In this August 27 photo provided by the Syrian anti-government activist group Aleppo Media Center (AMC), shows a Syrian man carrying a girl away from the rubble of a destroyed building after barrel bombs were dropped on the Bab al-Nairab neighborhood in Aleppo, Syria. Nearly 100 children were killed in a single week in Aleppo as Syrian and Russian warplanes sought to bombard into submission the rebel eastern districts of the city that have held out against Syrian government forces for five years. Without hope for the future, no regular schooling and little access to nutritious food, the children of Aleppo and their parents struggle to survive and fear the threat an imminent ground offensive.(Aleppo Media Center via AP)</s>AMMAN (Reuters) - Russian warplanes and their Syrian government allies battered rebel-held areas in and around Aleppo on Saturday, and rebels and aid workers accused them of destroying one of the city’s main hospitals and killing at least two patients.

M10, the city’s main trauma hospital, in eastern Aleppo, was struck as the United States and its allies urged Russia, which is trying to crush resistance to Syrian President Bashar al-Assad, to halt the bombing and reach a diplomatic resolution.

Saturday’s air strikes focused on major supply lines into rebel-held areas of Aleppo - the Castello Road and Malah district and around the Handarat camp.

Fighting also raged in the city in the Suleiman al Halabi neighborhood, the front line to the north of Aleppo’s Old City and in the residential Bustan al Basha quarter.

Rebels and rescuers said at least seven missiles were dropped on the hospital, more commonly known as Sakhour, by both Russian jets and Syrian helicopters.

An American relief organization said two patients were killed and 13 injured in the attack, which was the second on the hospital in less than a week.

“The hospital is now out of service completely. There’s destruction to walls, infrastructure, equipment and generators. There are no more guards or staff left. It’s complete darkness,” said Mohammad Abu Rajab, a radiologist in the hospital.

Footage of the bombed hospital on social media showed extensive damage.

The attack drew immediate condemnation from France and Germany. French Foreign Minister Jean-Marc Ayrault said the shelling of healthcare structures and personnel in Aleppo amounted to war crimes, adding: “Their perpetrators will be held to account.”

“The bombing of Aleppo needs to finally stop! Whoever wants to fight terrorists does not attack hospitals!” German Foreign Minister Frank-Walter Steinmeier tweeted.

The U.S envoy to the United Nations last week called Russia’s actions in Syria “barbarism,” not counter-terrorism.

An official for U.S. President Barack Obama’s administration condemned the bombing, citing “total disregard” for medical professionals and those needing their help.

“Reports of yet another hospital being destroyed further demonstrates the total disregard for the lives of medical professionals and their patients who need critical care because of the Assad regime and Russia’s relentless campaign against the Syrian people.”

Rebels said Moscow and the Syrian army have for months been targeting power plants, hospitals and bakeries to force into surrender the nearly 250,000 believed trapped in the city.

Hundreds of people have been killed in indiscriminate bombing of residential areas and many hundreds more wounded, with little access to treatment in hospitals that lack basic supplies.

The army, aided by hundreds of Iranian-backed militias who have arrived in Aleppo, have backed up the air campaign with a ground offensive on several frontlines.

“The regime is spearheading an attack on all fronts and is trying to open more than one major front and of course there are a lot of amassing of troops mostly based in Handarat,” Abu Haidar, a commander in Fastaqim, one of the rebel groups inside Aleppo, said via internet messaging.

In a telephone conversation with U.S. Secretary of State John Kerry on Friday, Russian Foreign Minister Sergei Lavrov said Moscow was ready to consider more ways to normalize the situation in Aleppo, the ministry said.

A man walks on the rubble of damaged buildings after an airstrike on the rebel held al-Qaterji neighbourhood of Aleppo, Syria. REUTERS/Abdalrhman Ismail

But Lavrov criticized Washington’s failure to separate moderate rebel groups from those the Russians call terrorists, which had allowed forces led by the group formerly known as the Nusra front to violate the U.S.-Russian truce agreed on Sept. 9.

