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INVESTIGATIONS

Attack on the Maryan Medical Centre in Idlib

December 14, 2022

An investigation into an attack on a medical centre in Idlib using the Krasnopol weapon system

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This investigation was conducted in collaboration with Focus Aleppo and with input from Armament Research Services (ARES), an apolitical research organisation.

Initial Summary

  • Place of incident: Idlib - Maryan
  • Impact sites: Medical Centre
  • Date: 8 September 2021
  • Time: Between 05:40 - 06:00 local time, according to witness statements, reports from flight observatories, and reports on social media
  • Victims: The death of a women and the wounding of her child were verified by the investigations team
  • Type of attack: At least one 3OF-39-series laser-guided projectile used in conjunction with the 2K25 Krasnopol artillery system hit a medical centre and a residential home
  • Munitions likely used: Unknown
  • Potentially responsible: A joint military station associated with Syrian and Russian forces in the village of Basqla in Idlib’s southern countryside

Introduction

Fatima Al Khatib—Umm Qasim—was killed and her child seriously injured, requiring the amputation of his hand, when their house was bombed with several projectiles at dawn on September 8, 2021. The two-storey home was hit by two projectiles, a few minutes apart, penetrating the building’s cement ceiling and greatly damaging the building. The building consisted of a home on the upper floor and a medical centre on the ground floor. The medical centre was completely destroyed and forced out of service. Fatima’s husband, Mohammed Al Khatib, is the director of the medical centre in Maryan and managed to escape the attack as he went to the nearby mosque to perform the Fajr prayer. Similarly, medical staff left the medical centre after the first attack. According to eyewitnesses, Fatima refused to leave her house previously with displacement campaigns and stayed with medical staff to treat patients from Jabal Al-Zawiya, an area where medical centres and services are completely absent. 

Mustafa Maan Al Khatib, warehouse manager at the Maryan medical centre, told Focus Aleppo that two projectiles hit the house and medical point at 05:40, killing Fatima Al Khatib and injuring her child, Abd Al Rahman Khatib as well as completely destroying the building’s upper floor and large parts of the medical centre on the ground floor.  

Al Khatib added that the medical centre was composed to two departments: emergency/ambulance and clinics, in addition to a free pharmacy. These departments were staffed by a doctor, nurses, anaesthesia technician, a security guard, and a general employee. The centre served people from the 25 villages in the surrounding area, 24/7. At the time of the incident, the Maryan medical centre was the only medical centre still in service in the Jabal Al-Zawiya area, after other centres and hospitals were hit in previous attacks.

Methodology

Syrian Archive conducted an investigation into the incident by:

  • Analysing  witness testimonies from journalists, photographes, and residents in the area;
  • Preserving, analysing, and verifying 42 videos, photos, and reports uploaded to social media showing the impact site, the damage, victims, and the initial response; 
  • Analysing 50 videos and photos of the damage, the impact site of projectiles, munition remnants, and the possible origin direction, comparing photos and videos taken by Focus Aleppo with those found online; and
  • Identifying the incident site on satellite imagery, mapping the origin of the attack from the direction of the projectile, interviews with observatories, determining the time of the attack based on testimonies and first reports, and analysing the position of the sun from a screenshots showing first responders; 

This investigation is a summary of multiple stages of analysis of available open source information. These sources provided information on the date, timing, locations, victims, and impacts of the attacks. By examining all available information, Syrian Archive investigation team developed an understanding of the incident and its likely perpetrator.

For more details about Syrian Archive’s methodology, please visit our site.

About the village of Maryan in Jabal Al-Zawiya

The village of Maryan is considered the northern gateway to the villages of Jabal Al-Zawiya. It is in the Ahsim district in the region of Ariha. The village is an important transportation node where Jabal Al-Zawiya Road branches off towards Maaret Al Numan and Kafr Nabl, two cities that have been controlled by Syrian government forces since the beginning of 2020. 

Satellite imagery of Maryan

Maryan and the villages of Jabal Al-Zawiya (about 33 villages) are located within de-escalation zones near the M4 international road. Jabal Al-Zawiya are in between and bordering large areas of the M4 and M5 roads, which are controlled by the Syrina Salvation Government. A truce was agreed between Russian and Turkish forces at the beginning of March 2021, which led to a ceasefire and joint patrols on the main road.

