Abdulmonam Eassa, AFP | Syrian civilians flee from reported regime air strikes in the rebel-held town of Jisreen, in the besieged Eastern Ghouta region on the outskirts of the capital Damascus, on February 8, 2018.

French President Emmanuel Macron urged Russian President Vladimir Putin to do more to protect civilians in a phone call on Friday as aid groups said air strikes had killed more than 220 civilians in just four days.

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Macron urged Putin to help ease the civilian suffering brought on by the Syrian government's recent onslaught on rebel positions, the Élysée Palace said.

The French leader "asked Vladimir Putin to do everything so that the Syrian regime puts an end to the unbearable deterioration in the humanitarian situation in Eastern Ghouta and Idlib" to the east of the capital Damascus, the statement said.

Macron is concerned by signs that chlorine gas may have been used multiple times against Syrian civilians in recent weeks and expressed those concerns in the phone call with Putin. The French president has said France is determined to hold anyone who uses chemical weapons accountable.

The intensity of the recent Syrian regime air strikes, which have killed more than 220 civilians, has made it extremely difficult for relief workers to assist the estimated 400,000 people who are under siege in the rebel enclave of Eastern Ghouta, the CARE International aid group said.

"Our partners are having a hard time moving around, so how can they reach vulnerable people?" asked the group's communications director for Syria, Joelle Bassoul.

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A CARE-supported community centre in the town of Douma was among the buildings hit, forcing those using it into underground shelters.

Moscow: Aid truce 'not realistic'

More than 4,000 families in Eastern Ghouta are living in basements and bunkers, according to the humanitarian NGO Save the Children.

The enclave is supposed to be one of four "de-escalation zones" declared last year in a bid to reduce the bloodshed.

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UN aid officials had appealed for a month-long humanitarian truce to allow supplies to be delivered and to let the sick and wounded be evacuated for treatment.

But the UN Security Council on Thursday failed to back the proposal, which Syrian ally Moscow described as "not realistic".

Bassoul warned that without such a truce the consequences for civilians would be disastrous.

"If there is no ceasefire, if this is all left unheard, we cannot imagine the scale of the humanitarian disaster," she said.

(FRANCE 24 with AFP, AP and REUTERS)

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