However, activists working inside the city said up to five other hospitals in eastern neighborhoods are still functioning.

"For the first time, eastern Aleppo is out of hospitals operating at full capacity," Dr Mazen Kewara, Director of the SAMS Turkey Office, told CNN. "There are remaining medical facilities but they are not operating at full capacity," he said.

One of those hit was a children's hospital, forcing staff to evacuate babies to safety.

The Aleppo Media Center activist group and medical crews reported that 46 people were killed and 75 injured Friday in airstrikes and shelling in the city and surrounding countryside, with the activists describing the fighting as some of the bloodiest yet. An AMC activist told CNN on Saturday that there are up to five hospitals now operating in Aleppo. The AMC said there were minor injuries to patients and staff at the M1 surgical hospital after artillery shelling and airstrikes caused major fires on Friday. One of the few doctors left in Aleppo speaks to CNN One of the few doctors left in Aleppo speaks to CNN At the second hospital the group visited, the al-Hakim children's hospital, the AMC told CNN that the medical crew and children were evacuated with no injuries and that all babies survived the attacks. The Syrian Observatory for Human Rights told CNN on Saturday that some of the hospitals struck in airstrikes in recent days were out of service for a time but are now operating to some extent in the besieged parts of Aleppo. The hospitals are desperately needed by an estimated 250,000 people trapped under bombardment in the eastern side of the city with dwindling reserves of food, fuel and medical supplies. A UK-based monitoring group, the Syrian Observatory for Human Rights, said Friday that more than 1,000 people have died in airstrikes and shelling across Aleppo and surrounding areas since a short-lived US and Russian-brokered ceasefire broke down on September 19. Syria's grinding five-year conflict has devastated the city, divided between government-controlled areas in the west and rebel positions in the east. Moscow has sought to distance itself from the latest blitz, with Deputy Foreign Minister Sergey Ryabkov saying Wednesday that the Russian air force had not carried out the Aleppo strikes, according to state-run news agency Tass.</s>After Syrian rebel shelling of the school in government-held western Aleppo.

Syrian rebel shelling of a school in government-held western Aleppo killed at least seven children on Sunday morning, the Syrian Observatory for Human Rights monitoring group reported.

Syrian state television reported that at least 10 people had been killed in shelling of government-held parts of Aleppo, including children at the Saria Hasoun school in al-Farqan district.</s>All hospitals in Syria’s besieged rebel-held eastern Aleppo are out of service after days of heavy air strikes, its health directorate and the World Health Organization (WHO) said, though a war monitor said some were still functioning.

White House national security adviser Susan Rice said the United States condemned “in the strongest terms” the latest air strikes against hospitals and urged Russia, an ally of Syrian President Bashar al-Assad, to take steps to halt the violence.

Intense air strikes have battered the eastern part of the city since Tuesday, when the Syrian army and its allies resumed operations after a pause lasting weeks. They launched ground attacks against insurgent positions on Friday.

The war monitor, the Britain-based Syrian Observatory for Human Rights, said 48 people, including at least five children, had been killed in eastern Aleppo on Saturday by dozens of air strikes and barrel bombs and dozens of artillery rounds.

That brings the number of people killed by the increased bombardment of Aleppo and the surrounding countryside over the past five days to about 180, including 97 in the city’s besieged eastern sector, the observatory added.

Warplanes, artillery and helicopters continued bombarding eastern Aleppo on Saturday, hitting many of its densely populated residential districts, the Observatory said. There were intense clashes in the Bustan al-Basha district, it added.

“This destruction of infrastructure essential to life leaves the besieged, resolute people, including all children and elderly men and women, without any health facilities offering life-saving treatment ... leaving them to die,” said Aleppo’s health directorate in a statement sent to Reuters late on Friday by an opposition official.

Elizabeth Hoff, the WHO representative in Syria, said on Saturday that a U.N.-led group of aid agencies based over the border in Turkey “confirmed today that all hospitals in eastern Aleppo are out of service”.

The monitoring group said some hospitals were still operating in besieged parts of Aleppo but said many residents were frightened to use them because of the heavy shelling.

Medical sources, residents and rebels in eastern Aleppo say hospitals have been damaged by air strikes and helicopter barrel bombs in recent days, including direct hits on the buildings.