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Maryan as shown on Google Maps

Since the beginning of May 2021, the villages of Jabal Al-Zawiya have witnessed a major escalation of air raids and indirect fire, forcing some of its displaced residents returning to the area to flee again. In a report from the Omran Centre for Strategic Studies is a table of the strikes that hit the Jabal Al-Zawiya area during the month of May 2021.  The number in May was ten and in June it rose to 36. Syria Response Coordinators documented, between 1 June and 25 July 2021, 791 ceasefire agreement violations, including attacks on 19 medical facilities, IDP camps, and schools, displacing more than 4000 people.

About Maryan Medical Centre (Medical Centre in Jabal Al-Zawiya) in Maryan - Jabal Al-Zawiya

Maryan medical centre went through periods of activity that varied in terms of importance, dependent on the services it provided, from its establishment until it went out of service as a result of the bombing on September 8, 2021. It’s considered one of the first and oldest medical points in Jabal Al-Zawiya, as it was established in 2012 with the support of Orient Organization, before it ended support in 2015.

A video published by Radio Fresh states that Maryan medical centre was not supported by any humanitarian agency or organisation, and was run by volunteers until the date of the incident. It received between (120-130) patients daily, and provided emergency services to the people of Jabal Al-Zawiya. 

Radio Fresh’s video also adds that the centre was run by a doctor and four nurses, and relied on the support of donors to cover expenses. It provided ambulatory services in addition to treatment for leishmaniasis and a pharmacy that provided medicines for people with chronic diseases.

The importance of Maryan medical centre came from the absence of medical facilities in Jabal Al-Zawiya, as the only centre in the area it served more than fifty thousand people. The nearest health centres are more than ten kilometres away from the villages of Jabal Al-Zawiya, located in the city of Ariha, while hospitals in Idlib are about thirty kilometres.

Geographical location of Maryan Medical Centre

Visual content published online related to the attacks on Maryan medical centre shows prominent landmarks on the outskirts of the centre. The landmarks match satellite images of the targeted location, which confirms the attack.

Photos and videos published online show damage to a two-storey building with a sign of Maryan medical centre on it, there are several houses, and a mosque near the medical facility. These landmarks can be seen clearly from satellite imagery, which confirms that the Maryan medical centre was the site of the attack.

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An image from the upper floor looking northwest, where the minaret of Al-Taqwa Mosque can clearly be seen - exclusive to Focus Aleppo

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Comparing landmarks shown in photos and videos published by Orient and Kafr Nabl al-Thawra, and photos obtained by Syrian Archive from the impacted site, with satellite images of the site from Google Maps

What Happened (and When)?

On September 8, 2021, at 05:42 local time, a two-storey building consisting of a residential house and a medical centre in the village of Maryan in the southern countryside of Idlib was hit by a Krasnopol artillery projectile, followed by another strike a few minutes later on the same site, approximately one metre from the first projectile. 

A video report published by Shaam Network on their Facebook page for an eyewitness stating that the first strike was at 05:42 local time, followed by another strike a few minutes after the first strike. The first report about the attack on the city was published at 05:51 local time.

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Source: Twitter

Approximately 38 minutes after the strike, the first report of the attacks on the medical point was circulated on the Internet at 06:20 local time.

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Source: journalist Ibrahim Khatib

Additionally, a video posted by journalist Anas Maarawi on his Facebook page, at 07:02 local time on the morning of the attack, which is, an hour and twenty minutes after the time of the attack, shows the arrival of the first responders to the impacted site. The footage shows the fires caused by the projectiles and the destruction of the residential house on the upper floor of Maryan medical centre.

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Screenshot from the first (upper) floor showing the damage and fires - Source: Video published by journalist Anas Maarawi

A few hours after the attack, activists and journalists rushed to the impacted site and began broadcasting videos and sharing news about attacks on the Medical centre in Maryan. Reports were published by Orient TV and Syria TV, in addition to materials published by journalists, activists and the Civil Defense.

Image of firefighters putting out the fire - Source: Syrian Civil Defense

A video published by Shaam News Network hours after the attack included the testimony of an eyewitness from the area, who spoke about the timing of the strike which occurred at 05:42 local time. The attack was followed by a second strike minutes later, the eyewitness spoke about moving a woman and her child from the impacted site and transporting them to Idlib, before the woman died in hospital. The video shows the wall where the name Maryan medical centre is written, while the near complete destruction of the location can also be seen.

Journalist Muhammad Balaas shared a video on his Facebook page in which he quotes the testimony of a witness who claimed “the place was targeted by two laser-guided missiles of the Krasnopol type, and that Mrs. Um Qasim lives on the upper floor of the centre that was targeted. She refused to leave and stayed with the working medical staff. The Medical Centre is located in the basement of her house, and the centre has been there for about ten years.”

