As Russia announced daily three-hour halts to military action for delivery of aid to the northern Syrian city of Aleppo, there was little relief in sight for its besieged civilians.

Fighting between rebels and Russian-backed Syrian forces reportedly continued in parts of the city, and Amnesty International protested a suspected chlorine attack it said had killed at least four people and left some 60 others seeking medical care.

Meanwhile, the UN, as well as aid workers and people on the ground, said the proposed pauses in attacks would do little or nothing to help civilians survive one of the worst continuous assaults of the war.

UN humanitarian co-ordinator Stephen O’Brien told reporters that the Russian plan fell far short of what was needed to restore water networks, food, fuel and medical aid.

Urgently needed items could be delivered “within 24-48 hours if we have safe access,” he said, adding that there must be a fully fledged ceasefire or, “at minimum,” 48-hour humanitarian pauses.”

The Russian announcement appears more strategic than humanitarian, said Mark Katz, a Russia expert at George Mason University in Washington.

“There are civilians who just want to get out,” he said. “But it could be used to split and weaken the opposition, so they will leave.”

Anyone who does leave would be under surveillance and the regime of Russia’s ally Bashar Assad “will want to find out everything they know about those who are still there. They’ll be attacked whether they stay or go,” Katz said.

In July, Syrian forces backed by Russian warplanes, cut off eastern Aleppo, which was held by rebel militias for four years. At least 250,000 people lost access to basic supplies, and air attacks devastated homes and medical facilities.

Although Syrian forces are accused of causing most of the 470,000 casualties of the war, Russia’s intervention turned the tide in Assad’s favour, and escalated attacks on civilians as well as rebels.

“Russia has created this humanitarian catastrophe not only in Aleppo but across Syria,” says Reza Afshar, a policy director for the advisory group Independent Diplomat, and adviser to the Syrian opposition coalition.

“The humanitarian corridors they suggested are, in the view of many Syrians, a cynical way (to) get rid of some people from Aleppo and justify the wholesale annihilation of anyone left, because if they stay they’re a terrorist.”

Afshar, the former head of Britain’s Foreign Office team on Syria, said that “Russia is in a strategic power play. It’s all about snubbing the West.”

Russia is also demonstrating that the U.S. and other Western countries need to co-operate with Moscow to end the war, says Katz. “You have European and western governments who see the continuation of the conflict resulting in more refugees who are heading for them.”

For the people trapped in Aleppo, a city of about two million under split rebel and government control, every day brings more suffering and bigger challenges.

“The east of the city has been completely cut off, so very few supplies are able to get in,” says Middle East media manager Alun McDonald of Save the Children.

“Food and water supplies are running dangerously low. Most people now have no access to running water and many of the markets are empty. Fuel, which is needed to keep water pumps and hospital generators operating, is also increasingly scarce.”

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Temperatures in the Middle East are soaring to record highs, and people are sick and dying from heat, lack of clean water and electricity, and disease. Those in Aleppo are under the added danger of daily bombing.

“Local doctors are doing incredibly brave work to keep going, often having to do operations in basements to try to avoid bombing,” McDonald said in an email. “Sometimes they run out of tables and have to operate on people on the floor.”

Washington could use its political will to end the misery, says Afshar. Peace efforts fell through when Assad, backed by Russia and the Iranian-supported Hezbollah militia helped him retake territory.

“The first principle should be to reduce civilian deaths,” Afshar said. “That doesn’t mean putting planes in the sky and confronting Russian jets.”

The U.S. knows where Syrian military targets are, he added, and could hit them by firing from warships in the Mediterranean without risking a wider war.

“The Russians would have to ask ‘Do we really want to risk the Syrian government being wiped out, or get to the negotiating table?’ ”

Washington has been reluctant to take that option, in the waning days of the Obama administration.

With little chance of relief from Russia’s announced ceasefires, Aleppo’s outlook is grim.

“We do not need tears or sympathy or even prayers,” wrote 15 doctors in eastern Aleppo in a letter to U.S. President Barack Obama, published in the Guardian.

“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.”

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