For a sixth straight day, warplanes flown by regime forces and their allies have pounded the densely populated enclave east of Damascus, the last opposition bastion near the capital.
The civilian casualties and devastation there are among the worst in Syria since the regime captured opposition-held parts of Aleppo in intense fighting in 2016.
At least 462 people have been killed and many hundreds injured, the Syrian Observatory for Human Rights monitoring group says. The dead include at least 99 children. Syrian state media reported one person was killed and 58 injured from opposition shelling of sites in Damascus, including a hospital.
Syria’s regime, with its allies Russia, Iran and Shiite militias, has often used the tactic of pushing opposition fighters to surrender their strongholds after long sieges and military offensives.
Insurgents in Eastern Ghouta have vowed not to accept such a fate, ruling out an evacuation of fighters, their families and other civilians of the kind that ended rebellion in Aleppo and Homs after heavy bombardment in earlier years.
“We refuse categorically any initiative that includes getting the residents out of their homes and moving them elsewhere,” Ghouta opposition factions wrote in a letter to the Security Council on Friday.
Eastern Ghouta has 400,000 people spread over a larger area than other enclaves the regime has recaptured. Late on Thursday, government aircraft dropped leaflets urging civilians to depart and hand themselves over to the regime army, marking corridors through which they could leave safely.
Medical charities say jets have hit more than a dozen hospitals, making it nearly impossible to treat the wounded.
The observatory said regime warplanes and artillery hit Douma, Zamalka and other towns across the enclave in the early hours on Friday.
A witness in Douma who asked not to be identified said by telephone that the early morning bombing was the most intense so far. Another resident, in the town of Hamouriyeh, said the assault had continued “like the other days”.
“Whenever the bombing stops for some moments, the civil defense vehicles go out to the targeted places. They work to remove the debris from the road,” Bilal Abu Salah said.
The Civil Defense there said its rescuers rushed to help the wounded after strikes on Hamouriyeh and Saqba. The emergency service, which operates in opposition territory, says it has pulled hundreds of people from under rubble in recent days.
Damascus and Moscow say they only target militants. They have said their main aim is to stop opposition shelling of the capital, and have accused insurgents in Ghouta of holding residents as human shields.
Hamza Birqdar, the military spokesman for the Jaish Al-Islam faction, said it had thwarted nine attacks by pro-regime militias trying to storm a front in the south-east of Ghouta.
The Security Council was expected late Friday to vote to demand a 30-day cease-fire in Syria.
The resolution being considered does not cover Daesh, Al-Qaeda and Al-Nusra Front, which Moscow and Damascus say they have targeted in Eastern Ghouta.