Instead of bringing calm to the besieged Yemeni city, calls for a ceasefire in Hodeidah have brought some of the worst violence the vital port has yet faced in the three-year war.

Baseem al-Janani, who lives in the city, said: “The clashes are absolutely crazy right now. I have a headache from the shelling and bombing in the east. People are trapped in their houses for hours at a time because of shrapnel and gunfire. But their houses are not safe either.”

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In the past few days, more than 100 airstrikes have hit civilian neighbourhoods – five times as many as in the whole of the first week of October, according to Save the Children staff in Hodeidah. One of their malnutrition clinics was attacked on Wednesday.

Pro-government militias are trying to seize as much ground as possible before fighting is supposed to stop at the end of November, when it is hoped UN-sponsored peace talks will restart in Sweden. Saudi Arabia and United Arab Emirates coalition-backed troops are inching closer to the city’s Houthi rebel-held centre from their current stalemate positions in the southern suburbs and at the airport in a three-pronged attack. On Wednesday, an Emirati-trained group known as the Giants, with the help of Apache attack helicopters, secured a key road leading to Hodeidah’s port.

The Houthis, too, have stepped up operations, resorting to burning tyres to obscure gunships’ view of the city and laying an estimated hundreds of thousands of landmines in anticipation of the coalition attack, codenamed Operation Golden Victory. On Tuesday, fighters raided the city’s May 22 hospital – named for Yemen’s national day – and set up sniper positions on the building’s roof, Janani said.

“We don’t have enough hospitals anyway. The patients and staff are now terrified they will be an airstrike target,” he said.

Hodeidah is Yemen’s lifeline. Before the war broke out in 2015, it handled most imports in a country where 90% of food had to be imported.

The port has been blockaded by the Saudi-led coalition for the past three years, a decision aid organisations say has been the main contributing factor to the famine that threatens to engulf half of Yemen’s 28 million population.

Since a fresh offensive on Hodeidah began in June, civilian deaths have risen by 164%, according to a report by the armed conflict location and event data project (Acled), and at least 50,000 people have been displaced. Many who would flee are trapped by Houthi roadblocks.

The coalition hopes retaking the city will clear a path to drive the Houthis out of the capital, Sana’a, and end the war. But a full-scale attack has been delayed several times, as the UN and aid agencies warn fighting that damages the port’s facilities could cause catastrophic suffering across the country.

Bhanu Bhatnagar, a spokesperson for Save the Children, said: “The hunger crisis in Yemen shows no sign of fading as long as the fighting persists.

“Even those children who are on the road to recovery are falling back into life-threatening, extreme hunger because the heavy bombardment prevents them from reaching clinics to seek help, or because their families become displaced due to the fighting.”

In the event of a full-scale attack, the rebels are expected to withdraw to the highlands surrounding the city, but have promised to deliver “hell on hell” to the coalition first.

Hisham al-Omeisy, a Yemen analyst, said: “We always thought Hodeidah was a red line. The international community was always opposed to an operation there. But the coalition is showing it is willing to cross it, and that must scare the Houthis.”

Yemen has largely avoided urban warfare to date. But the city’s 600,000 residents – of which Unicef says about half are children, a group particularly susceptible to the country’s cholera and malnutrition crises – have long feared a gruelling street-by-street offensive to retake the city.

“We have a saying in Yemen,” Omeisy said. “‘When you’re sacrificing a lamb, don’t drag the knife slowly across its neck.’ If it must be sacrificed, make it quick.”

The Houthis have proved hard to bring to the negotiating table, despite recent progress made by the UN’s special envoy, Martin Griffiths.

A proposal this summer to put the port under UN jurisdiction was reportedly rejected by the Houthi leadership, who feared giving up control of one of their most important assets.

Facebook Twitter Pinterest Yemeni government forces patrol as smoke billows from an alleged Houthi position. Photograph: Najeeb Almahboobi/EPA

The talks have been given a new lease of life in the aftermath of the killing of the journalist Jamal Khashoggi after he visited the Saudi Arabian consulate in Istanbul, which has led to almost universal opprobrium and a diplomatic crisis for Riyadh.

A Yemeni aid worker, who asked not to be named, said: “It seems there is a new push to end the war now from the coalition. The Saudis want to cover up their other crime.”

Riyadh’s allies in Washington have also signalled that hostilities in Yemen must be brought to a close – a marked change in tone from a few months ago, when the Trump administration all but gave the green light for an offensive on Hodeidah.

Dr Elisabeth Kendall of Oxford University said: “There is a reasonable chance that [December peace talks] in Sweden will materialise.

“Most of the ingredients required are in place. The international community, including the US and UK, is now even more stridently behind pushing for talks to happen, recognises that this may need unpalatable concessions from both sides, and acknowledges that the conflict will not be solved militarily.”

In the interim, though, the ferocious fighting in Hodeidah continues. Janani said: “Many people here are too poor to escape, fuel is too expensive. We are stuck, always waiting, always afraid.”