At least 22 have been killed in airstrikes against two hospitals in Syria.

A hospital in Maarat al-Numan in Syria’s Idlib province, supported by medical charity Doctors without Borders, was struck four times. At least seven people were killed, including 5 patients, a staff member, and a hospital guard. Eight are missing, the medical charity said, according to CNN.

“This appears to be a deliberate attack on a health structure, and we condemn this attack in the strongest possible terms,” Massimiliano Rebaudengo, the Doctors Without Borders head of mission said regarding the strike, according to New York Times.

In a separate attack near the Turkish border in Azaz, at least 12 people were killed in strikes on a children’s hospital and a school housing displaced people.

Under international humanitarian law, it is forbidden to attack medical facilities.

Attacks follow days after an agreement made last week in Munich between Russia and other world powers to limit the cessation of hostilities in Syria by the end of this week.

The five-year civil war in Syria has led to the deaths of over 250,000 people and has displaced over 11 million.