“The United States again joins our partners ... in demanding the immediate cessation of these bombardments and calling on Russia to immediately deescalate violence and facilitate humanitarian aid and access for the Syrian people,” Rice said in a statement.

British Foreign Secretary Boris Johnson tweeted that reports of air strikes hitting civilians and hospitals in east Aleppo were “sickening” and called for a return to diplomacy.

However, with the United States awaiting the inauguration in late January of President-elect Donald Trump, who has been critical of Washington’s Syria policy without laying out detailed plans himself, diplomatic efforts appear stalled.

Staffan De Mistura, the special envoy of the U.N. secretary general, is likely to meet Syrian Foreign Minister Walid al-Moalem in Damascus on Sunday after recent talks in Turkey and Iran, another diplomat said.

“He will push on Aleppo, perhaps on a ceasefire, but on the political file there won’t be anything until (U.N. Secretary– General Ban Ki-moon’s successor Antonio) Guterres is in office, the diplomat said.

Both Russia and Assad’s government have denied deliberately targeting hospitals and other civilian infrastructure during the war, which began in 2011 and was joined by Russia’s air force in September 2015.

Russia unilaterally called a ceasefire in late October and said on Saturday it was now only striking against groups that are not also observing it. Rebel groups in Aleppo have all said they do not recognize the Russian ceasefire.

The charity Doctors Without Borders said in a message there had been more than 30 hits on hospitals in eastern Aleppo since early July. “Doctors are few and medical supplies are depleted, with no possibility of sending more supplies in,” it said.

Health and rescue workers have previously been able to bring damaged hospitals back into operation but a lack of supplies is making that harder.

The Syrian war pits Assad and his allies Russia, Iran and Shi’ite militias against Sunni rebels including groups supported by the United States, Turkey and the Gulf monarchies and also jihadist groups.

Aleppo, for years split between a rebel-held east and government-held western sector, has become the fiercest front.

An army offensive backed by a major aerial bombardment from late September to late October killed hundreds, according to the United Nations, and tightened the siege, leaving eastern Aleppo with little food, medicine or fuel.

A rebel counter-attack early this month involved shelling that killed dozens of civilians, the U.N. said, but it quickly petered out and the army and its allies, including Hezbollah and Iraqi militias, reversed all insurgent gains in about two weeks.

Syrian state television said on Tuesday the air force had targeted “terrorist strongholds and supply depots” in Aleppo. Russia has said its air force is only conducting air strikes in other parts of Syria. The Damascus government describes all the rebels fighting it as terrorists.</s>At least eight children were killed Sunday in Syria when rockets struck a school in Aleppo, in a sixth straight day of airstrikes that included a barrel bomb that killed a family of six, Reuters reported.

A teacher was among the dead, the Associated Press reported.

The shelling killed at least eight children among 10 deaths in the Saria Hasoun School, bringing the death toll to about 300 since Tuesday, the start of one of the heaviest bombardments in the country’s six-year civil war.

Medics cited by Reuters said the al-Baytounji family had suffocated to death because of the barrel bomb, which fell at about midnight and reportedly was laced with chlorine gas.

The two medics identified the family in a film that was released online. The video showed the bodies of four children lying shoulder-to-shoulder on the floor, each showing blue lips and dark marks around their eyes.

The Syrian Observatory for Human Rights, however, which monitors the war, reportedly could not confirm that chlorine gas was used.

The Syrian government forces have used chlorine gas bombs – made by oil drums filled with high explosives and dropped from helicopters – at least three times during the war, the United Nations found, although government officials deny the charge.

At least 54 people were killed in bombing attacks on Saturday, and air strikes continued to hit several districts of eastern Aleppo on Sunday, the Observatory said.

On Friday alone, airstrikes hit four hospitals in east Aleppo, effectively rendering all hospitals in the enclave of 275,000 people out of service, according to the opposition's Aleppo Health Directorate and the World Health Organization.

Footage obtained by the Associated Press shows what appears to be a waiting room at the hospital as people milled about, including nurses in blue uniforms. The airstrike then hits, turning the room into a swirl of gray dust. Debris is strewn around and part of the false ceiling collapses.

