AMMAN (Reuters) - As Syria’s government presses a fierce assault on eastern Aleppo, its siege is making life ever harder for civilians who are being forced to sift through garbage for food and scavenge firewood from bombed-out buildings.

A general view shows the damage at a site hit by airstrikes in the rebel-held besieged al-Qaterji neighbourhood of Aleppo, Syria November 23, 2016. REUTERS/Abdalrhman Ismail

With winter setting in, shortages of food, medicine and fuel coupled with intense air strikes and artillery bombardment are testing the limits of endurance among a population the United Nations estimates at 270,000 people.

“People are worn out ... there are people today in Aleppo who are eating out of the trash,” said Mustafa Hamami, who lost two of his children and four other relatives when a six-storey apartment building was destroyed this week.

With government forces mounting their most concerted effort yet to capture the rebel-held east, these are the darkest days for the opposition in Aleppo since the beginning of the uprising against President Bashar al-Assad in 2011.

Backed by Russian air support, the Syrian army and allied Shi’ite militia from Iran, Lebanon and Iraq have gradually blockaded the rebel-held east of the city this year, first cutting the northern lifeline to Turkey and then fully encircling it from the west and south.

Pro-government forces identified as Shi’ite militias by the rebels have in recent days launched a ground attack aiming to split the rebel-controlled territory by seizing areas including Hanano, where fierce battles were underway on Friday.

The fall of eastern Aleppo would be the biggest victory to date for Assad, crushing the rebellion in its most important urban stronghold. Fierce bombardment and air strikes of the area has killed hundreds of people since late September.

BABY FED BOILED RICE

A pack of four bread loaves now costs the equivalent of about $3 - at least five times higher than it was before the siege began in July. The city council offers limited quantities at a subsidized price. A kilo of meat costs $50, a kilo of sugar costs $18, both also several times higher than before the siege.

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Rice, which is more readily available and has not risen as much, costs $3 a kilo.

“My wife is using boiled rice to feed our 11-month old baby. We can barely get one bottle of powdered milk a month,” said Abdullah Hanbali, who worked as an engineer before the war.

“People are not accustomed to just eating bread and a bit of rice. They are used to eating apples, cucumbers, lemons, butter, meat,” he said, speaking to Reuters from eastern Aleppo via the internet. “The weather is cold. You need nutrition.”

Residents say once-bustling markets are now devoid of shoppers. The few stalls with food to sell offer legumes, radishes, parsley, and other crops grown within the confines of the besieged area.

The United Nations says the last U.N. rations in Aleppo were distributed on Nov. 13. U.N. humanitarian adviser Jan Egeland said on Thursday rebel groups had agreed to a plan for aid delivery and medical evacuations, but the United Nations was awaiting approval from Russia and Damascus.

Asked about any “Plan B”, he replied: “In many ways Plan B is that people starve”. He said that could not be allowed to happen.

The government has besieged numerous rebel-held areas of Syria throughout the war that has killed hundreds of thousands of people, and the country has become partitioned into a patchwork of zones controlled by various combatants.

A number of the besieged areas near Damascus have succumbed to the government pressure in recent months, with rebels leaving to the northeastern province of Idlib in negotiated agreements with the government.

The desperation in eastern Aleppo has started to surface.

A brawl erupted last week outside the warehouse of a foreign charity that had been forced to suspend its distribution of food aid parcels as its supplies dried up. Two charity workers said people waiting for food had forced it to hand over all the remaining stock.

NO WORK, INCOME

“None of the charities and NGOs have food parcels to distribute to needy people, and hunger is starting to appear in some families,” said Mohamad Aref Sharifa, a councilor in the opposition-run city council.

“There is dissatisfaction among some civilians, especially in the poorest areas, because there is no work or income and prices are high,” Sharifa added.

The government appears to be hoping that desperation will turn into unrest. The army has called on residents to rise up against rebels it has accused of hoarding food and using civilians as human shields.

But with many residents of eastern Aleppo sympathetic to the opposition and deeply distrustful of Assad, there has been no sign of major unrest targeted at rebel fighters. Many families have relatives fighting with the rebellion.

The commander of one of the biggest rebel groups in eastern Aleppo, the Jabha al-Shamiya, told Reuters this week they planned to set up kitchens in poor neighborhoods to provide residents with at least one meal a day.

“We are also moving toward opening projects to produce methane gas,” added the commander, Abu Abdelrahman Nour.

(This story has been refiled to add dropped word in first paragraph)