A barrage of regime air strikes, rocket fire, and artillery slammed into several towns across the opposition-held Syrian enclave, killing and wounding hundreds, according to a war monitor.
The death toll from the ongoing bombardment of Eastern Ghouta over the past two days has almost reached the 200 mark with as many as 850 people being reported injured.
The Syrian Observatory for Human Rights, a Britain-based war monitor, said that about 190 have been killed since the bombardment began late Sunday while on Tuesday alone 45 people were killed.
The UN children’s fund UNICEF issued a blank statement to express its outrage at the mass casualties among Syrian children in the besieged enclave of Eastern Ghouta and neighbouring Damascus.
"No words will do justice to the children killed, their mothers, their fathers and their loved ones," the release from UNICEF's regional director Geert Cappalaere began.
There followed 10 empty lines with quote marks indicating missing text, and an explanatory footnote.
The United Nations called for an immediate ceasefire in the area on Monday, saying the situation was "spiralling out of control" after an "extreme escalation in hostilities.”
A day after Monday's barrage by the regime, retaliatory shells rained down on the capital Damascus, killing at least one person on Tuesday.
On Tuesday, at least two people were killed and 13 wounded by rebel fire on the capital, state television reported.
The targeted opposition-held suburbs – scattered across an area known as Eastern Ghouta –have been subjected to weeks-long bombardment that has killed and wounded hundreds of people.
Opposition activists say regime forces have brought in more reinforcements in recent days, suggesting a major assault is imminent to recapture the area that is the last main rebel stronghold near Damascus.
Monday's bombardment that killed nearly 100 people saw the use of warplanes, helicopter gunships, missiles as well as artillery, in a major escalation of violence near regime leader Bashar al Assad's seat of power.
The opposition-affiliated Syrian Civil Defence, also known as White Helmets, said the shelling and airstrikes killed 98 and that some people are still under the rubble. It said the dead included one of the rescue group's members, Firas Jomaa.
Both the Observatory and the White Helmets reported more air strikes and shelling on Tuesday in Eastern Ghouta as rebels pounded Damascus with mortar shells.
Rebels retaliated by hitting some Damascus neighborhoods with mortar shells, killing one person and wounding six people, according to the state news agency SANA. On Tuesday morning, Damascus residents reported shelling on areas in central Damascus.
"Shells are falling like rain. We are hiding in the corridor," a Damascus resident told The Associated Press, asking that her name not be mentioned for her own safety. She spoke while hiding in the corridor of an office building.
Videos have surfaced from the eastern suburbs showing paramedics pulling out the injured from under the rubble while others are seen frantically digging through the debris in the dark, in search for survivors.
"The humanitarian situation of civilians in East Ghouta is spiraling out of control," said Panos Moumtzis, the UN regional humanitarian coordinator for the Syria crisis, in a statement late on Monday.
"It's imperative to end this senseless human suffering now. Such targeting of innocent civilians and infrastructure must stop now," he said.
UN on Assad's disgusting siege of Eastern Ghouta: "Malnutrition rates have now reached unprecedented levels, with 11.9 per cent of children under five years old acutely malnourished – the highest rate recorded in Syria since the beginning of the crisis" pic.twitter.com/NRBmW8JlPL— kristyan benedict (@KreaseChan) February 19, 2018
Eastern Ghouta is in one of these areas, where violence is meant to be contained, but the agreement does not include a former Al Qaeda affiliate which has a small presence there.
Other insurgent groups in Eastern Ghouta, say the Syrian regime and Russia are using the former Al Qaeda affiliate’s presence as a pretext to continue their bombardment.
Neither the Syrian military nor Russia commented on the renewed bombardment in Eastern Ghouta, but they have often said they do not target civilians.
Held by rebels since 2012, Eastern Ghouta is the last opposition pocket around Damascus and regime leader Bashar al Assad is keen to retake it with an apparently imminent ground assault.
Al Watan newspaper, which is close to the regime, said on Tuesday that the bombing campaign "comes ahead of a vast operation on Ghouta, which may start on the ground at any moment."
Rebels based in the enclave often fire rockets and mortar rounds into residential neighbourhoods of east Damascus.