BEIRUT (Reuters) - The Syrian army and its allies fought intense clashes with insurgents in the opposition-held 1070 Apartments district of southwestern Aleppo on Tuesday, senior combatant sources on both sides said.

The 1070 Apartments are located next to Ramousah, the southern gateway into Aleppo. The area’s capture would allow the government to ease its own access into the city while consolidating a siege on rebel-held districts.</s>BEIRUT -- Syrian government forces captured a central rebel-held neighborhood in Aleppo on Tuesday after a week of blistering airstrikes.

Desperate residents describe horrific scenes in Syria's largest city and onetime commercial center, with hospitals and underground shelters hit by indiscriminate airstrikes that the United Nations said may amount to a war crime.

Syrian state TV said troops captured Farafra, near Aleppo's famous citadel, and that fighting was underway near the historic core of the northern city.

Aleppo has been fiercely contested since rebels captured several eastern neighborhoods in 2012.

Those neighborhoods are now under siege and over the past week have endured the worst aerial onslaught since the start of the war, with more than 200 people killed and several buildings flattened.

Last week, the Syrian army ordered civilians to stay away from rebel positions, saying a ground offensive would begin.

On Tuesday, government forces captured the rebel-held central neighborhood of Farafra near the Old City.

But the battle for the city still appears to be mired in stalemate.

Government forces captured the Handarat area on the northern edge of Aleppo over the weekend, only to lose it hours later.

The contested historic quarter of Aleppo, one of the world's oldest cities, is home to the Umayyad Mosque, a UNESCO world heritage site.

The 11th-century minaret of the famed mosque collapsed in April 2013 during fighting.

The Britain-based Syrian Observatory for Human Rights, which relies on a network of activists inside Syria, confirmed that government forces are advancing on the old quarter.

A Syrian military official in the capital, Damascus, said operations in Aleppo will continue until the "terrorists" in the eastern parts of the city are "wiped out." The official spoke on condition of anonymity in line with regulations.

In Russia, Deputy Foreign Minister Mikhail Bogdanov told Syria's ambassador that Moscow has "a firm intention to continue providing assistance to the Syrian government in fighting terrorism and to help achieve the soonest possible political settlement of the Syrian crisis."

Residents in Aleppo said they have been stunned by the intensity of the bombing, and they have seen a sharp increase in food prices due to the siege, which tightened earlier this month.

Ibrahim Alhaj, a member of the Syrian Civil Defense, said his parents' house was shelled, and he was able to save them only because he lives nearby.

Assad "listens to no one -- not the United Nations, not anyone," a desperate and exhausted Alhaj said. "Is there no humanity in this world?"

Clinics have been flooded with casualties in the past week. Many had to be treated on white-tiled floors covered with blood.

Mohamed Abu Jaafar Kahil, the head of a medical charity, said in a message that conditions in Aleppo were desperate.

"Hospitals have no more room to receive even one more case, due to the huge number of casualties, of wounded and of martyrs who died today at the hands of barbaric Russian warplanes backed by Syrian warplanes," he said.

Kahil recounted "nonstop bombing" by rockets and other artillery, including cluster munitions that are infamous for the indiscriminate way in which they maim and kill. He estimated that dozens had died and hundreds had been wounded.

Dr. Mohamed al-Ahmad, a radiologist reached via the messaging app Viber, described a dire situation at the hospital where he worked. "We're running short of drugs, we're running short of respirators, we don't have baby milk, especially for newborns," he said.

Several thousand rebels from different factions are believed holed up in eastern Aleppo, with the largest being the Nour el-Din el-Zinki group.

"The regime and its allies know very well the high price they will pay if they try to storm liberated Aleppo," said Yasser Alyousef, a spokesman for the group, referring to the rebel-held sector. "The rebels have become experts in street warfare and ways to drain the enemy."

Residents, fearing further targeting, deny the presence of any al-Qaida-affiliated fighters inside the besieged area.

Brita Hassan Haj, head of the Aleppo council in the area, said the government's aim was to drive residents out. On Monday, 25 of eastern Aleppo's 63 neighborhoods were bombed, he said.

"Bunker-buster bombs are penetrating underground shelters, leaving no one safe," he said. "The main roads are closed, the civil defense can't operate, and people are dying. ... It is like judgment day."

