More civilians in Syria were killed as a result of Russian military action than at the hands of Isis or forces loyal to President al-Assad, according to data compiled by a respected human rights group. A minimum 1,382 civilians were killed in January, according to the Syrian Network for Human Rights (SNHR), 679 of these as a result of Russian air strikes. These included 73 women and 94 children.

In the same month forces loyal to al-Assad, including government troops and related militias, are thought to have killed 516 civilians including 83 children and 60 women. 53 individuals were said to have been killed as a result of torture. Over the same period Isis - also known as Islamic State or Daesh - killed 98 civilians, including 21 women and one child, according to the SNHR report.

Russia has repeatedly denied targeting and killing civilians. In January (2016) Ministry of Defence spokesman Igor Konashenkov claimed his country's air force "does not even plan air strikes on such targets in the event of a threat of civilian deaths."

Russian actions in Syria have again come under scrutiny this week with the bombing of three hospitals in Idlib province in which at least 50 civilians were killed. Turkey has said Russia will face a very high price if the bombardments continue. UN secretary general Ban ki-Moon said the strikes were "blatant violations of international laws" that were "further degrading an already devastated healthcare system and preventing access to education in Syria."

However the Russians have categorically denied involvement in the bombing. President Putin's spokesman Dmitry Peskov told a Moscow press conference: "We categorically reject such claims, even more so because each time those who make such claims prove unable somehow to corroborate their unsubstantiated accusations." Peskov then referred journalists to the Syrian government response which is that the US coalition is to blame for the strikes on the hospital.

A ceasefire is due to commence on Friday but few observers are confident it will hold. To date an estimated 250,000 people have been killed in the conflict with millions more displaced internally and across the world, many of them making a desperate bid to reach Europe.