RUSSIA'S LONG-RANGE MISSILES STRIKE SYRIA

The civil war in Syria pits President Bashar Assad against mostly Sunni rebels. Assad is backed by Russia’s air force, Iran and Shi’ite militias, while Sunni rebels are joined by groups supported by the United State, Turkey and Gulf monarchies, according to the Reuters report.

The Syrian government on Sunday refused a U.N. proposal to grant the rebel-held eastern districts of Aleppo autonomy in order to restore calm to the war-torn city.

Foreign Minister Walid al-Moallem said the state's institutions "must be restored" across the city and the militants expelled.

At least 164 civilians have been killed since the government renewed its assault on the besieged enclave six days ago, according to the Britain-based Observatory.

The U.N. estimates 275,000 people are trapped inside. By Saturday, the government had damaged or destroyed every hospital in the east, according to the Syrian American Medical Society, which supports doctors and hospitals in Syria.

Rebels outside the city have meanwhile launched two unsuccessful offensives to break the government's siege and shelled the government-held western districts.

U.N. envoy Staffan de Mistura had proposed that the Syrian government grant eastern Aleppo autonomy in exchange for peace, and called on the estimated 900 Al Qaeda-linked militants in the east to depart to other rebel-held territory in Syria.

But al-Moallem refused the offer in a meeting with de Mistura in Damascus on Sunday. Addressing a press conference after the meeting, the foreign minister said restoring government rule was a matter of "national sovereignty." He said Damascus would not allow the people of eastern Aleppo to be "hostages to 6,000 gunmen."

The Associated Press contributed to this report.</s>(CNN) Syrian regime forces pounded eastern Aleppo with airstrikes for a sixth straight day Sunday, bringing the death toll to almost 300 in the most intense bombing since the war began five years ago, rescuers say.

Among the latest reported violence: a suspected chemical attack that killed four children and their parents. Two activist groups -- the UK-based Syrian Observatory for Human rights and Aleppo Media Center -- said a barrage of barrel bombs struck their neighborhood, al-Sakhour.

A wounded child is rescued by a White Helmets volunteer after airstrikes on eastern Aleppo Friday.

"This is the heaviest bombardment I have seen in the past five years," said Ismail Abdallah from the White Helmets.

At a time when hospitals are desperately needed, few have withstood the relentless bombardment -- not a single one is operating at full capacity, the Syrian American Medical Society told CNN.

UN Secretary-General Ban Ki-moon condemned the assault and "indiscriminate shelling" for killing and maiming scores of civilians, including children, and for leaving eastern Aleppo without a functioning hospital.

"The secretary-general reminds all parties to the conflict that targeting civilians and civilian infrastructure is a war crime," the statement said. "Those responsible for these and other atrocities in Syria, whoever and wherever they are, must one day be brought to account."

Disturbing video shows devastated family

A video from the Aleppo Media Center shows the toll in one neighborhood.

Five bodies -- three children, two adults -- are visible in the bed of a truck, covered in colorful blankets in the cold air. Their neighbors surround them in the street covered with rubble from bombed buildings.

The mother wears a lavender, black and pink headdress and red sweater. The father wears a heavy off-white or tan sweater while the two boys died in dark blue sweaters, matching their skin; a toddler girl is clad in a baby-blue one, emblazoned with a cartoon character.

Their eyes stare, their mouths are agape.

"We were sleeping when a barrel bomb fell near our home," a man explains on the video. "We went down and discovered it was chlorine gas. The victims weren't activists or anything ... but they were suffocating so much, they turned blue. It was a man, four kids, and his wife. The oldest boy was 10 years old. Why did this happen? May God curse you, Bashar (al-Assad)."

Another man shows coins to the videographer from the Aleppo Media Center, which appear tarnished. The man says he took the coins from the pockets of the dead. "The gas caused them to change color," he says.

They weren't the only fatalities from the suspected gas attack. A young man says his family was asleep at 1 a.m. when they were awakened by an explosion.

"We came down and started choking. We discovered it was chlorine gas," he said. "My mother was suffocating and my brother-in-law started foaming at the mouth."

'Aleppo is a Holocaust'

Syria's grinding five-year conflict has devastated Aleppo, divided between government-controlled areas in the west and rebel positions in the east.

