In Pictures: 13 photographs that depict the horrors of under-siege Syrians in Ghouta
These photographs show the reality of living in Syria's Eastern Ghouta as residents have claimed "they are waiting for death".
The photos (in the gallery above) show locals digging tunnels under their homes as they desperately try to survive one of the most intense bombardments of the war by pro-government forces on the besieged, rebel-held enclave near Damascus.
At least 27 people died and more than 200 were injured yesterday. At least 299 people have been killed in the district in the last three days, the British-based Syrian Observatory for Human Rights said.
Another 13 bodies, including five children, were recovered from the rubble of houses destroyed on Tuesday in the villages of Arbin and Saqba, the Observatory reported.
The eastern Ghouta, a densely populated agricultural district on the Damascus outskirts, is the last major area near the capital still under rebel control. Home to 400,000 people, it has been besieged by government forces for years.
A massive escalation in the bombardment - including rocket fire, shelling, air strikes and helicopter-dropped barrel bombs - since Sunday has become one of the deadliest of the Syrian civil war, now entering its eighth year.
Reuters photographs taken in eastern Ghouta yesterday showed men searching through the rubble of smashed buildings, carrying blood-smeared people to hospital and cowering in debris-strewn streets.
The United Nations has denounced the bombardment, which has struck hospitals and other civilian infrastructure, saying such attacks could be war crimes.
The pace of the strikes appeared to slacken overnight, but its intensity resumed later yesterday morning, the Observatory said. Pro-government forces fired hundreds of rockets and dropped barrel bombs from helicopters on the district's towns and villages.
"We are waiting our turn to die. This is the only thing I can say," said Bilal Abu Salah (22), whose wife is five months pregnant with their first child in the biggest eastern Ghouta town Douma. They fear the terror of the bombardment will bring her into labour early, he said.
"Nearly all people living here live in shelters now. There are five or six families in one home. There is no food," he said.
The International Committee of the Red Cross (ICRC) called yesterday for humanitarian access to Ghouta, especially to reach wounded people in critical need of treatment.
"The fighting appears likely to cause much more suffering in the days and weeks ahead," said Marianne Gasser, ICRC's head of delegation in Syria. "This is madness and it has to stop."
The Union of Medical Care and Relief Organisations, a group of foreign agencies that fund hospitals in opposition-held parts of Syria, said eight medical facilities in eastern Ghouta had been attacked on Tuesday.
The Syrian government and its ally Russia, which has backed President Bashar al-Assad with air power since 2015, say they do not target civilians. They also deny using the inaccurate explosive barrel bombs dropped from helicopters whose use has been condemned by the UN.
The Observatory said many of the planes over Ghouta appear to be Russian.
Kremlin spokesman Dmitry Peskov described as "groundless" accusations that Russia bears some of the blame for civilian deaths in eastern Ghouta.
A commander in the coalition fighting on behalf of Mr Assad's government told Reuters the bombing aims to prevent the rebels from targeting the eastern neighbourhoods of Damascus with mortars. It may be followed by a ground campaign.
"The offensive has not started yet. This is preliminary bombing," the commander said.
Rebels have also been firing mortars on the districts of Damascus near eastern Ghouta, wounding four people yesterday, state media reported. Rebel mortars killed at least six people on Tuesday.
"Today, residential areas, Damascus hotels, as well as Russia's Centre for Syrian Reconciliation, received massive bombardment by illegal armed groups from eastern Ghouta," Russia's Defence Ministry said late on Tuesday.