geneva 400,000 civilians besiege syrian enclave eastern ghouta face complete catastrophe aid deliveries block hundreds people need urgent medical evacuation u.n. humanitarian adviser jan egeland say thursday seven people die evacuate 29 imminent risk include 18 children tell reporters geneva regular meet u.n. humanitarian taskforce syria feel return bleak days conflict egeland say nowhere bad eastern ghouta say area surround army area east damascus completely seal since september leave u.n. aid convoy evacuations potential lifeline face bureaucratic wall inaction continue like get fraction need complete catastrophe say ceasefire area green light medical evacuations well people wound fight grow number acutely malnourish children mean close die say men 50s 60s like stop women children get medical service would save live beyond imagination change tomorrow russian syrian u.n. officials meet damascus try break deadlock eastern ghouta 55,000 civilians strand jordanian border desolate area know berm first meet still produce concrete result need strong feel russian federation want us get access want help us hopeful trilateral mechanism yield result berm receive aid distribution since june unite state russia others work detail plan supply aid damascus despite diplomatic efforts set de-escalation zone still fight many areas include aleppo idlib raqqa deir al-zor hama civilians catch crossfire say war last long second world war supply deplete come winter could tough war even last man-made disaster end egeland say syria 's eastern ghouta face 'complete catastrophe u.n