The news of death and destruction coming from Aleppo this week has been relentless. The images and stories of the more than 338 people killed in that city, including more than 100 children, and the huge number of wounded — 846 — (261 of them children) is heartbreaking.

But more than heartbreaking, it is extremely frustrating to keep watching these reports on television, and see the world powers, the United States and Russia, quibbling over this at the United Nations. The US threatened Russia this week that Washington would stop cooperating with Moscow in the targeting of extremist forces in Syria if Russia did not stop its indiscriminate bombing of civilian areas in Aleppo. The Russians then accused the US of promoting terror.

Ardent supporters of the murderous regime of Bashar Al-Assad, the Russians had offered 48-hour pauses in Aleppo to allow humanitarian aid in. Western countries and the UN rejected the proposal saying it was impractical and meaningless. So the barrel-bombing by Assad forces of Aleppo areas controlled by rebels continues, and the Russians have started to use bunker-busting bombs that are devastating the many underground hospitals that tend to the wounded civilians as best they can. With hardly any medical supplies, intermittent electrical power supplied by generators, doctors working in these hospitals often have to put the wounded on the floor because of a lack of beds.

Many times, twenty victims of a bombing will be rushed in at once and the doctors on duty have to decide very quickly which patients have a chance of surviving and those who do not. Unfortunately, they are forced to lay the most severely wounded aside and focus their attention and precious supplies on those deemed most likely to survive. It is a shocking and horrible game of medical roulette.

The US ambassador to the UN Samantha Powers had emotional words at a Security Council meeting on Thursday to describe the killing and devastation that Assad forces and the Russians are wreaking on that city. “What Assad and Russia are doing in Aleppo is soul-shattering,” she said. “Assad and Russia are unleashing a savagery against people they call terrorists. Children are not terrorists. Breadlines — and the individuals within breadlines — are not terrorists. Rescue workers are not terrorists. Hospital workers are not terrorists,” Powers added.

But Powers’ words have not proved capable of diminishing the carnage in Aleppo, where children are getting ball-bearings stuck in their backs and heads when cluster bombs are dropped on them by regime forces. It is highly unfortunate that the reluctance of President Barack Obama to commit US troops to yet another Middle East conflict means that millions of innocent Syrians have been forced from their destroyed cities, maimed and killed.

Russian President Vladimir Putin is using the tactics of absolute destruction in Aleppo that he used in the second Chechen war from 1999-2000. There he bombed the capital Grozny into the ground in his fight against rebels. Thousands were killed and the city was so destroyed that the UN described it as the most ruined city in the world. The Russians in Aleppo, in addition to the bunker-busting bombs, are using incendiary bombs that are capable of burning concrete. These have had a devastating effect on the buildings in the city, readily visible in the video footage of the destruction.

Some analysts believe that the Russians and Syrian regime are using such devastating bombing of Aleppo in order to drive the moderate rebels into cooperating with the more extreme ones, and therefore allow them to discredit all of the rebels as being “terrorists.”

Now Russia is reported to be sending yet more war planes to Syria to ramp up their bombing campaign of Aleppo. It is estimated that 250,000 Syrians are trapped in rebel-controlled areas of Aleppo, and are in dire need of food and medical supplies. The White House on Friday issued a statement saying that Obama and German Chancellor Angela Merkel described the Russian bombing of Aleppo as “barbarous.” And for sure it is, but Syrian civilians in Aleppo need action from Western powers and not mere words of condemnation. Putin and Assad have already showed for a long time that they are impervious to words of criticism. They are cold, calculating, merciless leaders who are ready to kill as many people as they deem necessary to gain control of Syria again. Meanwhile, Syrians endure unbearable violence and cruelty while the world does nothing to help them. Shame on us.

— The writer is a Saudi journalist based in Brazil.