Bassem Ayoub, an Aleppo resident, reported that food and medical supplies were running out. "Every day is worse then the last," he said. "Every day I leave my house, I keep in mind that I might not be back. All the people are doing the same here. We're living day by day.

The Observatory said 11 people were killed in airstrikes on rebel-held eastern Aleppo on Tuesday, and that insurgents shelled the nearby government-held villages of Nubal and Zahraa, killing a baby girl.

The latest escalation in Syria's 5½-year-old civil war came after a weeklong cease-fire brokered by the U.S. and Russia unraveled, with each side accusing the other of violating the agreement.

The fighting has killed more than 250,000 people and displaced half of Syria's population.

Information for this article was contributed by Bassem Mroue, Sarah El Deeb, Albert Aji and Vladimir Isachenkov of The Associated Press and by Hwaida Saad of The New York Times.</s>ALEPPO: The United States threatened Wednesday to suspend its engagement with Russia over the conflict in Syria following escalating attacks on rebel-held parts of Aleppo city, including strikes on two hospitals.

UN chief Ban Ki-moon denounced the attacks — which saw the two largest hospitals in Aleppo’s opposition-controlled east hit with air strikes and artillery fire — as “war crimes”.

President Bashar al-Assad’s forces and his ally Moscow have carried out a barrage of air strikes on eastern Aleppo since Syria’s regime announced a bid last week to retake all of the divided city.

Russia’s defence ministry said Moscow was prepared to relaunch talks with the United States on the crisis, but a Syrian opposition official said a political solution to the conflict was “no longer a viable option”.

Dozens of civilians have been killed, residential buildings have been reduced to rubble and residents of east Aleppo — already suffering under a government siege — are facing severe shortages.

The latest bombardment has been some of the worst in Syria’s five-year civil war, and comes after the failure of a short-lived ceasefire brokered by Russia and the United States this month.

Moscow and Washington have traded blame over the truce’s collapse, with the US harshly criticising Russia’s participation in the Aleppo offensive.

On Wednesday, US Secretary of State John Kerry warned Russian counterpart Sergei Lavrov that Washington will end talks on the conflict unless Moscow halts the Aleppo assault.

Kerry said the burden was on Russia to stop the assault and ensure humanitarian aid access, his spokesman John Kirby said.

“The United States is making preparations to suspend US-Russia bilateral engagement on Syria… unless Russia takes immediate steps to end the assault on Aleppo and restore the cessation of hostilities,” Kirby said.

Russia’s defence ministry said later Moscow was ready to relaunch talks with Washington.

“On orders of the Russian president, we are ready to continue joint work with our American partners on the Syrian issue,” and to send experts to Geneva to “relaunch consultations,” it said.

But a member of the key National Coalition opposition movement said the escalating violence, particularly against rebel-held Aleppo, meant a political solution was “no longer viable”.

Coalition vice-president Muwaffaq Nyrabia said rebels were “considering all options to defend the Syrian people against the Russian aggression on Syria”.

Wednesday’s attacks saw the M10 and M2 hospitals hit before dawn, forcing both to shut temporarily, said Adham Sahloul of the Syrian American Medical Society, which supports both hospitals.

Doctors Without Borders — a charity known by its French acronym MSF — said the two attacks killed at least two patients, wounded two medics and left just two of east Aleppo’s eight hospitals with surgical facilities.

It was unclear who had carried out the bombings, which UN chief Ban denounced before the Security Council.

“Those using ever more destructive weapons know exactly what they are doing. They know they are committing war crimes,” he said.

Inside one of the hospitals, patients and medical staff cowered in fear.

“I am in the M2 hospital now. I was inside when the entrance to the emergency room was hit. Three of my colleagues were hurt,” Aref al-Aref, a medical assistant, said.

“Everyone is terrified and scared today. We are afraid that we will be today’s victims.”

Sahloul warned the attacks could have devastating consequences.

“With these two hospitals gone, if today there is another offensive like Saturday or Sunday, this is signing the death warrant for hundreds of people,” he said.

The UN children’s agency UNICEF said at least 96 children have been killed and 223 wounded since Friday in the rebel-held sections of Aleppo where the health system was crumbling with only 30 doctors left.

More than 170 people have been killed in east Aleppo since Syria’s army announced its operation to retake the city, said the Syrian Observatory for Human Rights.

