‘It’s a wasteland’: Images lay bare Syria destruction

to the Union of Medical Care and Relief Organisations (UOSSM). More than 10 medical staff and volunteers have been killed, with 20 injured. Doctors treat and operate on patients in underground rooms to escape the air strikes.

“From looking at the satellite images, you can see it’s a scorched earth policy,” Ray said. “In contrast to Sarajevo, the damage is incomparable. Even in the worst hit areas of Sarajevo some buildings still stood.”

He said it was possible the Syrian government had used thermobaric weapons, explosives that use oxygen from the surrounding air to generate a high-temperature explosion, in an area west of Douma. “All the trees and vegetation are gone and the buildings are no longer there but there are no craters,” he said. “It’s possible they were trying to clear that area to serve as a buffer.”

The conflict enters its eighth year this month, having seen hundreds of thousands of people killed and half the pre-war population of 23 million forced from their homes.

Eastern Ghouta is not the first Syrian territory to be decimated. Swathes of Homs, Aleppo and Raqqa are uninhabitable after campaigns to oust rebel fighters and the Islamic State.

“Eastern Ghouta is straight out of the Aleppo playbook,” said one Western diplomat. “I’m afraid we’ll have no option but to sit and watch it all play out again. What we saw in Aleppo could pale in comparison to what’s to come in Eastern Ghouta.”

There is a fear the battle will become one of attrition. Assad’s “starve or surrender” tactic, as it has become known, has proved effective and is much less costly for his troops.

Cut off from the outside world, residents survive on what they can grow to eat and whatever they can smuggle in through one of their remaining tunnels. Tending to crops has become a deadly business, however, and few dare to venture out in full view of the drones overhead. Bread in Eastern Ghouta costs nearly 22 times the amount it does in government-held Damascus. Several children have died of malnutrition. Aleppo fell within weeks of a government offensive in December 2016. Eastern Ghouta could take months.

Under a truce declared by Russia, the Syrian government this week opened a “humanitarian” corridor for those who wanted to leave. So far only an elderly Pakistani couple have passed through. Residents fear a repeat of Aleppo, where civilians who made it out of the city were tortured, arrested or displaced. “Russia is the only one who can stop this now,” the diplomat said. “But they seem impervious to international condemnation and shame.”

However, he noted at January peace talks in the Russian city of Sochi there appeared to be tensions emerging between Syrian and Russian positions. In turn, the UN feels held to ransom by Vladimir Putin, Russia’s president. But Staffan de Mistura, the UN’s Syria envoy, warned: “We cannot afford the luxury of giving up.”