"We are somehow getting used to regular bombings but sometimes you are confronted with a scene that you just cannot cope with."

That is the eyewitness account of the "indescribable, horrifying destruction" wrought by Bashar al-Assad’s forces after a single day of air strikes by AK, a paramedic risking his life to save trapped civilians.

The bombing near Damascus on 23 January killed an estimated 70 people, including children whose bodies were hidden by the dust of entire buildings razed to the ground.

The Syrian President has denied using “indiscriminate weapons” on rebel-held residential areas, claiming his army’s strikes were aimed “at terrorists in order to protect civilians”.

A doctor and two paramedics have spoken to Doctors Without Borders (MSF) of their horror during intense bombing in Ghouta – an opposition-held district east of the capital that was the scene of the catastrophic chemical attack in 2013.

Here are their accounts of the regime’s attack on a crowded market in the town of Hamouriyeh that injured an estimated 147 people on 23 January.

Dr N - director of a hospital supported by MSF in East Ghouta

Around 200 to 250 people were gathered in the public square when it was bombed by a fighter jet. Ambulances were immediately directed to the area to evacuate the wounded. The first batch of wounded arrived few minutes later: 20 bodies and 15 wounded. The triage started right away and priority was given to people with life-threatening wounds.

Those who required urgent surgery were transferred to the operating theatre, while pleural tap, hemorrhage control and bone stabilisation were carried out in the triage zone, on the few beds available or on the ground. Paramedics were running and bringing in more wounded people, so I realised there was a catastrophe going on. It was not the “routine” shelling we have become used to.

The area was hit again as ambulances tried to evacuate the dead and wounded, causing more injuries, including among paramedics. Thankfully, their wounds were not serious. But one ambulance was hit and totally destroyed and a second was damaged. We could hear the explosions and the sound of the fighter jets. I couldn’t stop thinking about the possibility of a raid on the hospital, as this had happened before and we lost two of our colleagues.

Residents carry an injured man, after what activists said were air strikes by regime forces in Douma Assad, in Douma, Ghouta, on 2 February An injured Syrian boy is treated at a makeshift hospital following air strikes by Assad forces in the rebel held area of Douma, Ghouta, on February 6, 2015 Syrian children inspect the rubble of destroyed buildings following air strikes by regime forces in the rebel-held area of Douma, Ghouta, on February 6, 2015. Our medical team had mixed feelings of fear and sorrow, particularly when they started recognising family members and friends among the dead and wounded. The arrival of people looking for relatives created a state of shock and panic in the hospital. We carried on our work, trying to save as many lives as we could...

There were men, women and children among the wounded. Their wounds ranged from minor to critical. The most depressing were the nerve injuries. When the brain is hit by shrapnel there is not much we can do. There are no brain surgeons in the whole area and the means to perform a brain surgery are simply not available. Among the most painful cases for us are the children, when we have to amputate a limb to save their life. Such difficult decisions are a real test for doctors with very limited options.

The final toll was very heavy. We received 128 victims. We managed to save the lives of 60 people, but 68 of our patients died.

Hated: defaced posters of Bashar al-Assad in Aleppo (Getty) A Syrian couple mourning in front of bodies wrapped in shrouds following what a gas attack by pro-government forces in eastern Ghouta in 2013 Young guns: a rebel soldier has no qualms about showing a little boy the best way to hold an AK-47 for a photo opportunity On that single day, we used most of our medical stock attempting to respond to the emergency. We used almost 80 percent of our surgical and medical supplies, as well as using up most of our stock of venous catheters. We are currently struggling to make up for the shortage but it is almost mission impossible in view of the blockades and road blocks. If we are lucky we will get there, but the process will take a long time and require tremendous effort. The same goes for donations. We are hardly able to receive any donations because of the siege. Some hospitals in the region have shared some of their limited stock with us, but there is not really enough to go around. We can hardly imagine how we could cope should a similar emergency occur again.

The world has been watching for years. The medical situation and the general living conditions are beyond any red lines and alarm bells have been ringing in vain for a long time.

