At least 15 civilians have been killed in Syria‘s northwest region as Russian-backed government forces continued air raids and shelling in the last rebel-held territory in the country, activists and volunteer medics have said.

Five civilians including three children were killed when an air raid hit three homes and a vegetable market in the village of Ras al-Ain in Idlib’s eastern region on Tuesday afternoon, Ahmed Sheikho, a Syrian Civil Defence spokesman told Al Jazeera.

At least 20 others were injured in the attack in Ras al-Ain, he added.

Hussein al-Sheikh, whose home was among those that were hit, said he lost three cousins in the attacks – the youngest was five-years-old.

“I was standing near the front door watching the kids play just a few metres away,” al-Sheikh, whose house lies just a few metres away from his uncles’ home, told Al Jazeera.

“Suddenly we heard another explosion and we knew it was much closer than usual,” he said.

Al-Sheikh saw his uncle’s house collapse just after the three children ran towards the entrance.

In a “matter of minutes”, the children were being evacuated from under the rubble.

“It was a difficult scene to watch,” the 40-year-old said. “I can’t express what I saw.”

Tuesday’s air raids and shelling hit a string of other towns and villages, including the rebel-held Jisr al-Shughoor district, where six people were killed, activists told Al Jazeera. The area is close to a strategic commercial highway, sought by Syrian President Bashar al-Assad and military ally Russia.

Opening the commercial and passenger routes through Idlib province would reassert the government’s control over an economy fragmented during years of conflict.

‘Civilian structures’ hit

Attacks earlier on Tuesday also hit villages in adjoining parts of Hama province, according to the Syrian Civil Defence organisation, also known as the White Helmets, killing four civilians.

Sheikho said that dozens of air raids rained over “civilian structures”.

“The sounds of warplanes and explosions have not subsided for days – not in the day, and not in the evening,” he added.

In the past few days, government-led shelling struck at least four hospitals, or medical points, knocking them out of service.

Since April, at least seven facilities have been put out of service, United Nations spokesman Stephane Dujarric said.

“The United Nations is extremely concerned about attacks on healthcare facilities and hospitals in northwestern Syria,” Dujarric said.

The tactic has been used in the past ahead of fully-fledged assaults on provinces and cities held by opposition groups that fought against al-Assad’s government throughout Syria’s bloody civil war – now in its ninth year.

Idlib province lacks adequate medical facilities, which is one of the major issues faced by members of the White Helmets, many of whom volunteer as emergency medical workers.

“This lack of infrastructure forces us to transfer the injured to far-away locations,” Sheikho, whose team covers the southern region of the province, said.

“Even when we’re on the road, our vehicles are targeted,” he said. “We’re never, ever safe.”

Such indiscriminate attacks, as Sheikho put it, have led to massive delays in transferring those injured to a medical facility for treatment.

The White Helmets have faced so-called double-tap attacks – one bomb followed soon after by a second at the same location, according to Sheikho – which have killed many members of the organisation in the past.

The latest shelling and air raids are part of an intensified campaign launched by forces loyal to Assad on April 26.

The UN said on Tuesday the escalation in the northwest has displaced more than 150,000 people in the past week.

“We are alarmed by ongoing reports of aerial attacks on population centres and civilian infrastructure, resulting in hundreds of civilians dead and injured,” said David Swanson, of the UN Office for the Coordination of Humanitarian Affairs (OCHA).

“More than 152,000 women, children and men have been displaced in Aleppo and Idlib governorates over the past week alone,” he told AFP news agency.

In southern Idlib alone, at least 65 people have been killed and more than 146 injured since the escalation began, according to the Syrian Civil Defence group.

Idlib is a densely populated province, home to nearly three million people, most of whom are internally displaced, and is controlled by a range of armed opposition groups – some backed by Turkey.

The biggest group in control of much of Idlib is Hay’et Tahrir al-Sham (HTS), which is independent of the Turkish-backed umbrella of opposition factions in the region.

HTS has been designated a “terrorist” group by Russia, and their presence has been used as a justification for intensified attacks despite a deal that was meant to avert a fully-fledged assault in Idlib.

The deal, signed by Moscow and Ankara, included the creation of a so-called “demilitarised” zone in the region.

The UN has called for all sides to abide by the deal, signed September last year with the objective of avoiding a humanitarian disaster and preventing an influx of refugees from entering bordering Turkey.

Additional reporting by Mohammed Khalaf in Idlib.

Image: Carl Court/Getty Images

An Egyptian hospital and officials at the Yemeni embassy in Cairo were involved in a large-scale organ-trafficking ring from 2014 that included hundreds of patients and brokers from Yemen and Egypt, an Al Jazeera investigation has revealed.