On Wednesday, at least six civilians died in artillery fire near a bakery in the opposition-controlled Maadi district, the monitor said.

A hospital in the government-held west reported two people had been killed and 10 wounded in rebel fire on the Aziziyeh district.

Clashes also continued inside Aleppo’s Old City, the Observatory said, after pro-government troops seized control of the Farafira district northwest of Aleppo’s historic citadel on Tuesday.

Once Syria’s commercial hub, Aleppo has been ravaged by fighting and divided since mid-2012.

An estimated 250,000 people still live in the east, which has been under devastating siege by government forces since early September.

The head of the White Helmets volunteer rescue force, which operates in opposition-held territory in northern Syria, said that under current conditions civilian facilities in eastern Aleppo would no longer be able to function within a month.

“The civilians there would seize any opportunity to escape, to go wherever they could go,” Raed Saleh told Agence France-Presse.

“But nothing is available to provide safety and protection for those civilians.” AFP</s>DAMASCUS: Syria’s army took control of a rebel-held district in central Aleppo on Tuesday, after days of heavy air strikes that have killed dozens and sparked allegations of war crimes.

In the first advance since announcing plans last week to retake all of the divided city, pro-government troops seized the Farafira district northwest of Aleppo’s historic citadel, a military source told AFP.

“After neutralizing many terrorists… units are now demining the area,” the source said.

The push follows several days of Syrian and Russian air strikes on rebel-held Aleppo neighborhoods — some of the fiercest bombardment of the five-year conflict so far — after a ceasefire deal brokered by Moscow and Washington collapsed last week.

The Aleppo maelstrom prompted Western powers to accuse Russia of committing possible war crimes, charges the Kremlin condemned as “unacceptable”.

In the latest broadside, NATO Secretary General Jens Stoltenberg also condemned the air campaign. “The appalling attacks on Aleppo have shaken all of us, and the violence and the attacks we have seen… is morally totally unacceptable and is a blatant violation of international law,” Stoltenberg told a news conference in Bratislava.

On the ground in eastern Aleppo, an AFP correspondent said air strikes struck several neighborhoods simultaneously, including in Al-Shaar, where a five-storey building was leveled with a family stuck inside.

One young girl, her body encased in rubble, was among the dead. Her father, in shock as rescue workers picked up her lifeless body, collapsed beside her, saying: “She’s just sleeping. She’s just used to sleeping.”

The Syrian Observatory for Human Rights, a Britain-based monitor, said that Russian and regime bombardment on the city have killed more than 165 people since the government announced its offensive last week.

At least 23 civilians, including nine children, were killed Tuesday in raids on the neighborhoods of Al-Shaar and Al-Mashhad, it said.

As well as the intensified violence, residents have been left reeling from food shortages and skyrocketing prices.

The World Health Organization warned that medical facilities in east Aleppo were on the verge of “complete destruction”.

“Over the last weekend alone, more than 200 people were injured and taken to understaffed health facilities in east Aleppo,” a spokeswoman said in Geneva.

The UN body called for “an immediate establishment of humanitarian routes to evacuate sick and wounded from the eastern part of the city.”

The Observatory said that there were “significantly fewer” strikes on Aleppo on Tuesday than in recent days, but confirmed the advance by pro-government forces into Farafira.

Aleppo has been roughly divided between government control in the west and rebel control in the east since mid-2012, and the frontline has remained largely static despite continuous violence.</s>An army ground offensive on four different fronts has begun on rebel-held areas of the besieged city of Aleppo, Syrian state media is reporting.

The groud movement comes after five days of intense air strikes on east Aleppo, including the reported use of bunker-buster ground penetrating bombs and incendiary devices which have destroyed civilian infrastructure including a water station and emergency response centres. Activists on the ground say more than 400 people have died.

NATO said on Tuesday that the Russian backed attacks on Aleppo are in "blatant violation of international law." There are now fears that the approximately 250,000 people inside besieged rebel areas could be facing an "atrocity that would resonate in history," one diplomat warned.

The Syrian army and allied militias attacked at the same time on Tuesday around the Palestinian Handarat camp north of Aleppo, at the nearby Kindi Hospital area, in the Rashidin district in the centre of the city and at the 1070 Apartments district in the southwest.

Troops are also said to be advancing in the contested Old Quarter, where they have captured several buildings, towards the rebel neighbourhood of Farafra.