Walid Aslan, commander of the Ariha Syrian Civil Defense chapter, confirmed, in a video published by Orient TV, the targeting of the Maryan Medical Centre, which provides emergency services to the residents of Jabal Al-Zawiya, and the killing of Mrs. Fatima Al-Khatib and the injury of her child. Aslan also stated that the continuous shelling of the area forces the local residents to flee to the north.

An Orient correspondent spoke about the damage at the impacted site that was targeted by Krasnopol laser guided missiles, and the destruction of the medical point which resulted in it being put out of service.

Central Ambulance and Referral System published pictures of the injured being removed from the location, and talked about the Krasnopol projectiles that targeted Maryan medical centre. Syria TV correspondent also spoke in a video from the site about the fall of four Krasnopol missiles in Maryan, two of which fell on Maryan medical centre. A testimony of one of the witnesses, who lives in a house twenty metres away from the impacted site, saying, “At 5:42 minutes, a shell landed on the building where the medical centre is located. I went to the targeted site and tried to treat the injured. A woman and her child had been injured, and they were taken to Idlib, where she died after arriving at the hospital.”

In a written report published by the Civil Defense on its website, it states the type of attack is a Krasnopol, and confirmed the death of a woman and the wounding of her child.

Though analysing videos and photos of the attacks of Maryan medical centre, investigation team concluded:

  • The coordinates of the bombing matched the Maryan medical centre. The extent of the destruction at the impacted the site put the centre out of service,
  • The area is devoid of any military installations or positions. The centre is surrounded by a number of civilian homes, in addition to the Al-Taqwa Mosque from the western side.
  • Photos and videos posted on social media match Maryan medical centre.
  • Confirming the death of Mrs. Fatima Al-Khatib, and the injury of her child, as the investigation team obtained recent photos of the child, who is still in the hospital receiving treatment.

The investigation team concluded that an artillery bombardment hit a two-story building that contained a residential house and a medical centre. It was bombed on September 8, 2021, resulting in the death of a woman and the injury of her child, and putting the only medical centre in Jabal Al-Zawiya out of service.

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Screenshot from a video report of Maryan medical centre published on February 7, 2021 showing the northern entrance to the centre - Source: SY+

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Screenshot from a video report published on October 5, 2020 by Maryan medical centre, taken from the centre’s northern entrance. The name and the logo of  “Maryan Medical Centre” appear on the wall - Source: Enab Baladi

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Image to the northern entrance of the Maryan medical centre - exclusive to Focus Aleppo

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Image from an interview conducted with the director of Maryan medical centre, Muhammad Nazir Al-Khatib, a video report published on October 5, 2020 - Source: Enab Baladi

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Image from inside Maryan medical centre, published in a video report on October 5, 2020 - Source: Enab Baladi

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Image from the same angle from inside Maryan medical centre after the bombing - Source: Syria TV

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Image from the same angle from inside Maryan medical centre after the bombing - Source: Syria TV

Timing

The Al-Ahrar Aviation Observatory reported at 05:47 local time on its Telegram channel the presence of a Russian reconnaissance plane circling the airspace of Ahsim and Maryan. At 06:05 local time it reported the presence of reconnaissance planes circling near the impacted location that were reported at 05:59 local time, and was described as “laser”.

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A screenshot of the Al Ahrar Observatory reporting

The first announcements of the attack came from a tweet by “Abu Ibrahim”, in which he stated, at 05:51 local time on September 8, “shelling on Maryan in Idlib”. Journalist Ibrahim Al-Khatib also published a tweet at 06:20 local time, in which he spoke about the attacks on the medical point in Maryan village. At 06:21 local time, Maryan Today’s  page published news about the killing of a woman and the injury of her child in the raids on the health centre in Maryan.

Journalists and local activists published online news about the attack. Witness testimonies stated the time of the attack to be on September 8, 2021, at 05:42 local time.

Witnesses confirm the timing of the bombing was between dawn and sunrise. According to the SunCalc tool, the time of sunrise on the day and location of the incident is 05:45 local time, which corresponds to the time of the bombing specified by witness testimonies, between 05:00 and 06:00 in the morning.

Additionally, witnesses confirm that the bombing corresponds with the Fajr prayer in the Idlib region. The prayer call is raised in Idlib on September 8, at 04:40 local time, according to timesprayer.today, which corresponds with the time specified by the testimonies about the bombing, between five and six in the morning.

