This time last year, the world looked on as Syrian President Bashar al-Assad launched the final assault on opposition-held east Aleppo.
Operation Dawn of Victory dropped banned munitions such as cluster bombs, “bunker busters” and chlorine on neighbourhoods which were already starving and broken thanks to a months-long siege. More than 600 civilians died in the five-week-long offensive.
After four years of struggle against the government, the last rebel-held urban centre in Syria surrendered.
Now, east Ghouta, a rebel enclave of some 400,000 people in the suburbs of Damascus, faces the same fate.
The area is supposedly covered by a de-escalation zone deal brokered by Turkey, Iran and Russia earlier this year – but monitors and rebels say fighting has continued on many fronts.
In east Ghouta over the last two weeks there have been almost non-stop air strikes and shelling by government forces.
By some estimates there have been 181 separate attacks; including one unverified chlorine incident. Casualty figures are hard to verify, but accounts from local activists tally in the dozens.
Haunting pictures of 35-day-old baby Samar Dofdaa, who died from malnutrition last month, briefly sparked international outrage. But louder cries for the bombardment to stop and the unhindered flow of aid have already subsided.
In the interim, residents suffer in silence – and the situation is getting worse.
“Imagine yourself starving for many months. Imagine your diet was just grass or trash,” said Dr Kassem Eid, who managed to escape east Ghouta for the US in 2015.
“The whole world should be screaming about this, saying we cannot use starvation as a weapon of war.”
Ghouta has witnessed some of the worst brutality in Syria’s six-year civil war, including the 2013 sarin gas attack, which is one of the worst chemical incidents in modern history.
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