A White Helmets volunteer carries an injured man to safety on Saturday following an airstrike in eastern Aleppo.

The regime, backed by Russian air power, has decimated much of eastern Aleppo with aerial bombardments in recent months, and analysts have said the intensified air raids are a sign the regime may be planning a ground offensive to wrest control of the area.

A government siege on eastern Aleppo since July has essentially cut the area off from the rest of the world -- a stranglehold tactic that the Syrian regime is infamous for.

Today, eastern Aleppo is desperately short of food, medicine and fuel supplies, while the roads are full of rubble from destroyed buildings. The sound of bombings and news of children dying are the norm.

"Inside the city of Aleppo is a Holocaust," an Aleppo resident, who describes himself as an independent media activist, told CNN.

JUST WATCHED One of the few doctors left in Aleppo speaks to CNN Replay More Videos ... MUST WATCH One of the few doctors left in Aleppo speaks to CNN 02:37

He said neighbors and families were sharing what little food they had left to survive.

The United Nations has pushed to get into the area to deliver aid, and on Sunday it announced it had designed a detailed humanitarian plan to provide assistance and medical evacuations from Syria. It said it had shared the plan with all parties in the conflict, as well as its member states.

"It is imperative all parties agree to the plan and allow us to secure immediate, safe and unimpeded access to provide relief to those most in need in east Aleppo, but equally in all other parts of Syria where there are people in need," read a joint statement from Syria Humanitarian Coordinator Ali Al-Za'tari and Regional Humanitarian Coordinator for the Syria Crisis and Kevin Kennedy.

Children in the crosshairs

Meanwhile, in regime-held western Aleppo, rebel rocket fire hit a school in the government-held al-Furqan neighborhood, Syrian Foreign Minister Walid al-Mouallem said at a news conference in Damascus.

He said 10 students were killed in the attack, while the state-run news agency SANA put the number at eight.

"What did those kids do to die? I am sad about these students' death," he said.

JUST WATCHED War a daily routine for Aleppo's youngest victims Replay More Videos ... MUST WATCH War a daily routine for Aleppo's youngest victims 02:42

A student at Aleppo University in the west told CNN that security forces had gathered students in the university's main square on Sunday to protest against rebels in eastern Aleppo.

The student, who CNN is not naming for security reasons, also said they had been told to appeal to the United Nations to have opposition armed groups removed from the east so the siege on civilians can be lifted.

It is unclear how many children have died in the attacks, but at least eight have been reported killed in eastern Aleppo, and eight in the city's west. Activists said there were likely to be more children among the dead.

'Stop bombing hospitals'

Medical charities have renewed calls on the regime to stop targeting health facilities.

"For the first time, eastern Aleppo is out of hospitals operating at full capacity," said Dr. Mazen Kewara, director of the Syrian American Medical Society's Turkey office.

Several major trauma hospitals have been knocked out of service, the organization said, while three floors were destroyed in eastern Aleppo's only dedicated children's hospital, forcing the evacuation of babies, said the charity Doctors Without Borders, which also is known by its French initials MSF.

But activists working in the city said as many as five other hospitals in eastern neighborhoods were still somewhat functional.

Hospitals are desperately needed as 250,000 people remain in eastern Aleppo, pounded by airstrikes.

Doctors Without Borders emergency coordinator Teresa Sancristoval said Saturday's bombardment of hospitals marked "a dark day for east Aleppo."

"The attacks have destroyed entire hospitals, electric generators, emergency rooms and wards, forcing them to stop all medical activities," she said.

"It is not only MSF that condemns indiscriminate attacks on civilians or civilian infrastructure, including hospitals, but also humanitarian law. The message is simple and I don't know how to say it any louder: Stop bombing hospitals."

Tried protecting generator from shrapnel with sand bags. Attacks have destroyed emergency rooms, entire hospitals. https://t.co/MLO8b4qle1 pic.twitter.com/exqDOzz4WV — Doctors w/o Borders (@MSF_USA) November 19, 2016

Staffan De Mistura, the envoy of the United Nations secretary general, met with Syrian Foreign Ministry officials on Sunday and said there was "a total denial of any aerial bombing of hospitals in eastern Aleppo," Reuters reported.