The United States made clear it would not, at least for now, carry through a threat made on Wednesday to halt the diplomacy if Russia did not take immediate steps to end the violence.

Moscow and Assad spurned the ceasefire to launch the new offensive, potentially the biggest and most decisive battle of the civil war, which is now in its sixth year.

BACK AND FORTH

An army source quoted in state media said its forces had made advances, which was denied by rebels.

A news commentary by the state-run Ikhbariyah said “high level coordination from the air and ground by Syrian and Russian warplanes” had allowed the two allies to “successful hit locations where terrorist groups had dug in.”

But rebels said Syrian troops backed by fresh reinforcements from Iranian-backed militias were struggling to make any gains in a ground offensive in a key frontline in the old city.

“They are shelling the old city heavily after another failed attempt to gain ground. They have lost several fighters and we are steadfast,” said Abu Hamam, a rebel from the Failaq al-Sham group.

The Syrian Observatory for Human Rights, a British-based group that monitors the war, reported heavy bombardment by government forces and “back and forth” fighting in the Suleiman al-Halabi neighborhood.

Rebels led by the main Islamist rebel group Ahrar al-Sham said on Saturday they had regained several areas in the Bustan al-Pasha district seized a day before, a strategic point that would allow the army to press into the heart of the rebel held eastern sector.

Slideshow (6 Images)

Russia joined the war exactly a year ago, tipping the balance of power in favor of Assad, who is also supported by Iranian ground forces and Shi’ite militia from Lebanon and Iraq.

The army said it would press its advantage after retaking last Thursday the strategic Handarat camp north of Aleppo that had already changed hands once since the start of the attack.</s>The M10 hospital was hit by two barrel bombs, two cluster bombs and at least one rocket, Adham Sahloul, a spokesman for the Syrian American Medical Society, told CNN.

The hospital, which Sahloul's group supports, had just reopened to offer basic emergency care Friday, he said, following an airstrike two days earlier that had shut down the facility, including its desperately needed intensive care unit. The city's M2 hospital was put out of service after also being hit Wednesday.

On Friday alone, the M10 hospital saw 84 cases, including 22 children, Sahloul said. Sixteen of those died, including five children.

Aleppo's medical services are under appalling pressure. About 30 doctors remain in eastern Aleppo, Sahloul said, for a population of some 300,000 at a time of urgent need.

More than 450 people have been killed since a US-Russia brokered ceasefire collapsed September 22, he said. Most in the city's eastern districts also lack access to clean water following infrastructure damage from shelling and bombing, he added. Aleppo saw more aerial bombardments and clashes Saturday following the deaths of 36 people the day before, UK-monitoring group Syrian Observatory for Human Rights said. At least 20 people, including six children, were killed then in airstrikes on neighborhoods of rebel-held eastern Aleppo, the group reported. Separately, at least 16 people, including women and children, were killed Friday in shelling by rebel forces on regime-held parts of western Aleppo, it said. The state-run Syrian Arab News Agency, or SANA, said 13 people died Friday in Aleppo due to "terrorist rocket attacks." Rebel-held districts of Aleppo have suffered intense aerial bombardment by Syrian and Russian warplanes for more than a week, while the Assad regime prepares to take the northern city. Regime forces shelled areas of Aleppo's Old City on Saturday, the Syrian Observatory for Human Rights said. Regime forces and rebel fighters also engaged in violent clashes in the neighborhoods of Bustan al-Basha and Sheikh Khodr. A Syrian family leaves the area following a reported airstrike on Friday, September 23, in rebel-held east Aleppo. Following the airstrike, recovery teams from Syria Civil Defense, known as the White Helmets, began working to free the trapped and recover the dead, including small children. This photo was released by the volunteer group Syria Civil Defense of the bodies of a man, with his knee pulled up near his face, and a child covered in dust after they were killed in the airstrike. The volunteers work to recover the bodies the man and child. A Syrian man carries the body of his nephew, recovered from the rubble. The volunteers remove an infant's body from the destroyed building. A Syrian woman carries the body of her infant after he was recovered. The activist group Aleppo Media Center said at least one person was killed and several wounded Saturday in airstrikes by helicopters in eastern Aleppo's Al-Sakhour neighborhood. The group also reported artillery shelling by regime forces. SANA, quoting a police official, reported that at least 13 people were injured in rocket fire in the al-Maydan residential neighborhood in regime-held western Aleppo. Kerry in leaked audio: 'I lost the argument' on Syria Meanwhile, an estimated 10,000 Syrian-led troops have gathered in advance of what is believed to be perhaps a final ground assault by Syrian forces against rebels in Aleppo. The past week's assault on rebel-held areas of the key city involved some of the worst violence since the start of the war in 2011.</s>Russian war planes struck rebel held areas north of Aleppo on Saturday as the army shelled the besieged old quarter in a major offensive, rebels and a monitoring group said.

