including children and women, when airstrikes hit the village of Hayan. It was not clear what the target was but videos shared by activists of the scene of the attack shows bodies of women and children strewn on the side of the road as frantic locals scramble to pick them up.

Activist-operated Facebook page the Local Coordination Committees said collective open air Friday prayers were called off in Idlib because of the intensity of the airstrikes. Muslims around the world perform the weekly Friday prayers in and outside mosques.

Germany’s foreign minister called for UN-supervised humanitarian access to Aleppo, saying a unilateral three-hour daily cease-fire isn’t enough.

The Russian military is fighting alongside Syrian government forces in the civil war. A senior UN humanitarian official already has said that a 48-hour pause each week is needed in view of the logistics of providing aid.

German Foreign Minister Frank-Walter Steinmeier was quoted as telling Friday’s edition of the daily Frankfurter Allgemeine Zeitung that “humanitarian access can’t be under the single-handed control of one side of the conflict.”

“A unilaterally declared three-hour cease-fire per day isn’t enough to avoid a humanitarian catastrophe,” he said.