"We should be allowed to send a verification team to verify the damage in hospitals in eastern and western Aleppo," he said.</s>BEIRUT (Reuters) - Rebel shelling killed eight children at a school in the government-held part of Aleppo on Sunday and a barrel bomb killed a family of six in the rebel-held area, part of a heavy government bombardment that has knocked out all the hospitals.

Hundreds of people have been killed since Tuesday in a concerted push by the government and its allies to quash resistance in the rebel-held eastern part of Aleppo to reestablish control over Syria’s biggest pre-war city.

On Sunday they advanced into the Hanano district on its northern edge, but rebels said the battle was still continuing and that some of the pro-government forces’ gains had been reversed.

The bombardment, one of the most intense in the almost six year-old civil war, has taken a heavy toll on civilians.

Two medics said the al-Baytounji family had suffocated to death because the barrel bomb, which fell in the Sakhour district at about midnight, had been laced with chlorine gas.

The Syrian Observatory for Human Rights, which monitors the war, confirmed the bombing but could not confirm that chlorine gas was used. Damascus has denied use of the gas, which would contravene the international Chemical Weapons Convention.

Rebel shelling killed at least eight children, aged from six to 12 years, among 10 deaths in the Saria Hasoun school in al-Farqan district, the Observatory and Syrian state television reported.

The bombardment of eastern Aleppo drew condemnation on Sunday from the EU’s humanitarian aid commissioner, Christos Stylianides.

“The relentless bombing of East Aleppo by the Syrian regime in the last few days has now left hundreds of thousands of besieged civilians without access to food and to functioning hospitals,” he said.

An official with a rebel group based in east Aleppo said there were still no working hospitals there on Sunday, a day after the World Health Organization reported that bombing had put them all out of action.

Hospitals have previously been brought back into service after being knocked out through bombing in the rebel-held area but food supplies are running low.

The military and Russia’s air force had paused their bombardment of eastern Aleppo, except for on the frontlines, for two weeks after a month-long offensive from late September to late October, but recommenced strikes on Tuesday.

The army and its allies began some ground attacks on Friday. The Observatory reported intense clashes in Sheikh Saeed in southeast Aleppo and in Baeedain and Bustan al-Basha in northeast Aleppo.

Lebanon’s Hezbollah militia, one of the army’s main allies in the fighting, said on Sunday that the army and its allies had advanced in Hanano and pro-government forces were bringing big reinforcements to the city. The Observatory confirmed the Hanano advance.

TALKS

An inquiry by the United Nations and the Organization for the Prohibition of Chemical Weapons has said Syrian government forces have used chlorine gas in barrel bombs at least three times during the war. Damascus denies it.

Syria also denies using barrel bombs - improvised ordnance made by oil drums filled with high explosive and shrapnel and dropped from helicopters. Their use has been condemned by the United Nations for causing unnecessary suffering.

Air strikes continued to hit several districts of eastern Aleppo early on Sunday, the Observatory said, after at least 54 people were killed in bombing on Saturday.

People walk near rubble of damaged buildings, in the rebel-held besieged area of Aleppo, Syria November 19, 2016. REUTERS/Abdalrhman Ismail

So far, around 240 people have been killed in bombing in eastern Aleppo and the rebel-held countryside to the west of the city since Tuesday, it added.

Staffan De Mistura, the envoy of the United Nations secretary general, met Syrian Foreign Ministry officials on Sunday and later acknowledged differences.

He said he had proposed that Damascus should recognize the local administration in rebel-held east Aleppo if jihadist fighters left the city, but Foreign Minister Walid al-Moalem rejected this in a televised news conference.

An elected city council there oversees services and De Mistura said that while he recognized the government’s need to maintain sovereignty, Aleppo should be treated as a special case.

Moalem said that the arrangement was intended by rebel groups to control distribution of food and that they were holding the civilians of eastern Aleppo hostage.

Asked about Damascus’ expectations from U.S. President-elect Donald Trump, he said it wanted him to stop arming rebel groups and to curb regional powers who also did so.

Speaking to journalists separately, De Mistura condemned attacks on hospitals in both rebel and government-held areas. “We should be allowed to send a verification team to verify the damage in hospitals in eastern and western Aleppo,” he said.