A military official speaking on condition of anonymity told the AP on Tuesday that the offensive will continue daily on all fronts until "terrorists" in east Aleppo are "wiped out".

A rebel official told Reuters that the attacks had been repelled, but they expect two more assaults on a rebel-held district in the south of the city.

The Syrian government announced last week following the collapse of a US-Russian brokered ceasefire that it intends to retake Aleppo - the last major rebel stronghold - for good.

Government forces briefly captured Handarat from rebels on Saturday, but lost it in a counter attack the same day. Minor clashes in several other areas have so far been repelled by the opposition.

The leader of a Syrian-government allied elite Iraqi militia told Reuters on Tuesday that his soldiers were moving tanks and armoured vehicles in preparation for an assault on opposition-held east of the city.

East Aleppo's supply lines were completely shut off by goverment forces in July. The Syrian regime has not attempted to retake rebel neighbourhoods by means of a ground offensive since 2012.

Recapturing rebel districts of Aleppo would greatly strengthen President Bashar al-Assad's position in the six-year-long war, effectively wiping out non-Islamist resistance from all major cities and leaving pockets of opposition in the far north and south of the country.</s>An army ground offensive on four different fronts has begun on rebel-held areas of the besieged city of Aleppo, Syrian state media is reporting.

The ground movement comes after five days of intense air strikes on east Aleppo, including the reported use of bunker-buster ground penetrating bombs and incendiary devices which have destroyed civilian infrastructure including a water station and emergency response centres. Activists on the ground say more than 400 people have died.

Nato said on Tuesday that the Russian backed attacks on Aleppo are in "blatant violation of international law." There are now fears that the approximately 250,000 people inside besieged rebel areas could be facing an "atrocity that would resonate in history," one diplomat warned.

The Syrian army and allied militias attacked at the same time on Tuesday around the Palestinian Handarat camp north of Aleppo, at the nearby Kindi Hospital area, in the Rashidin district in the centre of the city and at the 1070 Apartments district in the southwest.

Troops are also said to be advancing in the contested Old Quarter, where they have captured several buildings, towards the rebel neighbourhood of Farafra.

A military official speaking on condition of anonymity told the AP on Tuesday that the offensive will continue daily on all fronts until "terrorists" in east Aleppo are "wiped out."

A rebel official told Reuters that Tuesday's attacks had been faught off, but they expect two more assaults on a rebel-held district in the south of the city.

Leaflets dropped on the city in the last day sought to assure trapped residents "there are no boundaries between us, break fears within you and come back to your normal life," urging them to flee to government-held parts of the city. However, several reports from the ground say that those who tried to approach the siege barricades were shot at by snipers. There are no reports of any east Aleppo civilians crossing over into western districts.

Another leaflet warns rebel fighters to surrender or die, showing the portraits of leaders recently killed in clashes struck through with red crosses.

The Syrian government announced last week following the collapse of a US-Russian brokered ceasefire that it intends to retake Aleppo - the last major rebel stronghold - for good.

Government forces briefly captured Handarat from rebels on Saturday, but lost it in a counter attack the same day. Minor clashes in several other areas have so far been repelled by the opposition.

The leader of a Syrian-government allied elite Iraqi militia told Reuters on Tuesday that his soldiers were moving tanks and armoured vehicles in preparation for an assault on opposition-held east of the city.

East Aleppo's supply lines were completely shut off by goverment forces in July, leaving residents inside living in siege conditions. There are only 35 doctors left in the district caring for hundreds of wounded, the World Health Organisation (WHO) said on Tuesday.

"WHO is calling for the immediate establishment of humanitarian routes to evacuate sick and wounded from the eastern part of the city," spokesperson Fadela Chaib said from Geneva.

The Syrian regime has not attempted to retake rebel neighbourhoods by means of a ground offensive since 2012.

Recapturing rebel districts of Aleppo would greatly strengthen President Bashar al-Assad's position in the six-year-long war, effectively wiping out non-Islamist resistance from all major cities and leaving pockets of opposition in the far north and south of the country.</s>BEIRUT — Syrian government forces and their allies attacked the opposition-held sector of Aleppo on several fronts on Tuesday, the biggest ground assault yet in a massive new military campaign that has destroyed a U.S.-backed ceasefire.

