The United Nations has expressed its outrage at the escalating violence in Syria’s East Ghouta by releasing a blank statement - because "no words will do justice to the children killed, their mothers, their fathers and their loved ones".

The symbolic message from Unicef’s regional director Geert Cappalaere on Tuesday contained ten empty lines with quotation marks to indicate the missing text before finishing with a footnote.

“We no longer have the words to describe children’s suffering and our outrage," it said.

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"Do those inflicting the suffering still have words to justify their barbaric acts?"

More than 100 civilians have been killed and five hospitals damaged in air strikes in the last 24 hours in the rebel-held Damascus suburb after unprecedentedly ferocious bombing, rocket attacks and shelling by the Syrian government and its Russian allies.

Photos and video sent to The Independent by locals show shell-shocked children and scores of bodies either covered in rubble dust or wrapped in bloodied sheets.

Eastern Ghouta bombings: Syrian war in pictures Show all 14 1 /14 Eastern Ghouta bombings: Syrian war in pictures Eastern Ghouta bombings: Syrian war in pictures A Syrian woman and children run for cover amid the rubble of buildings. AFP/Getty Eastern Ghouta bombings: Syrian war in pictures Smoke rises from buildings following the attack on the village of Mesraba in the rebel-held besieged Eastern Ghouta region on the outskirts of the capital Damascu. AFP/Getty Eastern Ghouta bombings: Syrian war in pictures Injured children receive medical treatment. EPA Eastern Ghouta bombings: Syrian war in pictures A Syrian man carries a child injured. AFP/Getty Eastern Ghouta bombings: Syrian war in pictures An injured child receives treatment following bombings on several areas of eastern Ghouta. EPA Eastern Ghouta bombings: Syrian war in pictures A child reacts inside a hospital after relatives were injured in the bombing. EPA Eastern Ghouta bombings: Syrian war in pictures Syrian children cry at a make-shift hospital in Douma following air strikes on the Syrian village of Mesraba. AFP/Getty Eastern Ghouta bombings: Syrian war in pictures Syrian Civil Defense group extinguishing a store during airstrikes and shelling by Syrian government forces. AP Eastern Ghouta bombings: Syrian war in pictures A wounded 12-year-old Syrian boy, cries as he receives treatment at a make-shift hospital. AFP/Getty Eastern Ghouta bombings: Syrian war in pictures Syrians carry a wounded man. AFP/Getty Eastern Ghouta bombings: Syrian war in pictures An injured man covered with blood at a medical point. Reuters Eastern Ghouta bombings: Syrian war in pictures People sit a medical point in the besieged town of Douma, Eastern Ghouta. Reuters Eastern Ghouta bombings: Syrian war in pictures Syrian Civil Defense running to help survivors. AP Eastern Ghouta bombings: Syrian war in pictures Injured children receive medical treatment. EPA

Doctors and first responders are struggling to cope with the mass casualties as their facilities are also hit in the offensive.

East Ghouta has been besieged by government forces for years, but in recent months the siege has been tightened, leaving the 400,000 civilians inside with dwindling food and medical supplies.

The area is supposedly one of four de-escalation zones created in May 2017 in an agreement brokered by Russia, Turkey and Iran to quell fighting between rebel forces and the regime.

The siege tactics and seemingly indiscriminate shelling of civilian infrastructure - President Bashar al Assad’s playbook in the war to date - contravene international law, the UN’s regional humanitarian coordinator also said on Tuesday.

“The recent escalation of violence compounds an already precarious humanitarian situation," Panos Moumtzis said in a statement calling for an immediate ceasefire.