The two medics identified the family they said was killed by chlorine in a film distributed online. It showed the corpses of four children stretched out on a floor, their lips blue and dark marks around their open eyes.

One of the medics, Abu al-Abbas, has a colleague who lives on the same street, he said. Another was the manager of a hospital and said doctors had confirmed the cause of their death as gas poisoning. A rebel official, Zakaria al-Malahifji, from the Fastaqim group, also said they had been killed by gas.

Medics and residents in rebel-held areas have often accused the Syrian military of using chlorine in barrel bomb attacks on their areas, but the difficulty of reaching besieged districts makes it hard for international agencies to verify this.

Slideshow (4 Images)

Syria and Russia have also accused the rebels of using toxic gas in shells, including during a major assault on the western fringe of the government-held zone in Aleppo early this month.

The civil war pits President Bashar al-Assad backed by Russia’s air force, Iran and Shi’ite militias against mostly Sunni rebels including groups supported by the United States, Turkey and Gulf monarchies.

Aleppo has become the focal point, as the army and its allies alternate intense bombardment and ground attacks with offers to rebels to quit the city during periods of reduced bombing.

The use of siege and bombardment tactics has previously forced rebels to surrender other encircled areas such as the large town of Daraya southeast of Damascus, seen for years as a stronghold of the rising against Assad.</s>However, activists working inside the city said up to five other hospitals in eastern neighborhoods are still functioning.

"For the first time, eastern Aleppo is out of hospitals operating at full capacity," Dr Mazen Kewara, Director of the SAMS Turkey Office, told CNN. "There are remaining medical facilities but they are not operating at full capacity," he said.

One of those hit was a children's hospital, forcing staff to evacuate babies to safety.

The Aleppo Media Center activist group and medical crews reported that 46 people were killed and 75 injured Friday in airstrikes and shelling in the city and surrounding countryside, with the activists describing the fighting as some of the bloodiest yet. An AMC activist told CNN on Saturday that there are up to five hospitals now operating in Aleppo. The AMC said there were minor injuries to patients and staff at the M1 surgical hospital after artillery shelling and airstrikes caused major fires on Friday. One of the few doctors left in Aleppo speaks to CNN One of the few doctors left in Aleppo speaks to CNN At the second hospital the group visited, the al-Hakim children's hospital, the AMC told CNN that the medical crew and children were evacuated with no injuries and that all babies survived the attacks. The Syrian Observatory for Human Rights told CNN on Saturday that some of the hospitals struck in airstrikes in recent days were out of service for a time but are now operating to some extent in the besieged parts of Aleppo. The hospitals are desperately needed by an estimated 250,000 people trapped under bombardment in the eastern side of the city with dwindling reserves of food, fuel and medical supplies. A UK-based monitoring group, the Syrian Observatory for Human Rights, said Friday that more than 1,000 people have died in airstrikes and shelling across Aleppo and surrounding areas since a short-lived US and Russian-brokered ceasefire broke down on September 19. Syria's grinding five-year conflict has devastated the city, divided between government-controlled areas in the west and rebel positions in the east. Moscow has sought to distance itself from the latest blitz, with Deputy Foreign Minister Sergey Ryabkov saying Wednesday that the Russian air force had not carried out the Aleppo strikes, according to state-run news agency Tass.</s>(CNN) A family of six was killed in a suspected chlorine gas attack in war-ravaged eastern Aleppo on Sunday, as the death toll in a six-day blitz neared 300, a monitor and activists said.

The UK-based Syrian Observatory for Human Rights said preliminary reports indicated a married couple and their four children were killed in one of many airstrikes to hit the al-Sakhour neighborhood in Aleppo's besieged east. The group said chlorine gas was used in the bombardment.

A wounded child is rescued by a White Helmets volunteer after airstrikes on eastern Aleppo Friday.

The Aleppo Media Center (AMC) activist group also reported that the family was killed and posted a photo of the aftermath on Twitter. The AMC said a barrel bomb containing chlorine gas was dropped on the neighborhood from helicopters.

CNN has viewed a video purporting to show the aftermath of the attack but cannot independently verify the use of the toxic gas.

A UN investigation in late August found that chemical weapons had been used in Syria, both by the national air force and ISIS militants. It found two instances where regime forces had used chlorine as a chemical weapon, and one where ISIS had used mustard gas.

