Syrian opposition factions announced on Tuesday that they had downed a regime fighter jet in the eastern Hama countryside. The jet was taking part in military operations in the area, which had witnessed an unprecedented escalation that left 20 people dead.

The Free Idlib Army said the L-39 jet was shot down by anti-aircraft weapons. Two pilots were on board the plane. The Syrian Observatory for Human Rights said that one was killed, while the fate of the other was not revealed.

It said that they initially made it out of the crash alive and tried to flee to a safe area until they could be rescued by Russian jets that are allied with the regime.The regime intensified its bombardment of the region once it heard about the crash. A helicopter was dispatched in an attempt to find the pilots before they were captured or killed.

The opposition factions however managed to find them before they could be rescued. In the southern and eastern Idlib countryside, the Observatory said that 20 people have been killed in regime bombardment that has been ongoing since Monday.

It also reported on fierce battles that had erupted once again between regime forces and opposition factions. The fighting was focused on the outskirts of al-Mshayrfa, al-Katiba, Tal al-Aswad and the villages of Ras al-Ain and Qobayat Um al-Huda.

The Observatory said that the regime made advances in the region and it is trying to reinforce its positions in al-Katiba and Tal al-Aswad.Clashes continue at a pace of violent between the regime forces supported by the regime forces and the militiamen loyal to them against the rebel and Islamic factions and Hayyaat Tahrir Al-Sham in areas southwest of Rif Dimashq.

Syrian Observatory for Human Rights monitored the regime forces continuing their violent attack attempting to achieve an advancement at the expense of the factions, and controlling more places of the besieged area remaining under the control the factions and Hayyaat Tahrir al-Sham.

This attack is concentrated in areas hundreds of meters away of Beit Jinn Farm and the outskirts of Mughr al-Mir town, where the regime forces were able in the past few days to firearm-control the road between the areas of Beit Jinn Farm, Beit Jinn town and Mughr al-Mir town, and closing the roads in front of the fighters between the mentioned areas.

On humanitarian side, Medical evacuations in the rebel-held eastern Ghouta region got underway on Wednesday after months of delays, announced the International Committee of the Red Cross.

Pictures posted with the tweets appeared to show a convoy of ambulances ready to move the critically ill patients from the Damascus suburb. The Syrian American Medical Society, another medical relief organization, said the evacuations covered "29 critical cases, approved for medical evacuation to Damascus. Four patients were evacuated today."

It said the remainder would be evacuated in the coming days. Eastern Ghouta is one of the last remaining rebel strongholds in Syria and has been under a tight regime siege since 2013, causing severe food and medical shortages for some 400,000 residents.

The Syrian Red Crescent said in a tweet that its volunteers "just started to transfer cases in need of medical care from east Ghouta to hospitals in Damascus after long negotiations".

Last week, Jan Egeland, the head of the UN's humanitarian taskforce for Syria, warned that at least 16 people had died while waiting for evacuation from Eastern Ghouta.

He said a list put together several months ago of nearly 500 civilians in desperate need of evacuation was rapidly shrinking. "That number is going down, not because we are evacuating people, but because they are dying," he told reporters in Geneva.

"We have confirmation of 16 having died on these lists since they were resubmitted in November, and it is probably higher," he said, highlighting the case of a baby who died on December 14, as the latest round of Syria peace talks in Geneva ended in failure.

Egeland said evacuations and efforts to bring aid into the region had been blocked by a lack of authorizations from the Syrian authorities.