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A screenshot showing the prayer times in Idlib on 8 September

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Image taken from the eastern entrance to the building showing the sun in its first hours of sunrise - Source: Journalist Anas Al-Maarawi

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Image taken during rescue operations by Syrian Civil Defense heading to the northeast, and we see the sun appearing from the eastern side - Source: Syrian Civil Defense

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Image showing the location of the sun and shadows at approximately 06:30 local time, which is estimated to be around the time the previous two videos were filmed - Source: SunCalc

The timing of the first reports of the incident correspond with the statements that indicated it occurred after the Fajr prayer, and the shadows shown in the videos from the first responders, which appears that the raids took place on September 8, 2021, between 05:40 and 06:00 local time.

Damage

Videos and photos published on social media, in addition to videos documented by Focus Aleppo and were given to Syrian Archive. Two holes in the roof of the outer building are visible, and solar panels are damaged. In addition to the complete collapse of the northern facade of the building, cracks are seen on the opposite walls, and windows and doors are blown out. The balcony wall was demolished, and only fragments remained in place.

In Maryan medical centre a crack can be seen on the building, and some walls have collapsed, as well as damage to its external fence and caravans. In addition to material damage to tools, equipment, medicines, and cracks in its external walls.

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Screenshot from the upper floor looking to the northwest, showing the damage to the house as a result of the bombing - Source: Orient

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Screenshot from the first (upper) floor facing north - Source: Video shared by journalist Anas Maarawi

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Screenshot from the upper floor looking to the north, showing the damage to the house as a result of the bombing - Source: Orient

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Screenshot from the upper floor towards the west showing one of the two holes in the roof caused by the bombing. An angle towards the north in the reinforcing iron of the concrete roof can be seen - Source: Video shared by  journalist Anas Maarawi

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Screenshot from the upper floor looking west showing two holes in the ceiling caused by the bombing - Source: Orient

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Analysis of the previous picture shows the extent of the destruction on the wall and the reinforcing bars. It is likely the source of the two projectiles is from the south.

Pictures showing two holes caused by the bombing - exclusive to Focus Aleppo

Images of the roof facing to the north showing holes caused by the bombing and the damage to the solar panel. In the background of the picture the minaret of the old Zawiya Mosque can be seen, which is located to the north of the medical point with an angle of inclination towards the northwest - exclusive to Focus Aleppo

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Picture from the north of the house facing south, showing the destruction to the house - exclusive to Focus Aleppo

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Image looking south at the destruction of the house on the upper floor.  Notice that the southern wall was not damaged and the northern wall was completely demolished - exclusive to Focus Aleppo

Image of destructed medical supplies in the basement - exclusive to Focus Aleppo

Munitions used

Syrian Archive obtained photos from Focus Aleppo of the munition used in the attack of Maryan medical point. Online pages published news about the incident claiming that the attack used Krasnopol system weapons, including a report by the Syrian Civil Defense in Idlib. 

The two munition pieces shown in the photos closely resemble photos of remnants of Krasnopol system weapons reportedly found in Ukraine in 2019 and shared by press secretary of the Prosecutor General’s Office of Ukraine Andriy Lysenko and other sources. In particular, the round base with screws shown in the prosecutor’s picture and tubularbase gas generator” appear to directly match remnants seen in the photos obtained by Focus Aleppo.

Pictures provided to Syrian Archive showing items allegedly recovered from the impact site. Pictured are what appear to be remnants of a Krasnopol-series guided artillery projectile (source: Focus Aleppo)

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A visual comparison of 3OF-39 Krasnopol projectile remnants presented by the press secretary of the Prosecutor General’s Office of Ukraine Andriy Lysenko (top) with the remnants recovered shown in photos given to Syrian Archive (centre) and a picture of projectile remnants, likely from a Krasnopol munition, shared by the Atlantic Council’s DFR Lab (bottom) (sources: Prosecutor General’s Office of Ukraine; Syrian Civil Defence; The Atlantic Council’s DFR Lab)

Further context provides more evidence for the use of the Krasnopol projectile in this attack. The presence of reconnaissance aircraft above the area of attack—one of two methods used to guide the laser-guided Krasnopol, onto its target—is consistent with the use of this type of munition. The Al-Ahrar Aviation Observatory reported at 05:47 local time on its Telegram channel the presence of a Russian reconnaissance plane circling the airspace of Ahsim and Maryan. At 06:05 local time it reported the presence of reconnaissance planes circling near the impacted location that were reported at 05:59 local time, and was described as “laser”.

Taken together, the combination of technical and contextual evidence leads Syrian Archive to assess with high confidence that at least one of the projectiles used in the attack on Maryan was a 3OF-39-series laser-guided projectile used in conjunction with the 2K25 Krasnopol artillery system. However, given the limited visual information present in available imagery of the remnants (which appear to show only one munition) and the number of 3OF-39 variants utilised by the 2K25 guided weapon system, Syrian Archive is unable to positively identify either the specific Krasnopol variant used (including calibre) or whether all munitions used in the attack were of this make and model.