The air strikes focused on major supply lines into rebel-held areas - the Castello Road and Malah district - while fighting raged in the Suleiman al Halabi neighbourhood, the front line to the north of Aleppo’s Old City.

An army source quoted in state media said its forces had made advances, which was denied by rebels who say they had repelled a new assault.

“They are shelling the old city heavily after another failed attempt to gain ground. They have lost several fighters and we are steadfast,” said Abu Hamam, a rebel from the Failaq al-Sham group.

The Syrian Observatory for Human Rights, a British-based group that monitors the war, reported heavy bombardment by government forces and “back and forth” fighting in the Suleiman al-Halabi neighbourhood.

The army said it would press its advantage after retaking the strategic Handarat camp north of Aleppo on Thursday.

On Friday, civil defence sources said air strikes on rebel held residential areas killed at least 30 people with the use of incendiary and phosphorous bombs causing extensive damage and fires.

The Observatory said at least 20 were killed by sustained Russian and Syrian army strikes and artillery shelling on Friday and into the early hours of Saturday.

State media said rebel mortar attacks on government-held Midan and other areas in the city killed at least 20 people.

The Syrian military and its allies launched a Russian-backed offensive nearly 10 days ago aimed at capturing rebel-held districts of eastern Aleppo that are home to more than 250,000 people.

Aleppo, Syria’s largest city and commercial hub before civil war began in 2011, has been divided into government and opposition sectors for four years.</s>The M10 hospital was hit by two barrel bombs, two cluster bombs and at least one rocket, Adham Sahloul, a spokesman for the Syrian American Medical Society, told CNN.

The hospital, which Sahloul's group supports, had just reopened to offer basic emergency care Friday, he said, following an airstrike two days earlier that had shut down the facility, including its desperately needed intensive care unit. The city's M2 hospital was put out of service after also being hit Wednesday.

On Friday alone, the M10 hospital saw 84 cases, including 22 children, Sahloul said. Sixteen of those died, including five children.

Aleppo's medical services are under appalling pressure. About 30 doctors remain in eastern Aleppo, Sahloul said, for a population of some 300,000 at a time of urgent need.

