The situation in northwest Syria has reached dangerous levels with the Syrian, Russian, and Turkish armies on a collision course. The United Nations is warning that the deteriorating situation could result in a “bloodbath” unless the sides can agree to a ceasefire.

Airstrikes by the Russians, in support of the Syrian government of Bashar Assad, on Thursday killed two Turkish soldiers and wounded five more around Idlib. The Turks responded with heavy strikes against government troops that killed more than 50.

The Turkish army has lost 15 soldiers in just the last three weeks, as the Syrians, backed by Russian airpower, are increasingly aggressive in trying to stamp out the last bit of rebel resistance in Idlib province. 

Although Turkey’s President Recep Tayyip Erdogan has cozied up to Russia in the past several years and grown increasingly hostile to the United States, he has asked the U.S. to deploy Patriot Missile batteries to protect Turkish troops from air attacks. That is a major shift with the government of Turkey and Russia now on a collision course. The Russian Defense Ministry released a statement that their SU-24 attack aircraft carried out airstrikes to stop a move by Syrian rebels that were backed by Turkish artillery.

For now, the Turks are in a holding pattern with the United States, who has yet to answer the request to deploy Patriot missiles. The Turks are now rethinking their antagonism with Washington over this escalation with the Russians.

“There may be a Patriot battery support,” Turkey’s Defense Minister Hulusi Akar said in an interview on Thursday. He added that Ankara is hoping for similar support from European allies.

“Turkey is determined to use force to ensure a cease-fire in Idlib,” Akar said. “Russia should not intervene in Turkey’s actions in Idlib, Turkey has no intention to face off with Russia.”

Turkey’s problem is that it has already received millions of refugees from Syria. Idlib is home to nearly three million Syrians and this offensive by the Syrian government could unleash as many as two million more refugees streaming toward the Turkish frontier. Turkey, as part of the agreement with Russia in 2018, is trying to establish a control zone in the Idlib area in which they are backing the enemy of the Russians and Syrians. 

Erdogan has sent thousands of troops to the area, and on Wednesday he said that the military had finished preparations for an offensive to protect Turkish interests in Syria. Erdogan spoke with Putin on the phone and said the solution was a return to the agreement they both signed in 2018. In that agreement, Turkey would establish military bases across Idlib designed to prevent a Syrian government assault. That agreement has been ignored, however, as Assad’s forces, with Russian air support, have been attacking the rebels and the Turkish forces with abandon.

“The president during the call stressed that the regime should be restrained in Idlib and that the humanitarian crisis must be stopped,” a statement from the Turkish president’s office read.

Meanwhile, the Russians are not backing down either. President Vladimir Putin is said to be “seriously concerned” by the “aggressive actions” of rebels in Idlib. The Kremlin released a statement backing the Syrian government’s move, underlying the “the necessity of unconditional respect for the sovereignty and territorial integrity of Syria.”

Jens Laerke, the spokesperson of the U.N. Office of Humanitarian Coordination, said at a news briefing in Geneva that 900,000 people have been displaced in the Idlib since December.

The “relentless violence” must stop before it degenerates into “what we fear may end in a bloodbath” for civilians, he added.

This isn’t the only area where Turkish and Russian interests have clashed. In Libya, the Russians are backing the rebel leader Khalifa Haftar, with Russian contractors from the shadowy Wagner Group supporting the now-stalled offensive on the capital, Tripoli. The Turks are deploying proxy forces to prop up the internationally recognized government of Prime Minister Fayez al-Sarraj.

So, now with the prospects of a much wider scale of violence expected in northwest Syria, the Trump administration must decide whether to get drawn deeper into the quagmire and come to the aid of a long-time ally. But this is an ally that has frequently turned its back on that long-term alliance in recent years.