ABOARD THE ADMIRAL ESSEN -- Russia fired a salvo of cruise missiles from the Mediterranean on Thursday and said they struck Islamic State targets in eastern Syria, where activists said at least 20 civilians were killed in what they described as a "fanatical" bombardment.
The activists blamed some of the attack on Russia and some on the United States.
It was not clear whether there was a connection between the Russian military strikes and the activists' accounts. It is often difficult to verify conflicting claims in the aftermath of attacks in Syria's civil war, now in its seventh year.
The seven Kalibr cruise missiles, launched from the submarines Veliky Novgorod and Kolpino, hit Islamic State installations in Deir el-Zour province, the Russian Defense Ministry said. The province is where forces backed separately by Washington and Moscow are racing to seize territory in the jihadist group's shrinking Euphrates River valley domain.
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But Turkey-based activist Omar Abou Layla said their contacts reported "fanatical" levels of bombardment on three Islamic State-held towns and villages along the valley -- far more than could be accounted for by seven missiles -- including an attack on the national hospital in the Islamic State stronghold of al-Mayadeen, where six civilians were reported killed. Abou Layla put the toll at 20 killed across the province. He added that the provincial capital, also called Deir el-Zour, suffered heavy airstrikes as well.
Russian-backed pro-government forces have been on the offensive to take back the city after breaking an Islamic State siege there last week. It was the first time reinforcements were able to reach the city in nearly three years.
The Britain-based Syrian Observatory for Human Rights said at least 39 people were killed and over 100 wounded in strikes in the river valley, including some against hospitals and ferry crossings. The monitoring group said the U.S.-led international coalition, which is supporting nongovernment forces, was behind some of the strikes.
It has been impossible to verify the claims independently. Russia and the Syrian government only allows journalists into the country on carefully orchestrated media tours meant to showcase their might and legitimacy in the conflict; the U.S. does not accept embedded journalists at all.
With pro-government forces already inside the city of Deir el-Zour, the chief U.S. partners in Syria -- the Syrian Democratic Forces -- began their own campaign to take what they can in the valley.
All sides say they are fighting terrorists in the energy-rich region that borders Iraq.
Activists said the campaigns are killing scores of civilians. The Observatory said it has documented 106 civilian deaths in airstrikes since Sunday; Abou Layla said his organization, Deir Ezzor 24, has recorded 90 fatalities in the same period.
"We believe they are trying to finish the Deir el-Zour battle as quickly as possible," Abou Layla said of Russia, citing pressure to capture the Euphrates River valley before the U.S. partners establish a foothold.
Aboard Russia's frigate Admiral Essen, journalists watched as the two Kilo-class submarines surfaced to launch the missiles, whose contrails gashed the clear blue sky.
The missiles hit southeast of Deir el-Zour, destroying a command center, a communications hub and an ammunition depot, killing an unspecified number of Islamic State fighters, said Defense Ministry spokesman Maj. Gen. Igor Konashenkov.
Russia has provided military support for Syrian President Bashar Assad since 2015.
The militants in Deir el-Zour city are surrounded by Syrian troops on three sides, with their backs to the Euphrates River. Government forces control more than 60 percent of the city, which is north of the Euphrates.
U.S.-backed Syrian forces, meanwhile, are advancing in the surrounding province from the east and north, on the other side of the river.
Bassem Aziz, a spokesman for the U.S.-backed and Kurdish-led Syrian Democratic Forces, said his troops took control of an industrial area east of the river, a few miles from the government troops.
Overnight, a convoy of Islamic State militants and their relatives being evacuated crossed into Deir el-Zour from a desert area in central Syria, ending a standoff with the coalition.
The evacuation, negotiated by Lebanon's Hezbollah group, removed the militants from the Syria-Lebanon border but angered Iraq and the U.S., which said the fighters should have been killed on the battlefield, not moved to the Iraq border.
A Section on 09/15/2017