Casualties

The bombing resulted in the killing of Mrs. Fatima Al-Khatib, and the serious injury of her child which resulted in the amputation of his hand. The northern side of the house was completely destroyed , and the building itself was severely damaged. Two projectiles put the medical centre out of service.

Potentially responsible

Focus Aleppo documented the location of the two projectiles, which penetrated a concrete ceiling more than 12 centimetres thick, before exploding inside the upper floor of the house inside the medical centre.

The two projectiles left two holes in an oval shape, about 40 centimetres in diameter. By determining the direction of the two holes, it is clear that they fell in the north-west direction, which indicates that the firing direction was from an opposing position from south-south-east.

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Analysing the damage to the roof of the building and the solar panel that faces the south with an angle of inclination towards the southeast: the image is directed to the north with an angle of inclination to the northwest and the arrows indicate the likely direction of the projectiles falling on the building from the south with an angle of inclination to the southeast of the impact site

Additionally, the collapse of the northern side of the building from the inside. The fragments spread to the outer wall and the caravan of the medical centre in the courtyard to reach the opposite building to the north, about 10 metres away. This confirms that the shells hit the roof of the building, came from the south.

Image from the upper floor facing north, showing the damage to the northern facade and the destruction of the wall, reaching the opposite building in the north, which is about 10 metres away - Focus Aleppo

In a radius of 20 kilometres prepared by the investigation team, the team was able to identify five possible launching points, all of which are controlled by the Syrian regime forces or affiliated militias.

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A map published by the Military Observer page showing in red the areas controlled by the Syrian regime and its allies, in green the areas controlled by the opposition on September 13, 2021

To better estimate the direction of the attack, Focus Aleppo reporter visited the impact site again in April 2022. He noticed the removal of the solar panels that were on the roof of the centre, which had been damaged by the bombing, and tried to determine the direction of the projectiles’ fall to help determine the direction of their launch. The reporter used a compass app on his mobile phone and placed his phone in the direction of the projectile’s fall that penetrated the solar panel. According to the compass, the direction of the projectile’s fall was to the north-northwest, with an inclination of 345 degrees. Analysing the compass result, the location from where the projectiles were launched is located in the south-southeast at a degree of inclination 165 (345-180=165), which is from the direction of Kafranbel.

Pictures from Focus Aleppo’s visit to the site where one of the projectiles fell at the Maryan medical point. The researcher used the compass app on his phone to determine the direction of the projectile’s fall - Exclusive to Focus Aleppo

By drawing a polygon for the direction of the projectile, 4 locations were excluded from the possible launching points. The direction of the projectiles denies that they were fired from Maarat Hormah or Al Daar Al-Kabira, as well as Maarat Mater or Maarat Al-Numan, and limits the angle of launching to Basqla and its surrounding areas.

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A satellite image showing the location of the artillery station in Bsaqla, about 14.7 km to the south-southeast, at an angle of inclination of 176 degrees from the Maryan medical centre

The Basqla camp is under joint administration between the Syrian regime and Russia, according to a report by Syrians for Truth and Justice. The report claims of a similar targeting by Krasnopol projectiles were fired from the same camp during the past months on villages and towns in Jabal Al-Zawiya.

Syrian government forces are stationed along the borders of Idlib, and in all areas, but the direction of the shells from the southeastern side indicates they fell from one of the artillery positions located in the village of Basqla in the southern countryside of Idlib. This was confirmed by a local observatory, which claimed that the shells came out of the “Akatsiya” artillery station in Basqla.

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Satellite image of the “Akatsiya” artillery located in Basqla

Conclusion

From the information detailed above Syrian Archive was able to confirm the bombing targeted a medical point and a residential house in the village of Maryan in the southern countryside of Idlib, on September 8, 2021, between 05:40 and 06:00 local time. The bombing killed Mrs. Fatima Al-Khatib and injured her child, Abdul Rahman, in addition to the destruction of the house and the medical point, and putting the latter out of service.

Due to limitations faced in the investigation, Syrian Archive is unable to definitively determine the type of missile and the responsible party. However, open source information, and materials and testimonies obtained by Syrian Archive indicate at least one 3OF-39-series laser-guided projectile used in conjunction with the 2K25 Krasnopol artillery system was fired from a military barracks in the village of Basqla in which both the Syrian and Russian forces share control. This indicates that these two parties are most likely responsible for this incident.

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