The United States says the assault on Aleppo is proof that President Bashar al-Assad and his Russian and regional allies have abandoned an international peace process to pursue victory on the battlefield after nearly six years of civil war.

Washington, which agreed a ceasefire with Russia this month that collapsed after a week, says Moscow and Damascus are guilty of "barbarism" and war crimes for targeting civilians, health workers and aid deliveries in air strikes.

More than 250,000 civilians are believed to be trapped inside the besieged rebel-held sector of Aleppo, where intensive bombing over the past week has killed hundreds of people, many trapped under buildings brought down by bunker-busting bombs.

Only about 30 doctors are left inside, coping with hundreds of wounded each day who are being treated on the floors of hospitals that are bereft of supplies.

The World Health Organization called for the "immediate establishment of humanitarian routes to evacuate sick and wounded" from the besieged eastern part of the city.

Tuesday's assault saw pro-government forces, which include the Syrian army and allied militia from Iran, Iraq and Lebanon, attempt to attack Aleppo's Old City near its historic citadel, as well as around several of the city's major access points.

Troops advanced from the countryside to the north and south, rebels said, leading to intense clashes. The military and the Syrian Observatory for Human Rights, a Britain-based war monitoring group, said the army had made some gains, but this was disputed by rebels who said they had held them off.

Senior combatants on both sides said pro-government forces were massing in several parts of Aleppo, Syria's biggest city before the war, now divided into a western zone held by the army and a smaller, besieged area held by rebels.

The commander of an Iraqi Shi'ite militia fighting in support of Assad told Reuters a large force spearheaded by the army's elite "Nimr", or Tiger, forces had started to move in armored vehicles and tanks for an attack on rebel-held areas.

Quelling the uprising in the city would give Assad his biggest victory yet of the war and deliver a powerful blow to his enemies.

It is far from clear whether an all-out attempt to storm the rebel-held area is planned soon: that would require a massive assault by the army, backed by Lebanese and Iraqi Shi'ite militias, Iran's Revolutionary Guards and Russian air power.

The government's strategy in other locations such as Damascus and Homs has been to use years of siege and bombardment to force eventual surrender, rather than attempting to storm of well-defended territory.

However, Assad's allies now openly say they have abandoned the peace process and are betting instead on military victory.

"There are no prospects for political solutions ... the final word is for the battlefield," the leader of Lebanon's Hezbollah Shi'ite movement, Sayyed Hassan Nasrallah, was quoted in a Lebanese newspaper as saying on Tuesday.

The head of Iran's National Security Council, Ali Shamkhani, was quoted on Tuesday as saying Aleppo's fate would be determined only "through a forceful confrontation".

Aleppo residents said ferocious air attacks of previous nights had abated somewhat. The Observatory said at least 11 people were killed in air strikes on Tuesday in two Aleppo neighborhoods.

State television reported that the army had retaken al-Farafra district in Aleppo's Old City and engineering units were clearing mines in the area.

A senior rebel source said the army had taken some positions near that area, but had been forced to withdraw. Neither assertion could be independently confirmed. The army had also been repelled after heavy fighting in assaults on four other fronts, he said, describing it as the biggest wave of ground attacks since the offensive was announced last week.

Zakaria Malahifji, a politburo member of the Fastaqim group which is active in Aleppo, said the army had assembled infantry and heavy vehicles in a military buildup in the city.

"Until today, thank God, attempts to advance have been blocked," he added.

The senior rebel official said pro-government forces were mobilizing near the rebel-held Sheikh Saeed district on the city's southern outskirts, near the location of the heaviest fighting this summer in Aleppo.

"They are working to expand on any opening they create," said the official from an Aleppo-based rebel faction, citing reports from his fighters.</s>BEIRUT (AP) — Syrian government forces captured a central rebel-held neighborhood in Aleppo on Tuesday after a week of blistering airstrikes, as a military official vowed that the offensive would continue until insurgents are "wiped out."

Syrian state TV said troops captured Farafra, near Aleppo's famous citadel, and that fighting was underway near the historic core of the northern city.

Aleppo, Syria's largest city and former commercial center, has been fiercely contested since rebels captured several eastern neighborhoods in 2012. Those neighborhoods are now under siege, and over the past week have endured the worst aerial onslaught since the start of the war, with more than 200 people killed and several buildings flattened.

