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The UN Security Council is struggling to agree a resolution seeking a ceasefire in Syria as a rebel-held area has been bombarded for a sixth day.

Russia wanted changes to a draft that calls for a 30-day calm to allow for aid deliveries and medical evacuations.

Western diplomats have accused Russia, Syria’s key ally, of stalling for time. France said failure to act may spell the end of the UN itself.

Activists say 426 people in the Eastern Ghouta have been killed this week.

Warplanes maintained the bombardment on Friday, witnesses said. Douma and Hamouriyeh were among areas hit.

Diplomats have announced that the UN Security Council will vote on the resolution in New York at 11:00 (16:00 GMT), but did not say whether a deal with Russia had been agreed.

Western powers suspect that Moscow wants to give Syria time to deal a final blow to rebel forces in the rebel-held enclave on the edge of Damascus.

The United States, the UK and France have called for the resolution to be approved without delay. UN special envoy Staffan de Mistura said a truce had to be followed by immediate, unhindered access to the Eastern Ghouta.

What does the resolution say?

The draft, put forward by Kuwait and Sweden, calls for a nationwide truce to go into effect 72 hours after the resolution is passed.

Medical evacuations and aid deliveries would start 48 hours after that. The draft says 5.6 million people in 1,244 communities across the country are in acute need.

Sweden’s UN ambassador Olof Skoog told the BBC that getting aid to the Eastern Ghouta, where conditions were described by the UN secretary general as “hell on earth”, was the main objective.

“I think that without the pressure coming from a united Security Council things are not happening the way they should on the ground,” he said.

“So I think for the council it’s a little bit less about the details and more about giving a political pressure to ensure that this happens.”

France’s UN ambassador François Delattre said the UN’s inability to help Syrian civilians would result in a devastating loss of credibility.

“The Syrian tragedy must not also become a graveyard for the United Nations,” he added.

The draft resolution also calls for all parties to avoid establishing military positions in civilian areas, including schools and hospitals. Sieges of populated areas should be lifted.

What are the Russian objections?

Under the terms of the draft resolution, any ceasefire would not apply to the Islamic State group, or the Nusra Front – formerly al-Qaeda’s official affiliate in Syria.

But Russian Foreign Minister Sergei Lavrov says it must go further and exclude other groups “co-operating with them” and which have shelled Damascus.

This could include the two biggest rebel groups in Eastern Ghouta – Jaish al-Islam and its rival Faylaq al-Rahman. Faylaq al-Rahman has been allied with the jihadist group Hayat Tahrir al-Sham, an alliance of factions led by the Nusra Front.

Russia’s UN ambassador Vassily Nebenzia stressed the need for a resolution that would actually work.

“What we need is not symbolism, not decisions for the sake of decisions, but rather measures that are undertaken that are commensurate with conditions on the ground,” he said.

Meanwhile, two of Russia’s most advanced fighter planes, Su-57s, have been sent to its coastal Hmeimim airbase, Russian military sources told BBC Russian.

The sources said the stealth fighter planes were still undergoing flight tests and there was no confirmation they had yet been used in combat.

How bad is the situation in the Eastern Ghouta?

For the fifth day running, Syrian government forces carried out a wave of air and artillery strikes on Thursday.

The US has also accused Russia of attacking Ghouta, allegations that Russian presidential spokesman Dmitry Peskov dismissed as “groundless”.

The number killed since Sunday has risen to 426, the UK-based Syrian Observatory for Human Rights monitoring group says, at least 98 of them children.

Barrel bombs and shell fire have also rained down on the area, where some 393,000 people remain trapped.

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The Syrian state news agency meanwhile reported on Thursday that a child was killed and six civilians wounded in the government-controlled Barzeh district of Damascus by rebel shellfire. Army units responded with “precision strikes”, destroying a number of rebel positions and inflicting heavy losses, it said.

The UN humanitarian co-ordinator for Syria, Panos Moumtzis, echoed calls for a ceasefire.

Referring to the harrowing images coming out of the Eastern Ghouta, he said: “If this is not going to convince [UN Security] council members, council states, of the need for a ceasefire, honestly we don’t know what is it that would convince them.”

The Syrian government has denied targeting civilians and insisted it is trying to liberate the Eastern Ghouta from “terrorists” – a term it has used to describe both jihadist militants and the mainstream rebel groups that dominate the enclave.

Aid groups report dozens of hospitals being put out of action since Sunday.

Médecins Sans Frontières (MSF) said the government’s siege was also preventing medics from obtaining essential life-saving supplies, warning that its facilities had completely run out of supplies of blood bags, general anaesthetic drugs and intravenous antibiotics.

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