More than 500 civilians, including over 121 children, in Eastern Ghouta, have been killed since February 18, marking one of the deadliest episodes since the beginning of the Syrian civil war. According to the Union of Medical Care and Relief Organization (UOSSM), 12 hospitals and clinics have been bombed since the relentless attacks began on Sunday, making it impossible to deliver sufficient medical relief to the region. The Russian-backed Syrian government continues to send reinforcements to Eastern Ghouta as they aim to flatten the city and relinquish rebel-control.

Eastern Ghouta is last region east of Damascus still held by rebels. Al-Assad’s forces have been trying to force the rebels into submission since 2013 when they installed a blockade around the region which has resulted in severe food and medical shortages for its 400 000 inhabitants.

With the ever-rising death toll, it is evident that the agreement to make Eastern Ghouta a de-escalation zone presented by Russia, Turkey, and Iran last year was not binding. The presence of rebel fighters that were part of al Qaeda’s Syria branch has created a loophole for Russia and Syria to renege on the agreement.

The surge of violence in Eastern Ghouta has made it impossible to send aid to the region, resulting in a full-fledged humanitarian crisis. According to Amnesty International, Eastern Ghouta is currently subject to “flagrant war crimes [on an] epic scale”. The al-Assad regime has been deploying barrel bombs – highly inaccurate weapons that are considered crimes of war by human rights watchdogs. According to the government of Damascus, Assad’s forces only target “terrorists”, which include jihadists and rebel militants. Russia also justifies its involvement under this assumption. However, with the use of such inaccurate weapons and the lack of civilian-evacuation from the area, minimizing civilian casualties is not being prioritized.

Nikki Haley, the U.S. Ambassador to the UN, pushed the Security Council on Wednesday to pass a 30-day ceasefire resolution in Eastern Ghouta, according to Al-Jazeera. This would relieve some pressure, minimizing casualties, and enable humanitarian aid to enter the region. However, the United Nations Security Council only came to a ceasefire resolution on Saturday after multiple delays due to amendments presented by Russia. The Security Council acquiesced to avoid Russia’s veto, but as a result, there is no specific time for the 30-day ceasefire to commence and the resolution does not encapsulate all of Eastern Ghouta.

Since the resolution passed, Syrian government forces have launched yet another ground and air offensive. Syria has committed to following the Security Council resolution but will continue to target individuals deemed terrorists and the areas they control, according to Mohammed Baqri, the head of Iran’s armed forces. Meanwhile, Russia and Iran continue to support the Syrian government forces. Russian planes have even been seen in the air raids.

The German Chancellor Angela Merkel and French President Emmanuel Macron have both pushed Russian President Vladimir Putin “to put ‘maximum’ pressure on the Syrian government to stop fighting in Eastern Ghouta,” according to The Independent. If the United Nations fails to enact yet another ceasefire, its reputation will be on the line as fidelity appears to be almost ceremonial.

The flattening of Eastern Ghouta by Assad’s forces brings al-Assad another step forward towards regaining control over the regions he lost when the rebellion began seven years ago. If the conflict is to stop, Russian-created loopholes in the resolution need to be filled. Otherwise, food and supplies cannot enter the region and a civilian evacuation is impossible, meaning more senseless casualties.