Smoke billows following a government airstrike on the besieged eastern Ghouta region on the outskirts of Damascus, late on Friday. The U.N. Security Council has struggled to agree on a ceasefire resolution.

Ammar Suleiman/AFP/Getty Images

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Ammar Suleiman/AFP/Getty Images

It has been one of the bloodiest weeks of aerial bombardment in the Syrian war.

In the eastern suburbs of Damascus, a region called Eastern Ghouta, nearly 500 people have been killed in a deadly escalation that began Sunday, the Syrian Observatory for Human Rights told The Associated Press. More than 120 of the dead are children, the group says.

“Airstrikes, artillery shells and barrels filled with TNT are being dropped on neighborhoods that are heavily populated by civilians who have no way to escape,” NPR’s Lama Al-Arian reports. “They’re being forced into bunkers and many of them can’t even find the time to bury their dead.”

Syria’s Civil Defense, known as the White Helmets, told Reuters that it counted at least 350 deaths in a four-day span earlier in the week.

“Maybe there are many more,” Siraj Mahmoud, a civil defense spokesman, told the news service. “We weren’t able to count the martyrs yesterday or the day before because the warplanes are touring the skies.”

Rescuers hurry to pull people from rubble, a difficult task amid the unrelenting barrage.

Hala, 9, receives treatment at a makeshift hospital following Syrian government bombardments on rebel-held town of Saqba, in the besieged Eastern Ghouta region on the outskirts of the Damascus on Thursday.

Amer Almohibany/AFP/Getty Images

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Amer Almohibany/AFP/Getty Images

“But if we have to go out running on our legs and dig with our hands to rescue the people, we will still be here,” Mahmoud told Reuters.

United Nations Secretary-General Antonio Guterres called for an immediate end to hostilities in Ghouta so the sick and wounded can be evacuated.

“I am deeply saddened by the terrible suffering of the civilian population in eastern Ghouta – 400,000 people that live in hell on earth,” he said to the U.N. Security Council. “I don’t think we can let things go on happening in this horrendous way. “

Syrian state media said that rebel factions had fired shells at the Old City of Damascus on Saturday, Reuters reported.

SCD @SyriaCivilDefe teams are working incessantly to evacuate the injured civilians amidst massive destruction, caused by aerial attacks of residential areas by Russian and Regime warplanes in #Douma city today. #SaveGhouta#Syria Feb 24

— The White Helmets (@SyriaCivilDef) February 24, 2018

The pounding of Ghouta comes as members of U.N. Security Council scramble to vote on a resolution for a 30-day ceasefire across Syria to allow aid delivery and the evacuation of civilians. The vote was delayed Friday as its sponsors worked to get a draft that Russia will approve.

The U.N. ambassador from Russia, an ally of the Syrian government, had called the draft resolution “unrealistic.” Most members of the Security Council want the ceasefire to go into effect within 72 hours, but Russia has pushed for a looser “as soon as possible” timeline.

The council is expected to vote on a resolution on Saturday.

A group of doctors and medical activists, from institutions including Harvard and Johns Hopkins, published an appeal on Friday to end the suffering in Ghouta. They urged citizens and health professionals to pressure government officials to act, and for the UN Secretariat to use more effective tactics.

“Inaction in the face of unrelenting attacks on civilians represents an epic failure of world leaders,” they write in The Lancet. “The UN Security Council has utterly failed the people of Syria. The UN Secretariat seems to operate without an effective strategy for political negotiations or aid delivery. These compounded failures are increasing frustrations with the UN as a legitimate interlocutor on human rights violations everywhere, and translate into deaths and suffering. We cannot allow this situation to continue.”

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