The battle for the city still appears to be mired in stalemate. Government forces captured the Handarat area on the northern edge of Aleppo over the weekend, only to lose it hours later.

The contested historic quarter of Aleppo, one of the world's oldest cities, is home to the Umayyad Mosque, a UNESCO world heritage site. The 11th-century minaret of the famed mosque collapsed in April 2013 during fighting.

The Britain-based Syrian Observatory for Human Rights, which relies on a network of activists inside Syria, confirmed that government forces are advancing on the old quarter.

The group said 11 people were killed in airstrikes on rebel-held eastern Aleppo on Tuesday, and that insurgents shelled the nearby government-held villages of Nubal and Zahraa, killing a baby girl.

"There was intense shelling (in eastern Aleppo) earlier. It seemed the (government) was preparing for the attack," said Ibrahim Alhaj, a member of the Syrian Civil Defense, volunteer first responders also known as the White Helmets. He added that news from the front line suggests a large mobilization of pro-government militias in the old city.

Alhaj and activist Yassin Abu Raed, who is based outside the city, said rebels were able to repel the offensive. Abu Raed said five troops were killed in the fighting. Alhaj said the house of his parents was shelled earlier Tuesday, but that he was able to rescue them and bring them to his own home.

The latest escalation came after a weeklong cease-fire brokered by the U.S. and Russia unraveled, which each side accusing the other of violating the agreement.

A Syrian military official in the capital, Damascus, said operations in Aleppo will continue until the "terrorists" in the eastern parts of the city are "wiped out." The official spoke to The Associated Press on condition of anonymity in line with regulations.</s>Syrian troops have launched a large-scale ground attack on rebel-held areas of Aleppo in a bid to make concrete military gains after nearly a week of punitive bombardment that has mostly hit civilians.

Forces loyal to President Bashar al-Assad opened multiple fronts in an apparent attempt to increase pressure on rebel forces experienced in close urban warfare.

They advanced on the old city of Aleppo, a former refugee camp in the north captured at the weekend then lost to rebel forces, and in two other districts, opposition forces and state television said.

Rebel commanders were defiant about their chances of repelling troops on the ground, pointing to years of resistance against a better-armed enemy and the advantages of battle-hardened opposition fighters in close street-to-street combat.

“The Syrian regime and its allies have threatened and vowed to seize rebel-held Aleppo dozens of times for the last few years now,” said one Aleppo commander for the opposition Free Syrian Army.

“Regime forces will lose their advantage inside the besieged city of Aleppo, as Russian air power loses its effectiveness in close urban battles.”

The city is a fiercely contested prize. It was Syria’s cultural and economic hub before civil war broke out, and is the last major urban centre where rebels have a presence.

There are estimated to be about 250,000 people still living in the besieged area of eastern Aleppo, but the barrage of explosives, including alleged bunker-buster bombs, have brought what daily life still existed in the battered districts to a near halt.

More than 200 people have been killed and many more injured in one of the most intense aerial attacks of the five-year civil war. Russia was directly accused of war crimes at the UN security council for its use of munitions against civilian targets.

Assad appears determined to try to break the stalemate that has gripped Aleppo since 2012 – when rebel forces seized most of the areas they hold now – at almost any cost.

Rare drone footage from Aleppo obtained by Reuters shows a wrecked city, with the shells of apartment blocks lining broad boulevards with vast shell craters and almost entirely empty of life.

Among the dead on Tuesday was a young girl, whose body was lifted down from the ruins of her home by a search and rescue team using a crane. Waiting below was her father, crazed with grief, held back by local people risking bombs to aid the rescue or support the bereaved.

A single bomb had trapped four families under the rubble of the same apartment block in the neighbourhood of al-Shar, where locals said the old buildings are easily brought down by ordinary munitions.

Another photo showed a single hand protruding from the ruins , which locals said belonged to another lost child. “Hasan is carrying five floors on his back. He is 10 years old,” said the activist Abdulkafi Alhamdo.

Nearly half of the casualties in eastern Aleppo since a ceasefire crumbled last week have been minors, Save the Children said on Monday. Some of the youngest victims have been born and died in a city divided and at war.

Many have died in hospitals where exhausted and overwhelmed doctors are running low on medical supplies and struggling to treat the victims flooding into their wards.

Only about 30 medics are left to provide care in the besieged area of the city, according to Dr Zaher Sahloul, a Syrian-American who has volunteered in Aleppo several times and now provides online advice on complex operations.