AA and AK - two paramedics working in East Ghouta

AA: I was shocked when I arrived. The place was hardly recognisable due to the extent of destruction. Dozens of people, dead and wounded, were scattered all over the place: children, men, women, old people.

AK: A thick cloud of dust covered the place. You could only see a few metres ahead, making it very difficult to locate the victims. The bombs brought entire buildings to the ground, with residents inside. There was indescribable, horrifying destruction. We immediately started evacuating as many victims as we could, driving them to hospitals in the region.

Destruction is seen following a reported barrel-bomb attack by Syrian government forces in the northern city of Aleppo Syrians gather at the site of reported air strikes by government forces in the Halak neighbourhood in northeastern Aleppo Men help a wounded girl who survived what activists say was an airstrike by forces loyal to President Bashar al-Assad in Douma AA: Immediately after the first trip, we rushed back to the raid area to evacuate more victims. There was a second raid. Bombs fell from everywhere. An ambulance was hit and I was wounded on the head, but my injury was superficial.

AK: I was also hit in the arm. Thankfully my injury was also superficial. It is not uncommon for there to be a second wave of bombing . As paramedics, every time we are dispatched to evacuate victims, we never discount the possibility that we could become one of the statistics. We had already been bombed before while evacuating wounded people. One of my colleagues was seriously injured in that bombing. He lost an arm. He is still alive but he can’t work anymore.

AA: We were feeling scared and anxious but started rescuing victims and evacuating the wounded. . The rescue operations are made harder by technical obstacles and lack of resources. Fuel is scarce and we have no personal protection gear, such as helmets. Our work is almost an impossible mission. Our attempts to respond to these needs fail most of the time.

Destroyed buildings in the Harasta area near Damascus Residents running from what activists say was shelling by forces loyal to President Assad in Raqqa, north-east Syria, where Isis fighters are closing in on a nearby army base Smoke rises as Free Syrian Army fighters react after firing a weapon towards forces loyal to Syria's President Bashar al-Assad, in the southern part of Maarat Al-Nouman, Idlib AK: Exactly. Our ambulances are just regular vehicles which have been transformed to fit two wounded people in the rear part of the cabin. On that Friday, we had to evacuate eight or nine people in each journey. There were other difficulties too - the vehicles are not equipped to be driven in devastated areas and the tyres frequently get punctured by the debris, making the operation harder and forcing crews to stop and change tyres.

We are somehow getting used to regular bombings but sometimes you are confronted with a scene that you just cannot cope with. I can never forget those tiny body parts that probably belonged to a little boy who was once full of life. This is of the sort of thing we see almost every day. We forget some images but others refuse to fade away.

What we are seeing here and what is happening is a tragedy. The risks we take are scary. We knew from day one that anything was possible as far as our destiny was concerned. We made up our mind and accepted the job as a humanitarian mission, with the knowledge that if we stopped doing what we are doing, the humanitarian situation would get worse. We don’t know what’s in store for us but we know that our lives are at stake, today more than ever. We try to be as cautious as possible but in reality we share the same general danger as everyone living here under the bombs. Our fate is dictated by the siege we are living under, but it only makes us more determined to do our job, hoping that we can help alleviate this ordeal.

People stand on the rubble of collapsed buildings at a site hit by what activists said was a barrel bomb dropped by forces loyal to Assad, in the Al-Fardous neighbourhood of Aleppo

Men try to put out a fire at a site hit by what activists said was an airstrike by forces loyal to Assad, in Idlib (Reuters)

Assad speaks to the BBC

The government’s official news agency, Sana, reported that Assad’s forces had carried out operations against “terrorists” on the day.

Dr Bart Janssens, Director of Operations for MSF, said the situation in Damascus had deteriorated “dramatically” in the past month.

“The number of patients treated in the hospitals we support has gone beyond breaking point, and the number of requests for medical supplies has shot up,” he added.

“The massive bombardment on 5 February, and the extremely deadly bombing in a crowded market on Friday 23 January are particularly horrific, and have chilled us to the core.

“But these incidents are in no way unique - they are part of an ongoing pattern of unimaginable violence.”