Two hospitals in rebel-held east Aleppo have been put “out of service” and dozens of people are reported trapped after being hit by Russian and Syrian government airstrikes in the latest round of intense bombardment in the battleground city.

Mohamad Zain Khandaka, a medical administrator at the M2 hospital, told Middle East Eye (MEE) it was targeted at about 3.30 a.m. An ambulance was destroyed, two patients were killed and three staff injured, and 90 people were reported trapped in the basement as jets circled overhead.

#Aleppo nurse in M2 hospital now: “if the hospital falls and we get stuck under the rubble, please no pictures. Don’t forget our dignity.”

— Adham (@adhamsahloul) September 28, 2016

The M10 hospital, eastern Aleppo’s largest hospital, was hit at about 4 a.m., destroying its main generator and medical equipment. Casualties are yet to be confirmed as the Syrian White Helmets civil defense group attempts to rescue those trapped under the rubble.

M2’s Khandaka told MEE, “The time between 3.30 a.m. and 5 a.m. was difficult as the repairs made to the M2 hospital in the last few days were once again completely destroyed.”

He also told MEE that patients from the M2 hospital were “being evacuated by foot” as the ambulances were damaged.

Both medical facilities, which are run by the Syrian American Medical Society (SAMS), have in recent months been forced to move underground in the face of heavy bombardment from Syrian and Russian air attacks.

A SAMS spokesperson said the M10 hospital was completely out of operation.

“There are now six active hospitals out of eight available. Three of those six have trauma/ICU capacity. The remaining three are a children’s, a women’s and an eye hospital.”

The attacks came a day after the launch of a ground offensive by Syrian forces and their allies along three fronts around Aleppo. Medical staff said they believed the bombings were “timed and deliberate” to coincide with the land assault and expected casualties.

Earlier this week, the Save Our Syria campaign, a coalition of Syrian civil society and humanitarian groups, said in a statement that the recent use of “bunker buster” bombs has meant “hospitals operating underground are no longer immune from deliberate attacks by the Syrian regime and Russian forces.”

Speaking at the U.N., Raed Saleh, who heads the Syrian White Helmets, said, “We have exhausted all the options of civilian protection – we’ve even dug hospitals underground and in caves, as if we are living in the Middle Ages.”

Last month, MEE reported on the use of “illegal” vacuum bombs being used against the M2 hospital.

SAMS advocacy officer Mohamad Katoub told MEE that a medical facility in Syria is “hit every 17 hours” by an airstrike.

Since the Syrian civil war began, about 13 hospitals and health facilities supported by SAMS have been destroyed in attacks.

According to Katoub, August saw the “highest amount of attacks on health facilities across the whole of Syria since the conflict began.”

This article was originally published by Middle East Eye and is reprinted here with permission.