An army ground offensive on four different fronts has begun on rebel-held areas of the besieged city of Aleppo.

The attack comes after five days of intense air strikes on east Aleppo, including the reported use of bunker-buster ground-penetrating bombs and incendiary devices, which have destroyed civilian infrastructure including a water station and emergency response centres. Activists on the ground say more than 400 people have died.

Nato said on Tuesday that the Russian-backed attacks on Aleppo are in “blatant violation of international law”. There are now fears that the approximately 250,000 people inside besieged rebel areas could be facing an all-out assault from the air and the ground. An “atrocity that would resonate in history," as one diplomat warned.

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Ammar al-Selmo of the White Helmets civil defence rescue service told The Independent that Tuesday had dawned quietly before strikes begin in earnest again at 3.30pm, approximately the same time ground troops began making their advance. Mr Al-Selmo said he had seen 14 dead in two strikes so far, before the phone line cut out.

The Syrian army and allied Iraqi, Iranian and Lebanese militias attacked four of the city’s major access points at the same time on Tuesday.

Rebels said the government troops were held off, but Syrian state media reported that the army captured several buildings near Aleppo's citadel in the historic Old Quarter, and successfully retook the rebel neighbourhood of Farafra. The UK-based Syrian Observatory for Human Rights confirmed that Syrian army troops had entered the Old Quarter.

The leader of a Syrian government-allied elite Iraqi militia said his soldiers were moving tanks and armoured vehicles in preparation for an assault on the opposition-held east of the city, Reuters reported.

A military official speaking on condition of anonymity told the AP that the offensive will continue daily on all fronts until “terrorists” in east Aleppo are “wiped out”.

Aleppo bears the brunt in another day of carnage and defiance

Aleppo bears the brunt in another day of carnage and defiance







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Damaged police vehicles and equipment lie scattered after one of the bombings that targeted security compounds in Aleppo

EPA

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A masked Syrian rebel

AP

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Syrian rebel at a demonstration in Idlib

AP

Leaflets dropped on the city in the past day sought to assure trapped residents “there are no boundaries between us, break fears within you and come back to your normal life,” urging them to flee to government-held parts of the city. However, several reports say that those who tried to approach the siege barricades were shot at by snipers. There are no reports of any east Aleppo civilians crossing over into western districts.

Another leaflet warns rebel fighters to surrender or die, showing portraits of leaders recently killed in clashes struck through with red crosses.

The Syrian government announced last week following the collapse of a US-Russian brokered ceasefire that it intends to retake Aleppo – the last major rebel stronghold – for good.

The UN’s envoy to Syria Staffan de Mistura warned that the battle could be a “grinding, street-by-street fight, over the course of months if not years”.

Government forces briefly captured Handarat from rebels on Saturday, but lost it in a counter-attack the same day. Minor clashes in several outskirts in recent days have so far been repelled by the opposition.

There are only 35 doctors left to tend the wounded in Aleppo (AFP/Getty Images)

East Aleppo’s supply lines were completely shut off by goverment forces in July, leaving residents inside living under siege conditions. There are only 35 doctors left in the district caring for hundreds of wounded, the World Health Organisation (WHO) said on Tuesday. A White Helmets representative told The Independent he estimated 2,000 people were in need of urgent medical assistance.

“WHO is calling for the immediate establishment of humanitarian routes to evacuate sick and wounded from the eastern part of the city,” spokesperson Fadela Chaib said from Geneva.

The Syrian regime has not attempted to retake Aleppo’s rebel neighbourhoods by means of a ground offensive since 2012.