Bombing raids have killed more Syrians in the besieged enclave of eastern Ghouta before a delayed UN vote on a ceasefire to allow medical and food aid to reach civilians.
Nearly a week into one of the most fierce assaults of Syria’s long civil war, over 520 people were dead and thousands more injured, Médecins Sans Frontières said.
Many of the bombing raids have targeted medical buildings, and doctors in the remaining facilities are struggling to keep up with the stream of severely injured patients.
The scale of the attacks from barrel bombs and other missiles was making it hard to find and count the dead, rescuers said.
The civil defence rescue service, known as the White Helmets, said it had documented at least 350 deaths in the first four days of the attacks.
“Maybe there are many more,” Siraj Mahmoud, a spokesman for the group told Reuters. “We weren’t able to count the martyrs yesterday or the day before because the warplanes are touring the skies.”
Most people who had escaped death or injury were hiding in underground bunkers with little or no electricity, and low food supplies.
“The situation is disastrous, kids didn’t eat for two days in a row,” one activist said. “Local councils cannot even provide meals for children. The adults might be able to endure but the kids can’t.
“We have large numbers of babies under the age of six months lacking formula, whose mothers [don’t have milk] to breastfeed them. Generally we have large numbers of kids aged between six months and five years with nothing to eat.”
Doctors and medical activists from around the world called for an end to the violence, protection for civilians, and greater action from the UN, in a joint appeal published in the Lancet.
The group represented medical centres from Harvard to Britain’s Royal Free hospital, Panzi hospital in the Democratic Republic of the Congo and the Syrian American Medical Society.
“Inaction in the face of unrelenting attacks on civilians represents an epic failure of world leaders,” the appeal said. It condemned “patterns of attacks, which predominantly target civilian areas, and demonstrate a position that all civilians in opposition-held areas are legitimate targets”.
On Friday, the UN security council failed to agree on a proposed 30-day ceasefire across Syria, to allow for emergency humanitarian deliveries and medical evacuations, because of Russian objections.
Intense talks at the UN headquarters in New York followed a direct appeal by French and German leaders to Vladimir Putin for Russia to support a ceasefire, but a vote was pushed back several times as talks stalled.
In an apparent attempt to win Moscow’s support, Kuwait and Sweden, who are sponsors of the draft resolution, dropped a demand for the ceasefire to take effect 72 hours after the resolution passed.
Russia’s UN ambassador, Vassily Nebenzia, has said an immediate ceasefire is unrealistic. A new text only demands that all parties halt fighting “without delay”.