More than 450 people have been killed since a US-Russia brokered ceasefire collapsed September 22, he said. Most in the city's eastern districts also lack access to clean water following infrastructure damage from shelling and bombing, he added. Aleppo saw more aerial bombardments and clashes Saturday following the deaths of 36 people the day before, UK-monitoring group Syrian Observatory for Human Rights said. At least 20 people, including six children, were killed then in airstrikes on neighborhoods of rebel-held eastern Aleppo, the group reported. Separately, at least 16 people, including women and children, were killed Friday in shelling by rebel forces on regime-held parts of western Aleppo, it said. The state-run Syrian Arab News Agency, or SANA, said 13 people died Friday in Aleppo due to "terrorist rocket attacks." Rebel-held districts of Aleppo have suffered intense aerial bombardment by Syrian and Russian warplanes for more than a week, while the Assad regime prepares to take the northern city. Regime forces shelled areas of Aleppo's Old City on Saturday, the Syrian Observatory for Human Rights said. Regime forces and rebel fighters also engaged in violent clashes in the neighborhoods of Bustan al-Basha and Sheikh Khodr. A Syrian family leaves the area following a reported airstrike on Friday, September 23, in rebel-held east Aleppo. Following the airstrike, recovery teams from Syria Civil Defense, known as the White Helmets, began working to free the trapped and recover the dead, including small children. This photo was released by the volunteer group Syria Civil Defense of the bodies of a man, with his knee pulled up near his face, and a child covered in dust after they were killed in the airstrike. The volunteers work to recover the bodies the man and child. A Syrian man carries the body of his nephew, recovered from the rubble. The volunteers remove an infant's body from the destroyed building. A Syrian woman carries the body of her infant after he was recovered. The activist group Aleppo Media Center said at least one person was killed and several wounded Saturday in airstrikes by helicopters in eastern Aleppo's Al-Sakhour neighborhood. The group also reported artillery shelling by regime forces. SANA, quoting a police official, reported that at least 13 people were injured in rocket fire in the al-Maydan residential neighborhood in regime-held western Aleppo. Kerry in leaked audio: 'I lost the argument' on Syria Meanwhile, an estimated 10,000 Syrian-led troops have gathered in advance of what is believed to be perhaps a final ground assault by Syrian forces against rebels in Aleppo. The past week's assault on rebel-held areas of the key city involved some of the worst violence since the start of the war in 2011.</s>Media playback is unsupported on your device Media caption Dr Abu Rajan shows cameras around the bombed M10 hospital in rebel-held Aleppo

Russian and Syrian air raids on the rebel-held eastern half of the city of Aleppo have forced the closure of the largest hospital in the area and killed two people, a medical charity says.

The Syrian American Medical Society, which supports the hospital, said it had been struck by barrel bombs.

There are also reports of Russian-backed Syrian government forces hitting Aleppo's historic Old City.

Clashes between government troops and rebels are occurring in several areas.

Russian and Syrian air forces resumed attacks on the rebel-held east of the city after a partial truce lapsed on 19 September. Government forces have also launched a ground offensive against the rebels.

Image copyright Reuters Image caption Hospitals in the east of Aleppo have been razed to the ground

Image caption Two people people were killed and about 10 reported injured at the hospital

The mounting civilian death toll has sparked international protests. The US says Russia is driving moderate rebels into the arms of jihadists.

Once Syria's commercial and industrial hub, Aleppo has been divided roughly in two since 2012.

The UN says at least 400 civilians, including many children, have been killed in the city this week as a result of Russian and Syrian government attacks.

Media playback is unsupported on your device Media caption Aleppo: Key battleground in Syria's civil war

Media playback is unsupported on your device Media caption Drone footage shows children playing football among Aleppo's ruins

On Saturday, air raids hit Aleppo's main trauma M10 hospital for the third time in a matter of days, medical workers say.

"The hospital is now out of service completely," radiologist Mohammad Abu Rajab was quoted by Reuters as saying.

"There's destruction to walls, infrastructure, equipment and generators. There are no more guards or staff left. It's complete darkness."

Hospital manager Dr Abu Rajan told local media that about 10 people at the hospital had been injured after it was hit by barrel bombs - improvised devices dropped from helicopters - cluster munitions, and a chlorine bomb.

Two patients were killed, while others have now been transferred to alternative facilities, the Syrian American Medical Society said.

A spokesman for US President Barack Obama condemned the bombing, which he said showed "total disregard" for medical professionals and patients.

"Reports of yet another hospital being destroyed further demonstrates the total disregard for the lives of medical professionals and their patients who need critical care because of the Assad regime and Russia's relentless campaign against the Syrian people."

French Foreign Minister Jean-Marc Ayrault also condemned the bombing, saying the shelling of healthcare structures and personnel constituted war crimes - and the perpetrators would have to be held to account.

'Shelling heavily'

The Syrian army says it is gaining ground but the rebels deny this.

