Shelling continued across Syria’s eastern Ghouta district on Tuesday, despite Russia’s call for a five-hour ceasefire to allow for civilian evacuations.
Two main rebel factions control eastern Ghouta. Syrian President Bashar Assad’s government has kept the area, located just outside of Damascus, under siege since 2013. Movement in and out is prohibited except at a handful of crossings, heavily guarded by both regime and rebel forces.
While the government campaign to regain control of eastern Ghouta has dragged on for years, the intensifying military offensive in recent weeks has produced what United Nations Secretary-General António Guterres called “hell on earth” for the almost 400,000 trapped civilians.
More than 500 people have been killed in the past week, according to estimates from Doctors Without Borders. Schools and medical facilities have been targeted, forcing people to take shelter underground. And because the Assad regime has placed a blockade on humanitarian access, food is severely limited. As of last November, the proportion of children under age 5 suffering from acute malnutrition in eastern Ghouta was the highest percentage recorded during the Syrian civil war.
The U.N. unanimously approved a resolution on Saturday calling for a 30-day ceasefire.
“The resolution will be immediately implemented and sustained, particularly to ensure the immediate, safe, unimpeded and sustained delivery of humanitarian aid and services, the evacuation of the critically sick and wounded and the alleviation of the suffering of the Syrian people,” Guterres said.
Yet no convoys have been able to travel into Syria since the U.N. vote.
“We still don’t have the green light to go inside and bring desperately needed food and medical supplies, and to do medical evacuations,” Panos Moumtizis, the U.N.’s regional humanitarian coordinator for the Syria crisis, told France 24.
The Syrian government has by and large prevented humanitarian aid from reaching eastern Ghouta in the last few years, with the exception of a few deliveries of food and medical aid.
Assad cut off the tunnels used by those smuggling in aid supplies in February of last year, said Aron Lund, a fellow with The Century Foundation, and the U.N. has barely been granted access since September. In October, the government closed the last remaining checkpoint leading into the eastern Ghouta city of Douma, the al-Wafideen crossing, according to Amnesty International, which isolated that area from basic necessities like food and medication.
At the same time, rebel groups have been known to use the blockade on humanitarian access for their own political or financial gain, Lund said. Rebels have monopolized the local economy by being the ones to smuggle in goods and sell them at highly inflated rates, while government soldiers manning the checkpoints profit from their control over some of the smuggling routes.
Violence has repeatedly flared up between Islam Army and Failaq al-Rahman, the two predominant rebel factions in eastern Ghouta, due to disputes over smuggling profits, Lund noted.
“The government has used the humanitarian crisis to its advantage in ways that are not legal under international law,” he said. “It’s not a fair tactic. But you’ve had rebel groups also making money off people’s hunger, so it’s not a black and white situation.”
With both checkpoints and tunnels out of commission, however, innocent civilians are the ones bearing the brunt of the political fighting between the regime and the rebels.