Fifteen of the last 35 doctors in rebel-held eastern Aleppo have written a letter to Barack Obama with an urgent plea for intervention to stop the bombardment of hospitals in the besieged city by the Russian-backed Syrian air force.

“We do not need tears or sympathy or even prayers: we desperately need a zone free from bombing over eastern Aleppo to stop the attacks, and international action to ensure Aleppo is never besieged again,” the doctors wrote.

Their letter came as the Russians said they would suspend aerial action over Aleppo for three hours a day – starting on Thursday from 10am and 1pm (7am to 10am GMT) – and the UK circulated plans at the UN in New York for a ceasefire in which humanitarian relief was implemented by impartial actors, rather than the Syrian and Russian military.

There has been little respite from the fighting despite the Russian announcement, with battles ongoing in the city and its surroundings. The Syrian government acknowledged that it had launched a counter-offensive “in cooperation with its allies” against the rebels who broke the siege of opposition-controlled eastern Aleppo, and did not indicate there would be a halt for humanitarian reasons.

“It’s a lie,” said Osama Aboul Ezz, a doctor in the city. “During the time of the ceasefire there were air raids in the city and there are a lot of wounded in Aleppo today, and other doctors have told us that they received wounded during the time the Russians declared the ceasefire.”

Some factions of the Free Syrian Army who took part in the operation to break the siege had said that they were ready to negotiate with the UN to allow humanitarian convoys in to both western and eastern Aleppo. The western, government-controlled side has been cut off since the weekend after the rebels seized Ramouseh, a key artery into the area, which houses 1.5 million civilians. The regime imposed a siege last month on the eastern side, which has a quarter of a million civilians, and few supplies have made it across amidst the fighting.

The latest violence came on the heels of yet another suspected chlorine attack, this time on the rebel-held Zubdiya district in the city, which killed three people and left others suffering respiratory injuries, according to local medics. Just last week local doctors in the neighbouring province of Idlib said they had treated more than two dozen patients in a suspected chlorine attack on the town of Saraqeb.

Facebook Twitter Pinterest A man breathes through an oxygen mask after a hospital and a civil defence group said suspected chlorine was dropped on Aleppo, Syria. Photograph: Abdalrhman Ismail/Reuters

The UN’s Syria envoy, Staffan de Mistura, said that reports of a gas, believed to be chlorine, being dropped on Aleppo are being investigated. “There is a lot of evidence that it actually did take place,” he told reporters, adding that if confirmed the attack would amount to a war crime.

He also said the UN was attempting to find a “workable” solution to deliver humanitarian aid with Moscow to Aleppo’s struggling civilians.

Few observers believe the three-hour windows proposed by Russia on Wednesday are sufficient to deliver useful quantities of supplies.

Aleppo 'hell' prevents Syria peace talks, say diplomats Read more

The UN humanitarian chief, Stephen O’Brien, said he was willing to consider the Russian plan, but added that getting sufficient aid into Aleppo would require a 48-hour pause in the fighting and an open single-carriageway road.

“When we’re offered three hours, then you have to ask: what could be achieved in those three hours?” he said. “Is it to meet the need or will it only just meet a very small part of the need?

Islam Alloush, a spokesman for Jaysh al-Islam, one of the most powerful rebel groups in Syria and a key faction in the Aleppo offensive, said the proposal was a propaganda ploy but that the group would cooperate with any plan to deliver humanitarian aid to Aleppo.

“We welcome anything that would preserve the blood of the Syrian people and reduce their suffering,” Alloush said. “But the reality is that this announcement is for media consumption and has not been implemented on the ground, and the regime and its allies continue to wreak destruction on Syrians during the allotted time window and outside it.”



The US ambassador to the UN, Samantha Power, has made repeated pleas for 48-hour ceasefires to allow aid into the bombarded city, and for some of the most seriously injured to be removed. A meeting of the UN security council on Tuesday failed to produce an immediate agreement on a ceasefire.

The joint letter written by the doctors urged the US president “to act now to stop the bombs that continue to fall on the city and ensure they are never held under siege again”.

It has been claimed that one medical facility is being attacked every 17 hours, and doctors are being forced to make appalling decisions to let children die due to a shortage of blood, medical supplies and more complex scanners.

Some doctors refused to sign the letter because they had no wish to make any more appeals to the west.

Facebook Twitter Pinterest Sandbags protect the entrance of a children’s hospital in Aleppo. Photograph: Abdalrhman Ismail / Reuters/Reuters

There seems little doubt in the minds of western diplomats that the Syrian forces have decided to target the remaining medical facilities in the eastern part of the city in an attempt to terrorise the remaining 250,000-300,000 citizens into submission, starvation or exodus. The six facilities hit in and around Aleppo included a paediatric clinic inside the city where four infants died after their oxygen supply was cut.

It has not been possible to verify the names of all the doctors listed in the letter, but their account tallies with evidence given by US doctors to the UN after a working visit to Aleppo’s hospitals in the past fortnight.

Aleppo is a such a prize for both sides that its suffering just goes on Read more

Aleppo is the second-largest city in Syria and has a symbolic importance to the revolution; its fall would confirm the extent to which the president, Bashar al-Assad, had gained the military upper hand thanks to Russian air support.

In their letter, the Syrian doctors write: “For five years, we have faced death from above on a daily basis. But we now face death from all around. For five years, we have borne witness as countless patients, friends and colleagues suffered violent, tormented deaths. For five years, the world has stood by and remarked how ‘complicated’ Syria is, while doing little to protect us. Recent offers of evacuation from the regime and Russia have sounded like thinly veiled threats to residents – flee now or face what fate?

“Last month, there were 42 attacks on medical facilities in Syria, 15 of which were hospitals in which we work. Right now, there is an attack on a medical facility every 17 hours. At this rate, our medical services in Aleppo could be completely destroyed in a month, leaving 300,000 people to die.

“What pains us most, as doctors, is choosing who will live and who will die. Young children are sometimes brought into our emergency rooms so badly injured that we have to prioritise those with better chances, or simply don’t have the equipment to help them. Two weeks ago, four newborn babies gasping for air suffocated to death after a blast cut the oxygen supply to their incubators. Gasping for air, their lives ended before they had really begun.”

They warn Obama that “unless a permanent lifeline to Aleppo is opened, it will be only a matter of time until we are again surrounded by regime troops, hunger takes hold and hospitals’ supplies run completely dry.

“We do not need to tell you that the systematic targeting of hospitals by Syrian regime and Russian warplanes is a war crime. We do not need to tell you that they are committing atrocities in Aleppo,” the letter states.

The UK has circulated a draft UN resolution on the Aleppo crisis making it clear that any humanitarian solution cannot be run by the Russians or Syrians alone, but must instead be led by impartial humanitarian actors.

The draft resolution states: “Any proposed humanitarian initiatives for civilians to escape the fighting must be guaranteed by all sides and independently implemented and monitored, and all civilians should be guaranteed voluntary, free movement, including the right to choose their route and destination, if they choose to leave. Humanitarian aid must be delivered to the population wherever they may be, irrespective of whether they chose to leave or remain in Aleppo.”



The former Liberal Democrat leader Lord Ashdown urged UK ministers to end their summer silence and speak out against the carnage in Syria.

He said: “The UK must act quickly and decisively to establish humanitarian access to Aleppo, and if necessary provide RAF plans to aid in air drops to the desperate, besieged citizens.”