The Syrian regime is on the verge of winning back the city of Homs – known as the capital of the revolution for its role in the three-year-old uprising.

The Syrian army began a large scale military campaign on Monday to retake the last four neighbourhoods in opposition hands. Those inside face a stark choice between surrender to the regime or fighting till death. “Life is disastrous in every meaning of the word,” says one activist inside the Old City.

Following a siege of almost two years, there are less than a thousand people remaining in the area. The majority are fighters, but there are several families and two dozen Christians who refused to leave during a UN orchestrated evacuation in February.

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Mortars, shelling and aerial bombardments currently pound the remaining residents. There is little to stay for; the buildings are burned out carcasses and there is no food or drinking water. “My last meal was 48 hours ago, and it consisted of grass unfit for cattle to eat” said Hasan Abu Zain, an activist. The cattle has long been eaten, as have locusts, pet turtles and cats. Drinking water is found in stagnant old wells or contaminated with sewage. Morale is low, even before renewed offensive people were pondering whether to leave the enclave. Tunnels, previously used to smuggle food, are no longer possible as they have been sealed off. The only way out is to surrender.

Unable to bear it any longer, three hundred people, mostly rebels and draft evaders, left the Old City two weeks ago. Another 50 people surrendered today, according to the governor’s office, who estimate another 5-600 fighters remain. Between 10 and 15 people have been leaving daily, in exchange for relinquishing their weapons according to the governor, Talal al Barazi.

The men turn themselves in at the Al-Andalus school, where they are subsequently held to investigate their involvement in fighting. The school also holds 100 young men who left the besieged old city during the evacuation in February. The United Nations halted that evacuation, in which 1,400 primarily women, elderly and children left the old City, due to concerns about the fate of the arrested men.

Negotiations to peacefully end the situation in Old Homs have failed. “It is a matter of deep regret that negotiations were brutally stopped and violence is now rife again when a comprehensive agreement seemed close at hand,” Lakhdar Brahimi, the joint UN-Arab League Special Envoy said in a statement, calling the city “a theatre of death and destruction”.

There are some who will not leave, no matter what. “It’s impossible for anybody to go out,” insists Abu Jarrah, a fighter who vowed to fight till the end. “If we retreat the regime will slaughter us, and all of the people in Homs know this,” he said. Although he denied reports of fighters wearing suicide belts, he said they would be ready to die. “God willing, we will fight until the last drop of blood and we will be martyrs.” The opposition National Council has warned of a “potential massacre” if government troops enter the rebel-held district.

As the regime consolidates its territory in central Syria in the run up to anticipated elections in June, it is being attacked in other areas of the country. The northern coastal strip near Latakia, the homeland of President Bashar al Assad, has come under attack recently, most notably the Armenian town of Kassab. The city of Aleppo, at a stalemate with rebel areas facing heavy barrel bombardments for months, has also seen a new, coordinated push by rebels on the Western part of the city, held by the regime.