Through interviews and documents obtained by Al Jazeera, the investigation exposes officials who have been giving out false papers for personal gain in order to facilitate the organ-trafficking.

The organ-trafficking ring preyed on poor Yemenis willing to travel to Egypt and sell a kidney in a desperate bid to gain income that would keep them going, at least for a while.

One of these Yemenis was Ahmed*, who was told in 2014 by a friend that he could get $5,000 for one of his kidneys. He agreed, and before he knew it, he was on a plane to Cairo.

At the time, Yemen wasn’t yet home to the world’s worst humanitarian crisis and a destructive war that has left 80 percent of its population in need of humanitarian assistance.

But it was the poorest country in the Middle East with half the population living below the poverty line.

In Yemen, selling your organs is not illegal. However, it is illegal in Egypt, where three donors Al Jazeera spoke to, and hundreds of others who told their story to a Yemeni NGO, went to sell their organs.

Recruited by a broker

The trafficking ring found its donors through brokers in Yemen who would find willing individuals and connect them with brokers in Egypt to arrange their travel, accommodation, and surgeries.

The brokers get involved for different reasons. One Egyptian broker Al Jazeera spoke to became involved after his brother needed a kidney and bought one from a Yemeni donor.

“After the operation, [the Yemeni donor] went back home and we stayed in touch … he started telling me he could find others willing to donate if I knew of anyone who needed transplants.”

The Yemeni broker Al Jazeera spoke to was initially recruited to be a donor but was not compatible with any of the ring’s clients.

Instead, he was asked to find others in Yemen who would be willing to sell a kidney and was told he would make a $1,000 commission on every donor he recruited.

Nabil al-Fadhil, head of the Yemeni Organization for Combating Human Trafficking, told Al Jazeera that his organisation verified some 1,000 cases of organ sales, but they were certain that there were tens of thousands.

“Of the thousand we interviewed, 900 had sold their kidneys then came back to Yemen as brokers looking to find new victims,” al-Fadhil said in an interview at the end of 2018.

Egyptian hospitals implicated

Patients in need of a kidney would get in touch with the network, which maintained a pool of candidates to act as donors.

Once a compatible donor was found, he would have the surgery almost immediately and be flown back to Yemen with little to no time to recover, leaving him vulnerable to health complications that made returning to his typically labour-intensive work very difficult.

Several hospitals across Egypt have been accused of operating on these donors, and the government has busted prominent doctors and institutions working in trafficking rings over the past five years.

“We work with public and private hospitals,” the Egyptian broker confirmed to Al Jazeera.

In al-Fadhil’s records from 2014, one hospital kept coming up, one that saw no arrests in spite of his notifying anti-trafficking organisations in Egypt: Wadi El Neel Hospital in Cairo.

It is one of 48 hospitals licensed by the Egyptian government to perform transplant procedures and Al Jazeera sources in Egypt say it is referred to as the Mukhabarat (or Intelligence) Hospital by many Egyptians.

“The Mukhabarat Hospital is used for Yemeni [donors] only, and the receiving patients are Saudis and other foreigners,” the Yemeni broker told Al Jazeera.

Al Jazeera reached out to the hospital and spoke to an individual who presented himself as a manager there.

He denied the accusations, citing Egyptian law: “If the patient is Yemeni then the donor must be Yemeni, with a passport accredited by the embassy, and the embassy’s approval to donate. This law has been in place for years. Everything but that is nonsense.”

In Egyptian hospitals licensed to perform transplant surgeries, donors are also required to testify that they are donating by choice, either in writing or on camera, which all three of our Yemeni donors did.

‘Yemeni embassy’s involvement’

All three donors claim they sold their organs to non-Yemeni nationals.

“They found a woman from the UAE who needed a kidney, so we did the blood and tissue tests, and found that we were a match. So I went in for the surgery … Afterwards, she asked me how much I got, I said $5,000. She told me that she had paid $50,000,” Ahmed* told us.

Besides having to be of the same nationality, the donor and recipient of an organ must be related, according to the Yemeni embassy in Cairo.

Proof of relation is signed off on by the Yemeni Ministries of Foreign Affairs and Justice, but it is the responsibility of the embassy that receives the paperwork and coordinates with the Egyptian Ministry of Health to finalise approval for a transplant.

According to our Yemeni broker, they were quite lenient, for a price.

“The embassy announced it was illegal to donate an organ unless it was to a family relation and the relationship would have to be approved by the embassy.

“There were 15 or 20 people waiting [to donate] but they stopped them. So, the network sent me to Yemen to get the necessary paperwork to prove a relationship.” the broker told Al Jazeera.