"They are shelling the Old City heavily after another failed attempt to gain ground," Abu Hamam, from the Failaq al-Sham group, was quoted as saying by Reuters news agency.

"They have lost several fighters and we are steadfast."

The Syrian Observatory for Human Rights, a UK-based monitoring group, also reported government barrel bomb and jet attacks on the Ghouta area outside Damascus on Saturday.

In another development, it said government forces were battling fighters from the Islamic State group in Homs region.

War of words

Washington and Moscow have continued to spar over Syria, with the US dismissing Russian accusations that it was protecting a jihadist group in its bid to oust Syrian President Bashar al-Assad.

Russian Foreign Minister Sergei Lavrov said the US had broken its promise to separate the powerful Jabhat Fateh al-Sham (formerly known as al-Nusra Front) and other extremist groups from more moderate rebels.

Media playback is unsupported on your device Media caption Russia's claim is "absurd", says state department spokesman Mark Toner

State department spokesman Mark Toner said the Russian allegations were "absurd".

He told reporters the US had not targeted al-Nusra for months because they had become "intermingled" with other groups and civilians.

Media playback is unsupported on your device Media caption Sergei Lavrov: "We believe the plan was to spare Nusra"

At least 250,000 people have been killed in the conflict since it began in March 2011 with the Observatory estimating the true number to be about 430,000.

More than 4.8 million people have fled abroad, and an estimated 6.5 million others have been displaced within the country, the UN says.</s>In this August 27 photo provided by the Syrian anti-government activist group Aleppo Media Center (AMC), shows a Syrian man carrying a girl away from the rubble of a destroyed building after barrel bombs were dropped on the Bab al-Nairab neighborhood in Aleppo, Syria. Nearly 100 children were killed in a single week in Aleppo as Syrian and Russian warplanes sought to bombard into submission the rebel eastern districts of the city that have held out against Syrian government forces for five years. Without hope for the future, no regular schooling and little access to nutritious food, the children of Aleppo and their parents struggle to survive and fear the threat an imminent ground offensive.(Aleppo Media Center via AP)</s>Syrian government and allied forces advanced north of Aleppo, pressing their week-old offensive to take the insurgent-held, eastern part of the city after dozens of overnight air strikes.

The Syrian Army told rebels to leave the area, offering safe passage and aid supplies.

The Syrian military, supported by Iranian-backed militias and Russian air power, began their push to take the whole of the divided city after a ceasefire collapsed last month.

Healthcare destroyed

 

 The assault has nearly destroyed eastern Aleppo's healthcare system, the U.N said. An air campaign by the Syrian government and its allies was reinforced by a ground offensive targeting the besieged eastern half of the city where insurgents have been holding out.

The Syrian Observatory for Human Rights and the Syrian military said the Army and its allies had advanced south from the Handarat refugee camp north of Aleppo city, which they took earlier this week, taking the Kindi hospital and parts of the Shuqaif industrial area. Air strikes and shelling continued on Sunday, the Observatory said.

The Syrian Army said on Sunday that rebel fighters should vacate east Aleppo and it would guarantee them safe passage and necessary aid.

The relentless Russian and Syrian air campaign in east Aleppo has damaged hospitals and water supplies.

East Aleppo came under siege in early July after its main supply route, the Castello Road, fell under government control.

On Saturday, the largest trauma and intensive care centre in eastern Aleppo was badly damaged by air strikes and had to close. Two patients were killed.

The Syrian American Medical Society (SAMS), which partly supported the hospital, said the hospital had been hit seven times since July, with three attacks this week alone.</s>BEIRUT — Syrian government and allied forces have advanced towards Aleppo, pursuing their week-old offensive to take the rebel-held part of the city after dozens of overnight airstrikes.

The Syrian army told the insurgents to leave their positions, offering safe passage and aid supplies.

Syrian forces supported by Iranian-backed militias and Russian air power began their push to take the whole of the divided city after a ceasefire collapsed last month.

