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More than 460 civilians, including over 100 children, have been killed in almost a week of bombardment that has been one of the 7-year-old conflict's bloodiest episodes.

(Ghouta Media Center via AP) A man carries an injured boy as he walks on rubble of damaged buildings in the rebel held besieged town of Hamouriyeh, eastern Ghouta, near Damascus, Syria, February 21, 2018.

The U.N. Security Council scheduled a vote Friday on a resolution demanding a 30-day cease-fire across Syria to deliver humanitarian aid to millions and evacuate the critically ill and wounded.

Russia's UN Ambassador Vassily Nebenzia called an immediate ceasefire unrealistic.

As a permanent member of the UN Security Council, Russia wields veto power and has repeatedly blocked resolutions on Syria.

Several council diplomats who examined the draft, speaking on condition of anonymity because they were not authorized to speak publicly, said it was unacceptable.

Witnesses said that the attack was more intense than previous strikes over the last seven days and claim hospitals and medical clinics had been targeted. "Yes, I'm very frustrated with that", Skoog said. "Everyone knows it's an extermination", he told the Associated Press. He said a barrel bomb had fallen less than half a kilometer (one-third mile) away.

"The Assad regime is carrying out a massacre in eastern Ghouta".

"Maybe there are many more", Siraj Mahmoud, a civil defense spokesman, told the news service.

Residents have holed themselves up in basements to escape falling shells and medical charities have decried attacks on a dozen hospitals in Ghouta, the only remaining large rebel bastion near the capital.

White House Deputy Press Secretary Raj Shah said the USA is monitoring the situation in Syria, where more than 400 civilians were killed in the last five days in the regime-led air strikes and bombardments in rebel controlled areas.

On Saturday, it said 29 civilians died, including 17 in the main town, Douma, of the Eastern Ghouta region. Then, as now, it cited the presence of al-Qaida-linked groups as grounds for the sweeping operation.

"Russia's routine use of its veto had become the equivalent of acquiescence in war crimes, allowing all parties in Syria's conflict to act with impunity, with civilians paying the ultimate price", Amnesty says.

Negotiations have also stumbled over Russian demands that rebel groups fighting President Bashar al-Assad s forces comply with the truce. "During writing this message to you more than 20 rockets have fell around us", he added.

In another concession to Russian Federation, the draft also specifies that the ceasefire will not apply to operations against the Islamic State group or al-Qaeda, along with "individuals, groups, undertakings and entities associated" with the blacklisted terror groups.

This could include the two biggest rebel groups in Eastern Ghouta - Jaish al-Islam and its rival Faylaq al-Rahman.

News that the U.S. was preparing to create a 30,000-strong Syrian border force out of the Kurdish-led Syrian Democratic Forces, or YPG, precipitated Turkey's military offensive against Kurdish militias in the northwestern enclave of Afrin.

Syrian regime air strikes and artillery fire hit the rebel-held enclave of Eastern Ghouta for a sixth straight day Friday killing 38 civilians, as world powers struggled to reach a United Nations deal to stop the carnage.

Eastern Ghouta is one of four Syrian de-escalation zones created during the Astana Syrian reconciliation talks.

Referring to eastern Ghouta, Alan Thomlinson said: "The challenge is that this is an urban area with over 400,000 civilians stay living there; they are trapped in this cycle of violence".

The enclave has been controlled by Islamist and jihadi groups since 2012.

Hundreds of pro-Syrian government fighters entered Afrin this week as part of an agreement with the Kurdish militia, known as the YPG, to bolster resistance to Turkey's assault.