The World Health Organisation and the International Committee of the Red Cross called on Tuesday for safe corridors into the city to allow ill and wounded people to be evacuated for treatment.

The toll from the attacks has been exacerbated because they hit civilian infrastructure left in besieged areas, including hospitals, the White Helmet search and rescue group’s facilities, markets and homes.

“I feel lost after my house was targeted by warplanes two days ago,” said Abdulrazak Zaksouk, a media activist living in al-Ansari district.

“Also many important things are starting to run out in the markets, like gas, fuel, many kinds of food. There is also a shortage of electricity. We depend on a large generators, but sadly because of the shortage of fuel we just use them for three hours a day.”

The commander of an Iraqi Shia militia fighting in support of Assad told Reuters a large force spearheaded by the army’s elite Nimr or Tiger forces had started to move in armoured vehicles and tanks for an attack on rebel-held areas.

Rebel forces and the government traded claims about fighting for Farafra neighbourhood in the old city.

Syrian state TV said government troops had claimed several blocks, but a commander fighting in the area told the Guardian they had pushed back the advance and killed seven troops. There was no way to independently verify the situation.

The Associated Press quoted a military official as saying the fighting would continue until opposition fighters were wiped out, but rebels insisted that their spirit had not been broken.



They pointed to their success this week in pushing government forces back from the deserted Handarat refugee camp, strategically important because it overlooks a road into the city, and seizing a military academy last month.



“The rebels prepared themselves for the siege well, even though of course our troops and munitions are being drained,” the opposition commander said.

“The Russian bombers are relying on a scorched earth policy. We think they lack accuracy in targeting, because they couldn’t hit our troops near the frontline where they are deployed. They are taking revenge on civilians.”</s>Washington (CNN) As Aleppo teeters on the brink of falling to Syrian regime forces, there is no consensus in the Obama administration on what, if any, action to take to help the beleaguered opposition with which the US is allied, several American officials have told CNN.

The administration may have less than a week before regime and Russian attacks result in Aleppo's collapse, potentially displacing tens of thousands of civilians and worsening the strategic environment for the United States, according to one internal US government calculation.

The Obama administration has blamed Russia for the collapse of a ceasefire negotiated more than a week ago by Secretary of State John Kerry and Russian Foreign Minister Sergei Lavrov, which would have stopped the fighting around Aleppo and paved the way for joint US-Russian military cooperation against terrorist groups in Syria.

In a phone call with Lavrov on Wednesday, Kerry threatened to "suspend US-Russia bilateral engagement on Syria ... unless Russia takes immediate steps to end the assault on Aleppo and restore the cessation of hostilities," according to a State Department statement.

But Kerry has said there are no good alternatives to working with Russia, and the US has little leverage to force Russia's hand given the reluctance of the White House to risk a military confrontation in which US planes could be shot down by Moscow.

A senior administration official told CNN Tuesday that interagency discussions are taking place and that many across the administration feel the US should intervene militarily to keep Aleppo in opposition hands.

But there is little sense that the White House is ready to take military steps and there is no indication that President Barack Obama has yet been presented with any such options or even asked for them.

White House spokesman Josh Earnest expressed concern Tuesday that arming the opposition "only further militarizes a situation that doesn't have a military solution."

However, he noted that the situation in Aleppo "continues to be of deep concern to the President and his national security team, and it's something that we're going to continue to closely monitor."

Earnest said the US is looking for "creative ways" to expedite delivery of humanitarian assistance, describing it as the "prominent goal" of diplomatic efforts.

The US has assembled an international coalition to fight ISIS and other terror groups that have established safe havens in the chaos of the Syrian civil war. But it has not taken military action to boost the rebels, even as it has sided with the moderate opposition and called on Syrian President Bashar al-Assad, a close Russian ally, to step aside.

The White House has faced criticism for not doing more to help Syrian civilians caught in the conflict, particularly in the blockaded city of Aleppo. Many Aleppo residents have already fled, contributing to the massive Syrian refugee crisis, but those who remain have faced food shortages, a lack of medicine and chemical attacks.

US officials are privately warning that if the attacks on Aleppo do not stop, Arab allies in the anti-ISIS coalition may decide to start shipping shoulder-fired, anti-air weapons to the moderate opposition.