An air campaign by the Syrian government and its allies has been reinforced by a ground offensive against the besieged eastern half of Aleppo, where insurgents have been holding out. Hospitals have been badly hit in the assault, medics say.

While Russian Foreign Minister Sergei Lavrov and U.S. Secretary of State John Kerry spoke by phone to discuss normalization of the situation, Britain said the bombing of hospitals by forces loyal to Syrian President Bashar al Assad made it impossible talk about peace.

“It is the continuing savagery of the Assad regime against the people of Aleppo and the complicity of the Russians in committing what are patently war crimes — bombing hospitals, when they know they are hospitals and nothing but hospitals — that is making it impossible for peace negotiations to resume,” British Foreign Secretary Boris Johnson said.

The Syrian Observatory for Human Rights and the Syrian military said Sunday that the army and its allies had advanced south from the Handarat refugee camp north of the city, taking the Kindi hospital and parts of the Shuqaif industrial area.

Zakaria Malahifji of the Aleppo-based rebel group Fastaqim told Reuters there were clashes in this area Sunday.

The Observatory said airstrikes and shelling continued Sunday, and there was fierce fighting all along the front line that cuts the city in two.

The Syrian army said that rebel fighters should vacate east Aleppo in return for safe passage and aid supplies.

“The army high command calls on all armed fighters in the eastern neighborhood of Aleppo to leave these neighborhoods and let civilian residents live their normal lives,” a statement carried by state news agency SANA said.

East Aleppo came under siege in early July after its main supply route, the Castello Road, fell under government control.

International attempts to establish ceasefires to allow in United Nations humanitarian aid have failed, although other aid groups have brought in limited supplies.

The relentless Russian and Syrian air campaign has badly damaged hospitals and water supplies.

U.N Under-Secretary-General for Humanitarian Affairs Stephen O’Brien said he was “deeply alarmed by the ferocious pummeling of eastern Aleppo” and reiterated U.N. calls for a pause in fighting, medical evacuations and access for aid.

“The health system is on the verge of total collapse with patients being turned away and no medicines available to treat even the most common ailments.”

“With clean water and food in very short supply, the number of people requiring urgent medical evacuations is likely to rise dramatically in the coming days,” he said.

The European Union announced an initiative for Aleppo aimed at allowing humanitarian organizations to do their work and civilians to be rescued and protected.

“The EU calls on all parties to urgently provide the necessary authorizations for aid delivery and for medical evacuations to proceed,” a statement said.

On Saturday, the largest trauma and intensive care center in eastern Aleppo was badly damaged by airstrikes and had to close. Two patients were killed.

The Syrian American Medical Society, which partly supported the hospital, said the hospital had been hit seven times since July, with three attacks this week alone.

“The situation in Aleppo is beyond dire … People are stuck under the rubble and we can’t get to them because of the intensity of the shelling. We are pleading for help to stop the bombing,” Mohamed Abu Rajab, a medical society nurse at the hospital, said.

The Syrian American Medical Society said only five hospitals remained operational in east Aleppo.

The Syrian Foreign Ministry said in a statement carried by state media that the participation of Russia’s air force in the conflict now in its sixth year had “tightened the noose on terrorist groups and reduced their ability to spread terror to other countries.”

The Syrian government refers to all groups fighting against it as terrorists.</s>(CNN) Russia warned the United States about taking direct action against the Syrian regime, saying it would cause negative consequences across the Middle East, Russia's state-run Sputnik news agency reported Saturday.

Meanwhile, intense fighting continued in the besieged Syrian city Aleppo on Saturday, with one of the main hospitals bombed by Russian-backed Syrian forces.

She said the United States risked creating a power vacuum in Syria were it to depose Syrian President Bashar al-Assad. Such a power vacuum would be filled by "terrorists of all sorts," Sputnik reported.

Secretary of State John Kerry, in a meeting with a group of Syrian civilians last week, expressed sympathy for their demands that the United States intervene more forcefully amid Syrian and Russian airstrikes, according to an audio recording obtained by CNN.

