Pro-government forces are closest they have ever been to seizing entire city as rebels beg for five day ceasefire to allow civilians to leave

Forces loyal to the Syrian regime have ousted rebel groups from Aleppo’s Old City as an increasingly battered opposition pleaded for a five day ceasefire to allow remaining civilians to be evacuated.

The advances were the most significant of the past week and edged the fighting in Syria’s second city towards a final showdown in neighbourhoods where it all began for the besieged rebel groups four and a half years ago. Bashar al-Assad’s forces, backed heavily by militias that have been instrumental in shifting his fortunes in the war, are now the closest they have ever been to seizing the entirety of east Aleppo – a city central to the fate of the war.



The battlefield advances came as the US, Britain, France, Italy and Canada released a statement condemning both Russia and Syria for the “humanitarian disaster taking place before our very eyes” in Aleppo. There was no immediate response from either country, both of whom had rebuffed earlier demands for a ceasefire while vowing to crush the remaining opposition and claiming that any lull would allow rebels to regroup.



The Old City had remained a centre of gravity for the opposition since its fighters, a combination of Aleppo locals and residents of the surrounding countryside, overran security forces in July 2012. Its proximity to Syrian army positions and the ancient Citadel that stands at its heart had made it less of a target for Russian and Syrian jets that have bombed much of the rest of east Aleppo into ruins in preparation for the ground offensive.



The advance, which has been led by Iraqi groups and Hezbollah from Lebanon, both backed by Iran, has laid waste to much of the Old City’s approaches and cut off opposition routes to elsewhere in the east, which has seen fierce fighting this week. Up to 75% of east Aleppo is now under the control of loyalist forces, who say they could claim the rest of the city within one week.



The conquered areas are a crumbling mess of largely uninhabitable neighbourhoods of 4-6 storey apartment blocks, which have collapsed on to the roads beneath them. The damage is worst at the eastern edges of the city, from where the ground offensive was launched. Towards the centre, where the Old City and Citadel stand, destruction is less obvious, but even there, shops and homes have crumpled in the face of concussion waves from enormous explosions, as well as direct hits.



The battle for eastern Aleppo in maps: how rebel territory is shrinking Read more

As their fortunes diminished, opposition leaders again refused regime demands that they abandon Aleppo, insisting that they remain as guarantors of the safety of civilians who have stayed behind. Rebel fighters have bunkered down in the hull of what was once Syria’s industrial heartland, forming underground basements in husks of apartment blocks, and running the war by the light of car batteries.



“What Aleppo has witnessed in the past five months is nothing short of a war of extermination against its civilian population,” the opposition leadership said in a statement. “Hundreds of innocent young men have been detained and their future is uncertain. Women, who have been hardest hit by the realities of the siege, have been raped in despicable acts of revenge.



“Civilians should either be protected, or evacuated to a safe area, where they will not be under the mercy of Assad and his henchmen.”



Some rebel factions acknowledged that they were considering abandoning the city, which was at the time of its seizure meant to have been an epicentre of the push to oust Assad as leader. How to flee, if such a decision is made, remains a dilemma, with no roads open to the north or south, and the east remaining a stronghold of the forces that are attacking them. Humanitarian corridors, except two into west Aleppo, have been killing zones for the past three months, rebel groups say.



The rebellion, which started as a revolt against the four-decade rule of the Assad family, spawned by popular uprisings across the Arab world, has waned elsewhere in Syria, leading to increasing calls for a managed political settlement.



Civilians were being steadily bussed to regime-held west Aleppo on Wednesday, with hundreds more displaced by fighting that has already driven thousands out of their homes in recent weeks. More than 30,000 people are reported to have crossed the frontline that has separated both sides, with more than 500 military-aged men taken by Syrian troops from conquered neighbourhoods, or at checkpoints. Unicef estimated that 51% of the recent refugees were children.

Aid groups also backed ceasefire calls. The International Rescue Committee said: “Medical evacuations would be a lifeline for the 400 gravely ill and seriously injured people in urgent need of treatment. The UN must be allowed to oversee a ceasefire that also guarantees the first food and medicine deliveries to enter east Aleppo since it was besieged in July, as well as fresh staff to relieve the small number of doctors and nurses providing medical care of a quarter of million people. There must not be any military preconditions attached.”

East Aleppo’s few remaining physicians said they can no longer treat patients. A blitz by Russia and the Assad regime has destroyed all of east Aleppo’s hospitals over the last two months, when systematic attacks on the city’s healthcare system intensified.



The latest offensive seized the M10 hospital in the Sakhour neighbourhood of the east, which had been heavily damaged by airstrikes. Staff had managed to use some rooms for basic treatment in between attacks, but have not been able to perform complex surgeries for much of the past month.



“We are completely paralysed and cannot treat anyone,” said one doctor. “We are suffering what we have to suffer under this vicious campaign and this extermination and invasion. The civilians are worried and horrified, everyday people are getting displaced from one street to the next.”



Aleppo’s unrelenting misery has exposed the powerlessness of the international community to stop the suffering and Monday’s statement marked a rare attempt by global leaders to collectively shift debate about the conflict outside of the UN Security Council, where permanent members Russia and China have blocked measures aimed at Assad over the past five years.





