A suicide car bomber has killed and injured at least 100 people and fractured a complex deal to evacuate four besieged towns in Syria, leaving thousands of people trapped in limbo.

The bomber targeted buses full of evacuees from government-held towns as they waited in a rebel-held area on the outskirts of Aleppo. He drove his explosives up to their vehicles in a van meant to carry aid supplies.

The Syrian Civil Defence in Aleppo province, also known as the White Helmets, said their volunteers pulled at least 100 bodies from the site of the explosion. White Helmets member Ibrahim Alhaj said the dead included many children and women.

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Syrian state media said at least 39 were killed, including children. The opposition Syrian Observatory for Human Rights put the death toll at 43, adding that it would likely rise because of the extensive damage.

Images from the scene showed bodies on the ground around blackened vehicles, as thick smoke rose into the air. A senior rebel official said about 20 fighters guarding the buses had been killed, along with people inside.

Residents of rebel-held towns waiting in buses in government territory said they were terrified they could face reprisal attacks.

They appealed to international organisations including the UN for security guarantees, asking them to “provide the necessary protection to reach our final destinations”.

UN secretary-general Antonio Guterres condemned the attack on Saturday in a statement from his spokesman Stephane Dujarric, and called on all parties “to ensure the safety and security of those waiting to be evacuated.”

“Those responsible for today’s attack must be brought to justice,” the statement added.

Several hours after the explosion, the Lebanese TV channel al-Manar, which is close to the Syrian government, showed new buses arriving to replace those damaged, as reports suggested the stalled exchange would soon restart.

Activists in opposition-held areas said they were waiting for confirmation that buses were on the move again. Both groups of evacuees, effectively being held as hostages, are just a short drive from their destinations.

About 7,000 people and fighters were being evacuated this weekend in a complex humanitarian deal that took months to agree.

Under it, 5,000 people were offered safe passage from the government-held towns of Foua and Kefriya, which are surrounded by rebels, and 2,000 left the rebel-held towns of Madaya and Zabadani near Damascus, which are besieged by government forces.

Both groups became stranded outside Aleppo, however, after the deal stalled and the two sides started wrangling over the number of fighters to be evacuated.

Ahmed Afandar, a resident evacuated from his home near Madaya, said: “The people are restless and the situation is disastrous. All these thousands of people are stuck in less than half a kilometre.”

The evacuees from Madaya were expected to head to rebel-held Idlib, 30 miles south-west of Aleppo.

Critics say the string of evacuations, which could see some 30,000 people moved across battle lines over the next 60 days, amounts to forced displacement along political and sectarian lines.

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