These allies are deeply opposed to the Assad regime and invested in the opposition prevailing in a civil war that has major reverberations for their region.

Until now, officials across the administration have feared that ramping up the arming of Syrian rebels would be disastrous because of the risk that such weapons could easily fall into the hands of terrorists and be used to shoot down civilian airliners.

So far, the US has been able to convince the allies not to send large numbers of those weapons into Syria, though a small amount have been shipped in.

But officials now say there is discussion about lifting opposition to allies sending additional, more powerful, surface-to-surface weapons to US-backed rebel groups.

The situation in Aleppo has only become more dire in the last week as Moscow and Damascus have pummeled the environs, including hitting UN aid trucks bound for the city under the terms of the unsuccessful ceasefire worked out by the US and Russia.

Russia has claimed that the recent bombing campaign against Aleppo is an attempt by Moscow and the Syrian regime to go after one-time al Qaeda affiliate Jabhat Fateh Al-Sham, previously known as al Nusra Front.

US officials, however, are skeptical of that explanation. Though Russia has said that its aim in intervening militarily in Syria is to fight terror groups, it is widely seen as bolstering Assad as he battles the rebel insurgents.

"They are trying to take Aleppo," a US official said of Russia. "They are trying to go after opposition. They are using Nusra as an excuse, but nobody thinks this is about Nusra."

The goal of any US intervention, in part, would be to show Russia that Washington could still intervene, even though so far it has not.

Aleppo's fall could be boon for ISIS

In addition, there are implications for the fight against ISIS.

If thousands of civilians flee the strategic city, it would bring a new and unprecedented level of largely ungoverned territory to northern Syria that ISIS is likely to take advantage of by moving into new areas, according to a recent assessment by US officials.

The reason, officials said, is because the Syrian regime ground forces will not be able to govern such a broad area of unrest. It also is likely to mean that Kurdish and Turkish forces will delay any move on Raqqa, the self-declared capital of ISIS and a foremost US target.

It is also not clear what an Aleppo collapse might do to the continued presence of US Special Operations Forces in northern Syria, should the battlefield then shift to that terrain.

Officials advocating some type of intervention told CNN that a decision might have to be made as soon as the next five days for limited airstrikes against Syria military airfields and bases if Aleppo is to be saved.

The State Department was publicly gloomy Monday about the prospect of any diplomatic initiative to get the Russians to back off Aleppo.

"I don't want to say we've thrown in the towel," said State Department spokesman Mark Toner. "But it's hard -- unless we see some gestures by Russia on behalf of the regime ... we don't see this moving forward."

Toner added, "We're still committed to pursuing this process. It's just we're not in a good place. I don't know how to put it more frankly than that."

Before the most recent violence in Aleppo began, Kerry pointed obliquely to the potential issues associated with military action if diplomacy failed.

"Options are ugly because one option moves in a direction of trying to get a ceasefire and trying to get to the table to have a negotiation," he said in an interview with CNN. "The other option moves to more arms moving into the area, more fighting, more destruction, more migrants, more refugees, more children, women, schools, hospitals hit -- literally, possibly the destruction of Syria as an entire nation-state, and it's getting close to that even now."

Officials told CNN that Kerry is extremely frustrated by the situation but has little leverage to change the balance of power on the ground with Russia without some US military muscle.

Kerry last met with Lavrov in New York last week during the United Nations General Assembly meetings.

At that time, Kerry called on Russia to ground the Syrian Air Force and said there was no point in continuing to talk until Russia came forward with "serious" proposals on ending the violence.

Officials said they believe the White House was hoping it could have made the now-failed ceasefire agreement work long enough for any policy change to become more involved in Syria to be made by the next administration.

Privately, US defense officials are emphasizing that there is no internal planning at the Pentagon for military options.

Defense officials insist there must be a formal policy decision before they can even assemble new options for the President. But US military intelligence officials are aware of the locations the Syrian regime is using for its attacks.

The White House publicly has said its still working on the possibility of expanded sanctions against the Syrian regime.

But when asked if there are "new things" the White House is considering in Syria, Earnest said earlier this week, "I don't have any announcements at this point."

He added, "With regard to Russia, what I would say is simply that Russia will have to account for their actions in the context of the consequences they are likely to provoke."
The Syrian Army clashes with insurgents in the 1070 Apartments district of Aleppo.