Strikes continued Sunday, but at a lower intensity, activists said.

The death toll is likely to climb, as the White Helmets said another 950 people were injured. And dozens remain missing in what the rescue group described as "nonstop attacks."

Saturday saw intense bombardment, with 68 people killed, according to the Aleppo Media Center activist group.

Syria's grinding five-year conflict has devastated Aleppo, divided between government-controlled areas in the west and rebel positions in the east.

The Syrian regime, backed by Russian air power, has decimated much of eastern Aleppo with aerial bombardments in recent months, and has threatened a ground offensive to seize control of the area.

Aid agencies have struggled to get aid into the zone. Government forces have besieged the area since July, essentially cutting the area off from the rest of the world -- a stranglehold tactic that the Syrian regime is infamous for.

As a result, food, medicine and fuel supplies are desperately low. Hospitals and blood banks are near nonexistent. And the roads are full of rubble from buildings that once were.

"Inside the city of Aleppo is a Holocaust," an Aleppo resident, who describes himself as an independent media activist, told CNN.

He said neighbors and families were sharing what little food they had left.

The UN said Sunday that it had designed a detailed humanitarian plan to provide assistance to civilians and medical evacuations in Syria, and that it had shared the plan with all parties in the conflict -- as well as its member states.

"It is imperative all parties agree to the plan and allow us to secure immediate, safe and unimpeded access to provide relief to those most in need in east Aleppo, but equally in all other parts of Syria where there are people in need," read a joint statement from Syria Humanitarian Coordinator Ali Al-Za'tari and Regional Humanitarian Coordinator for the Syria Crisis and Kevin Kennedy.

On Saturday, the Syrian American Medical Society told CNN that not a single hospital in eastern Aleppo was operating at full capacity.

"For the first time, eastern Aleppo is out of hospitals operating at full capacity," said Dr. Mazen Kewara, director of the medical society's Turkey office.

Several major trauma hospitals were knocked out of service during recent attacks, the organization said.

But activists working in the city said as many as five other hospitals in eastern neighborhoods were still somewhat functional.

Doctors Without Borders (MSF) emergency coordinator Teresa Sancristoval said Saturday's bombardment of hospitals marked "a dark day for east Aleppo."

"The attacks have destroyed entire hospitals, electric generators, emergency rooms and wards, forcing them to stop all medical activities," she said.

"It is not only MSF that condemns indiscriminate attacks on civilians or civilian infrastructure, including hospitals, but also humanitarian law. The message is simple and I don't know how to say it any louder: stop bombing hospitals."

One of those hit was a children's hospital, forcing staff to evacuate babies. MSF said that three floors were destroyed in the facility -- the only hospital exclusively for children in the area.

"What is not clear is how much longer the health system, already on its knees, can carry on functioning unless the bombing stops and medical supplies are allowed in," said Luis Montial, MSF deputy head of mission for Syria.

CNN has not been able to independently verify the extent of the strikes, with little access to eastern Aleppo.

It is unclear how many children have died in the attacks, but at least four were reported killed in strikes on Wednesday. Activists said there were likely to be more children among the dead

In regime-held western Aleppo, two people were killed and seven were injured Saturday when two neighborhoods were bombed by "terrorist groups," according to the state-run Syrian Arab News Agency. On Friday, five people were killed in the shelling, including two children, the state agency said.

A student at Aleppo University in the west told CNN that security forces had gathered students in the university's main square on Sunday to protest against rebels in eastern Aleppo.

The student, who CNN is not naming for security reasons, also said they had been told to appeal to the United Nations to have opposition armed groups removed from the east so that the siege on civilians can be lifted.</s>A barrel bomb killed a family of six in rebel-held eastern Aleppo early on Sunday, a war monitor, a rebel and two medics said. Meanwhile, rebel shelling killed seven children at a school in the government-held sector, state television reported.

The medics said the al-Baytounji family had suffocated to death because the barrel bomb, which fell in the Sakhour district at about midnight, had been laced with chlorine gas. Britain-based war monitor the Syrian Observatory for Human Rights could not confirm that chlorine gas was used.

Rebel shelling killed at least seven children among 10 deaths in the Saria Hasoun school in al-Farqan district, Syrian state television and the observatory reported.

