The UN Secretary General has demanded an immediate end to fighting in the Eastern Ghouta in Syria, describing the rebel enclave as a “hell on earth”.
“I believe Eastern Ghouta cannot wait,” Antonio Guterres told the UN Security Council on Wednesday.
The Eastern Ghouta has been under fierce bombardment from government forces backed by Russian airpower in recent days.
The region is the last major rebel-held area near the capital Damascus.
The Syrian military says it is trying to liberate the area from what it terms terrorists – but it has also been accused of targeting civilians.
“This is a human tragedy that is unfolding in front of our eyes and I don’t think we can let things go on happening in this horrendous way,” Mr Guterres said.
He said an end to the fighting would allow the evacuation of hundreds of people who require urgent treatment as well as allowing humanitarian aid to reach the region.
UN human rights commissioner Zeid Raad Al Hussein has joined calls for an end to the conflict in the region.
“How much cruelty will it take before the international community… take resolute, concerted action to bring this monstrous campaign of annihilation to an end?” he said in a statement.
But Russia, which supports the Syrian government, said peace talks with the rebels had failed on Wednesday.
Moscow earlier called for an urgent Security Council meeting to discuss the violence in the Eastern Ghouta.
How bad is the situation in the Eastern Ghouta?
Pro-government forces, backed by Russia, intensified their efforts to retake the last major rebel stronghold on Sunday night.
A doctor working in the region says the situation is “catastrophic” – and he believes the international community has abandoned the people living there.
“They targeted everything: shops, markets, hospitals, schools, mosques, everything,” Dr Bassam told the BBC on Wednesday.
“Maybe every minute we have 10 or 20 air strikes… I will treat someone – and after a day or two they come again, injured again.”
“Where is the international community, where is (the UN) Security Council? … they abandoned us. They leave us to be killed,” he said.
What is the death toll?
The UN says at least 346 civilians have been killed and 878 have been injured, mostly in airstrikes.
But they say precise figures are still difficult to establish.
“These figures are far from comprehensive, representing only those cases the UN Human Rights Office has managed to document in the midst of the chaos and destruction in Eastern Ghouta,” a statement said.
Activist groups have offered various estimates on the number of casualties.
The head of safety and security for the Union of Medical Care and Relief Organizations (UOSSM), which operates medical facilities in the Eastern Ghouta, told the BBC that 45 people had been killed and another 250 injured on Wednesday alone.
The UK-based Syrian Observatory for Human Rights put the total death toll since Sunday at 296.
It said that barrel bombs – containers filled with explosives and shrapnel – were used in government strikes on the towns of Jisreen and Kfar Batna on Wednesday.
It follows the bombardment on Tuesday of at least 10 towns and villages across the Eastern Ghouta.
Is humanitarian aid getting in?
No. The government has allowed one humanitarian convoy into the Eastern Ghouta since late November, and there are severe shortages of food.
A bundle of bread now costs close to 22 times the national average and 12% of children under five years old are said to be acutely malnourished.
On Wednesday, the International Committee of the Red Cross (ICRC) joined the UN in calling for emergency humanitarian access to allow much needed aid to be delivered and the wounded to be evacuated.
“Wounded victims are dying only because they cannot be treated in time. In some areas of Ghouta, entire families have no safe place to go,” the ICRC’s Marianne Gasser said in a statement.
What about the fighting elsewhere in Syria?
Meanwhile, pro-government fighters have been sent to the Kurdish enclave of Afrin in northern Syria to confront an offensive by Turkish troops and Syrian rebels.
Turkey fired shells near the advancing columns, which, it says, forced the pro-government fighters into retreat.
Afrin lies just south of the Turkish border. Turkey is trying to oust the Kurdish YPG militia, which controls the area and which has called on the Syrian military for help.
Syria has denounced the Turkish offensive as a “blatant attack” on its sovereignty, while Turkey has insisted it will not back down.
Syrian government forces are also carrying out offensives on the rebel-held north-western province of Idlib. The UN says more than 300,000 people have been displaced by the fighting there since December.