He told the group that he "lost the argument" for using military force against the regime of Syrian President Bashar al-Assad.

"I've argued for the use of force. I'm the guy who stood up and announced that we're going to attack Assad for the use of weapons," Kerry is heard telling the Syrian attendees, referring to internal deliberations within the administration of President Barack Obama that followed Assad's use of chemical weapons in 2013.

The facility was struck by a "torrent" of weapons including two barrel bombs, two cluster bombs and at least one rocket, said Adham Sahloul, spokesman for the Syrian American Medical Society.

One person died and 15 were wounded in the bombings, according to an activist with the opposition-aligned group Aleppo Media Center. Some patients hurt in the attack were also wounded when bombs struck the same facility Wednesday, the activist said.

M10, the largest surgical hospital in Aleppo, is now out of service, the activist said.

The hospital had just reopened to offer basic emergency care Friday, Sahloul said, following the airstrike earlier in the week that also shut down its desperately needed intensive care unit. The city's M2 hospital was also put out of service by shelling Wednesday, activists said. The Syrian American Medical Society supports both hospitals.

The attacks on M2 and M10 have left only two surgical hospitals in Aleppo, the media center activist said.

On Friday alone, the M10 hospital saw 84 cases, including 22 children, Sahloul said. Sixteen of those died, including five children.

Aleppo's medical services are under appalling pressure. About 30 doctors remain in eastern Aleppo, Sahloul said, for a population of some 300,000 at a time of urgent need.

Doctors have resorted to triage, prioritizing those they believe have the best chance of survival, the activist said.

Another three medical facilities in al-Shaar neighborhood -- a women's hospital, a children's hospital and the central blood bank -- were also hit Friday, Sahloul said.

More than 450 people have been killed since a US-Russia brokered ceasefire collapsed September 22, he said.

Syrian government war jets have targeted gathering places such as markets, hospitals and mosques for three days, the Aleppo Media Center activist told CNN.

The United Nations' aid chief Stephen O'Brien repeated a call for a 48-hour weekly pause in the fighting so that aid could enter the city.

"The health system is on the verge of total collapse, with patients being turned away and no medicines available to treat even the most common ailments," O'Brien said in a statement.

"Hundreds of critical medical evacuations are urgently required. With clean water and food in very short supply, the number of people requiring urgent medical evacuations is likely to rise dramatically in the coming days."

Most in the city's eastern districts lack access to clean water following infrastructure damage from shelling and bombing, Sahloul said.

Aleppo saw more aerial bombardments and clashes Saturday following the deaths of 36 people the day before, UK-based monitoring group Syrian Observatory for Human Rights said.

At least 20 people, including six children, were killed then in airstrikes on neighborhoods of rebel-held eastern Aleppo, the group reported.

Separately, at least 16 people, including women and children, were killed Friday in shelling by rebel forces on regime-held parts of western Aleppo, it said.

The state-run Syrian Arab News Agency, or SANA, said 13 people died Friday in Aleppo due to "terrorist rocket attacks."

Regime forces shelled areas of Aleppo's Old City on Saturday, the Syrian Observatory for Human Rights said. Regime forces and rebel fighters also engaged in violent clashes in the neighborhoods of Bustan al-Basha and Sheikh Khodr.

Aleppo Media Center said at least one person was killed and several wounded Saturday in airstrikes by helicopters in eastern Aleppo's Al-Sakhour neighborhood.

The group also reported artillery shelling by regime forces.

SANA, quoting a police official, reported that at least 13 people were injured in rocket fire in the al-Maydan residential neighborhood in regime-held western Aleppo.

Meanwhile, an estimated 10,000 Syrian-led troops have gathered in advance of what is believed to be a possible final ground assault by Syrian forces against rebels in Aleppo.

The past week's assault on rebel-held areas of the key city involved some of the worst violence since the start of the war in 2011.
Russian and Syrian government attacks on rebel-held east Aleppo kill two people and injure 13 others. The Syrian American Medical Society reports the city's main trauma hospital closes.