Hundreds of people have been killed since Tuesday in one of the heaviest bombardments of the country’s civil war, now in its sixth year, as the government and its allies attempt to quash resistance in Aleppo’s rebel-held eastern zone.

Syria’s military and Russia’s air force had observed a unilateral pause in the bombardment of eastern Aleppo, except for on the frontlines, after a month-long offensive from late September to late October, but recommenced strikes on Tuesday.

An inquiry by the United Nations and the Organisation for the Prohibition of Chemical Weapons has found that Syrian government forces have used chlorine gas in barrel bombs at least three times during the war, though Damascus denies it.

Syria also denies using barrel bombs – improvised ordnance of oil drums filled with high explosive and shrapnel and dropped from helicopters. Their use has been condemned by the United Nations for causing unnecessary suffering.

Staffan De Mistura, the envoy of the United Nations secretary general, arrived in Damascus for talks with Syrian foreign ministry officials on Sunday, with Aleppo on the agenda.

Air strikes continued to hit several districts of eastern Aleppo early on Sunday after at least 54 people were killed in bombing on Saturday.

The two medics identified the al-Baytounji family in a film distributed online. It showed the corpses of its four children stretched out on a floor, their lips blue and dark marks around their open eyes. The manager of a hospital said doctors had confirmed the cause of their death as gas poisoning.

A rebel official, Zakaria al-Malahifji, from the Fastaqim group, also said they had been killed by gas.

The civil war pits President Bashar al-Assad backed by Russia’s air force, Iran and Shi’ite militias against mostly Sunni rebels, including groups supported by the US, Turkey and Gulf monarchies.

Aleppo has become the focal point for fighting as the Syrian army and its allies attempt to end insurgent resistance there, alternating intense bombardment and ground attacks with offers to rebels to quit the city during periods of reduced bombing.

The use of siege and bombardment tactics has previously forced rebels to surrender other encircled areas such as the large town of Daraya southeast of Damascus, seen for years as a stronghold of the rising against Assad. – Reuters</s>A Syrian civil defence volunteer, known as the White Helmets, carries an injured man on Saturday following a reported air strike on Aleppo’s rebel-held neighbourhood of Bab Al Nayrab (AFP photo)

DAMASCUS — Top UN officials said Saturday they were “appalled” by escalating violence in Syria, and urged immediate access to Aleppo, where government forces are waging a ferocious assault to retake rebel-held districts.

“The United Nations is extremely saddened and appalled by the recent escalation in fighting in several parts of Syria,” the UN’s humanitarian coordinator for Syria Ali Al Zaatari and regional humanitarian coordinator Kevin Kennedy said.

In a statement, they called on “all parties to cease indiscriminate attacks on civilians and civilian infrastructure”.

The comments came as government bombardment rocked rebel-held east Aleppo, where more than 250,000 people are living under regime siege.

The bombardment, which began on Tuesday, has killed nearly 100 people, according to a monitor, and forced hospitals and schools to close.

Zaatari, the most senior UN official based in Damascus, and Kennedy said the organisation had a plan to provide east Aleppo with assistance.

“The UN has shared with all parties to the conflict in Aleppo and member states concerned a detailed humanitarian plan to provide urgently needed assistance to the inhabitants of east Aleppo, and conduct medical evacuations for the ill and injured,” they said.

“It is imperative all parties agree to the plan and allow us to secure immediate, safe and unimpeded access to provide relief to those most in need in east Aleppo, but equally in all other parts of Syria where there are people in need.”

The UN has not accessed east Aleppo since government forces surrounded the rebel-held side of the city in mid-July.

Moscow has organised several brief truces intended to encourage civilians and surrendering rebels to leave east Aleppo, but few have done so, and the UN has said it was unable to organise secure aid deliveries or evacuations within such short windows.

Russia is a key ally of the government in Damascus and has waged a military campaign to bolster President Bashar Assad’s government against rebels.

Moscow says it is not currently bombing Aleppo, though earlier this week it announced a “major operation” in neighbouring Idlib province, as well as in central Homs province.

More than 300,000 people have been killed since Syria’s conflict began in March 2011, with anti-government protests.
Six people are killed in a suspected chlorine gas attack in Aleppo, Syria.