Mohamed Adel has been inside his office, a basement below a building in Douma in Eastern Ghouta, for four days now. Yesterday at midnight he decided to risk the seven-metre journey and ran to his house to check on his family. "It was terrifying," he says, pausing as a missile hit the building opposite.
Since the increased bombardment on Eastern Ghouta began almost a week ago, hundreds of families have sought shelter in basements, some without food and water, recounts Adel, a journalist covering the Syrian war. Yesterday a volunteer went out to get food for 200 families trapped underground and was killed.
This morning this video was posted on Twitter which appears to be of a young girl in Eastern Ghouta explaining the desperate situation within one of these shelters:
— قناة وصال (@Wesal_TV) February 22, 2018
— belal kharpotly (@belalkh16) February 21, 2018
"Some of these children haven't eaten for two days," says Adnan Al-Qadiri, who is also inside Ghouta. Al-Qadiri is a board member of Assous Centre, a civil society organisation which helps women in the country find jobs, offers psychosocial support to children and provides wheat so that residents can make bread. Even the bakeries have been bombed.
Adel says the civilian defence has calculated that between Monday and Thursday the number of dead stands at 334 including 57 women and 44 children. There have been 338 air raids, he tells me, 169 explosive barrels, three cluster bombs, 34 napalm missiles and over 2,800 missiles and heavy mortars. Some 260 were killed on Monday and Tuesday alone and a further 45 on Wednesday.
It was onto Eastern Ghouta in August 2013 that Al-Assad dropped sarin gas, killing over 1,000 people. In fact since 2013 the 400,000 or so residents of the towns here have been bombed and shelled by the regime with a maximum of one or two days respite per week. But the regime's intensified bombardment since 19 February is the worst attack since the start of the Syrian uprising.
The situation is very, very, very bad. It's the worst since the beginning of the revolution. The situation is getting worse every day, the shelling and bombardment is increasing every day. It hasn't stopped since the beginning of the campaign
Since Monday, seven hospitals have been bombed, says Adel. Because the regime has long targeted hospitals, makeshift centres have been up in secret locations, underground or on farms for example. The injured and the dying are carried to them to be treated because all the ambulances have been destroyed. Civilians have called this "a dirty war against doctors" because targeting medical workers has long been a tactic used by the regime.
"None of the doctors that were taken by the regime are alive now," Al-Qadiri tells me. "All of them have been killed by the regime in detention, or even before they were taken to prison."
Anyone who worked in the medical field was targeted by the regime during the revolution.
"Until now the regime continues to bomb and shell all the medical centres," he continues. "Many of the hospitals that were destroyed during the revolution in areas controlled by the rebels were rebuilt and doctors started working there again but the regime targeted them again. In Douma, Homoriya, Saqba and Kafr Batna. Now there is only one medical point in Douma."
Since Monday 22 of these medical points have also been hit.
Warplanes carried out airstrikes targeting #Beit_Sawa town.
ER & Medical Center in #Beit_Sawa totally destroyed by airstrikes, now it's out of service.
Eastern #Damascus cs #Syria Feb 21#EasternGhouta #Syria Feb 21#Act4GhoutaNow @MhdKatoub @JennRollins1002 @indigochild585 pic.twitter.com/TS3jcnkFux
— B&n&dict (@benedicte36120) February 21, 2018
Vital electricity for these centres to run is supplied through generators donated by the UN, international NGOs or which were smuggled through the tunnels before they were destroyed. Sometimes there is no power at all because the electricity lines built by activists six years ago have also been destroyed which means there is also a severe lack of water. When the generators go down doctors perform operations using light from their mobile phones.
It's difficult to get the necessary medical equipment, says Al-Qadiri, because for two years the regime has stopped medical aid from entering on the UN convoys. Medicine in the pharmacies has expired but "people use it anyway", he says.
Some medicine has been smuggled in but the prices are high and they are increasing every day. After surgery people are allowed one pill each, with a maximum of two so there is enough to go round, says Al-Qadiri. Some operations are performed without anesthetic, adds Mohamed Adel: "We in Ghouta are suffering a shortage in everything medical – doctors and nurses. Most of the people we have now are trained volunteers."
Eastern Ghouta now has only one doctor within each specialism, for example there is just one surgeon and one pediatrician. Since the punishing siege began in 2013 no one has been able to enter including international doctors. "Some of the students studying medicine were helping the doctors every day. They had not graduated but they had to help," says Al-Qadiri.
These medical centres can't accept all the injured people – when the area is shelled 100 or 200 injured people are in need of medical assistance. "They can't treat all of these people. They have to choose who will die soon, then treat him," he adds.
As has been the case throughout the seven-year war in Syria, people living through this hell are condemning the deafening, international silence. The bloodshed continues because the regime has not been held to account, says Adel: "They will repeat the crimes because there is no deterrent."
Bringing Syria onto the top of the news agenda every day is a "dream as long as Assad is in the presidential palace," he adds. "With Assad I don't see any future in Syria except war and death."
"Why has the international community not done anything to help people, they can do something if they want to but they won't," adds Al-Qadiri.
The regime is killing people and the whole world is watching. What are they waiting for? Nobody knows.