“I made a deal with a judge to pay him 80,000 Yemeni rials [$320] per case, and he’d get it signed by the Ministry of Foreign Affairs. I had done three when they got in touch and told me to stop because they’d found someone at the embassy who could approve the requests for $500 each,” he explained.

According to the Egyptian broker, cooperation by Yemeni officials was instrumental to the process. “To be honest, our work would be impossible without cooperation with government entities there [in Yemen] that makes bringing Yemenis over to Egypt much easier for us.”

Al-Fadhil said he had come to suspect the embassy’s involvement.

“There were laws in Egypt being broken, and our embassy could have acted, but they just denied it … the embassy is still involved to this day because this business makes them a lot of money,” he said.

After repeated efforts to contact the embassy, Al Jazeera received a response from the media attache, Baleegh al-Mukhlafi, who said: “The only thing the embassy does is to address medical authorities after the documents required by the [Egyptian] Ministry of Health and the courts have been completed.”

The embassy denied any other form of involvement.

Yemenis trapped in Egypt

There are now many Yemenis already in Egypt who are resorting to selling their organs to make ends meet, says al-Fadhil.

They came to Egypt to escape the violence in Yemen and are unable to return because of the worsening situation and because of the closure of Sanaa airport.

In addition, the Egyptian government began denying entry to Yemeni citizens in 2014 and 2015, leading to a decrease in the overall number of cases.

“Yemenis who went to Egypt when the war broke out are now stuck there and have been forced to sell their kidneys out of desperation. We’ve recorded more than 200 such cases,” al-Fadhil told Al Jazeera.

What al-Fadhil and others working to end this trade would like to see is a change in government policies that would end this trade.

However, given the state Yemen is in today, it is unlikely that any significant changes will be made. Even civil resistance to human trafficking is struggling to survive.

“We still face threats and a lot of pressure. This is probably going to be my last interview because we’re living in a country where even humanitarian work is prohibited.”

A few months after our interview in 2018, al-Fadhil’s organisation was shut down by Houthi forces and he was forced to leave Yemen.

“There’s no way we can actually work to stop this when we’re in the middle of war and destruction and poverty and people can barely afford food. There’s no solution except to stop the war, rebuild the country, hire people … that’s the only solution … and it’s just not possible.”

*Names have been changed to protect the identities of those featured in this article

Former White House Counsel Don McGahn is refusing to comply with a congressional subpoena for documents related to special counsel Robert Mueller’s investigation, deferring to a last-minute instruction from the White House to disregard House Democrats’ demands.

William Burck, McGahn’s attorney said that his client would defy the committee’s subpoena for documents that were due by Tuesday as part of the panel’s investigation into allegations that President Donald Trump obstructed justice.

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“The committee seeks to compel Mr. McGahn to produce White House documents the executive branch has directed that he not produce,” Burck wrote in a letter, obtained by POLITICO, to House Judiciary Committee Chairman Jerry Nadler (D-N.Y.).

“Where co-equal branches of government are making contradictory demands on Mr. McGahn concerning the same set of documents, the appropriate response for Mr. McGahn is to maintain the status quo unless and until the committee and the executive branch can reach an accommodation,” Burck added.

The committee’s subpoena to McGahn also demanded that he testify publicly on May 21. A source involved in the negotiations said the White House’s request only applies to documents and is silent on whether McGahn would be permitted to testify in public later this month.

Nadler’s office did not immediately respond to a request for comment. Democrats have argued that because McGahn already provided voluminous testimony and documents to Mueller — much of which has already been made public — executive privilege no longer applies.

But McGahn’s successor as White House counsel, Pat Cipollone, indicated to Burck earlier Tuesday that the White House considers documents in McGahn’s possession to be subject to executive privilege and that any discussion about sharing them with Congress should be between lawmakers and the White House.

“The White House records remain legally protected from disclosure under longstanding constitutional principles, because they implicate significant executive branch confidentiality interests and executive privilege,” Cipollone wrote to Burck on Tuesday. “For these reasons, the Acting Chief of Staff to the President, Mick Mulvaney, directs Mr. McGahn not to produce these White House records in response to the committee’s April 22 subpoena.”

The White House’s intervention in McGahn’s testimony is the latest skirmish in a broader effort to defy Democratic investigators’ demands for documents and testimony that the president and his Republican allies have said amounts to a political witch-hunt.

McGahn delivered some of the most damning testimony in Mueller’s investigation of whether Trump attempted to obstruct the probe of his 2016 campaign’s links to the Russian government.

His testimony, combined with notes from his deputy Annie Donaldson, portrayed a White House in chaos, a president fuming at the special counsel investigation and repeatedly attempting to disrupt the probe.

Jordyn Hermani contributed to this report.