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An assault on rebel-held northwest Syria by government forces has pushed some 700,000 people to flee toward the Turkish border and raised the specter of an international crisis, U.S. Special Envoy for Syria James Jeffrey said on Thursday.

Backed by Russian air power, government forces have advanced on Idlib at a rapid clip since last week, taking back dozens of towns and upending a region where millions have taken refuge since the start of Syria’s nearly nine-year war.

The campaign has ratcheted up tensions between Moscow and Ankara. Turkey fears a fresh wave of migrants piling across its border and has a dozen observation posts in Idlib, part of a de-escalation agreement it says Russia is now violating.

Speaking at an online news briefing, Jeffrey said that in the last three days Syrian government and Russian warplanes had hit Idlib with 200 airstrikes “mainly against civilians,” and that several Turkish observation posts had been “cut off” by the government advance.

There are “massive movements of troops pushing back hundreds of square kilometers and setting — I think now — 700,000 people who are already internally displaced on the move once again towards the Turkish border, which will then create an international crisis,” said Jeffrey.

Turkey already hosts more than 3.5 million Syrian refugees.

Moscow and Damascus say they are fighting jihadi militants who have stepped up attacks on civilians in Aleppo in northern Syria, but rights groups and rescue workers say airstrikes have demolished hospitals, schools and hit other civilian areas.

In a significant milestone for President Bashar Assad’s stated drive to reclaim all of Syria, government forces on Tuesday took Idlib’s second-biggest city, Maarat al-Numan, an urban center that straddles the M5 international highway linking the capital, Damascus, to Aleppo and is considered vital for trade.

A Syrian army general speaking on a media tour of Maarat al-Numan on Thursday said the latest military campaign was focused on securing all of the M5 highway. “God willing in four to five days it will be ready,” he said.

Smoke still billowed from some buildings in the city on Thursday while the demolished exteriors of others tumbled onto streets emptied entirely of civilians.

Syria’s war-torn economy has plunged deeper into crisis in recent months, with a rapidly weakening currency driving up inflation and aggravating hardship for Syrians struggling to afford basic goods.

“What they’re doing is using Idlib as a sort of distraction that allows time to keep their loyalist constituencies on a war footing,” said Yezid Sayigh, a senior fellow at the Carnegie Middle East Center in Beirut. “This is a regime that is unable to demonstrate effective control and revive economic activity, revive markets and hold up the lira.”

A U.N. report on Thursday described increasingly bleak conditions for Syrians in urgent need of shelter and food while fleeing bombardment.

“Whole towns have emptied as an increasing number of civilians flee northward to areas deemed safer, but which at the same time are rapidly shrinking, as territorial advances against opposition forces continue,” said David Swanson, the U.N. regional spokesperson for the Syria crisis in Amman.

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