DOUMA - Syrian regime air strikes and artillery fire hit the rebel-held enclave of Eastern Ghouta for a sixth straight day Friday as the world struggled to reach a deal to stop the carnage.
More than 400 civilians have been killed in one of the seven-year Syrian conflict's bloodiest episodes and rescuers were finding more bodies buried in the rubble.
France and Germany's leaders urged Russian President Vladimir Putin, whose airforce is also striking Eastern Ghouta, to back a 30-day truce up for a UN Security Council vote at 1600 GMT Friday.
Russia called for "guarantees" that the ceasefire would be respected by rebel fighters.
Few of the enclave's nearly 400,000 residents -- mostly living in a scattering of towns across the semi-rural area east of the capital -- ventured out on Friday.
A correspondent in Douma, Eastern Ghouta's main town, saw a handful of people stealthily crossing rubble-strewn streets to assess damage to their property or look for food and water.
But death has fallen from the sky relentlessly since government and allied forces intensified their bombardment on Sunday and rocket fire soon forced everybody to run for cover.
Exhausted and famished families cowered in cramped and damp basements, exchanging information on the latest casualties of the government's blitz.
Some of the only people braving the threat of more bombardment were medical staff in those hospitals still standing and rescuers sifting through the wreckage of levelled buildings.
- Trapped bodies -
The new strikes on Friday killed at least nine people, the Syrian Observatory for Human Rights said.
"The air strikes and the artillery fire are continuing on several towns in Eastern Ghouta," Rami Abdel Rahman, the head of the Britain-based monitoring group, said.
He said that five of the nine people killed on Friday died in air strikes on Douma, the main town in the enclave east of Damascus, and that two of them were children.
The latest deaths brought to 436 the number of people killed since the Syrian regime and its Russian ally intensified their bombardment of the besieged area on February 18.
More than 2,000 people have been wounded.
Diplomats at the United Nations failed to clinch Russian approval late Thursday on a resolution calling for a 30-day truce to allow for humanitarian aid and medical evacuations.
They then announced that a vote would take place on Friday but did not make clear whether they had rallied Moscow to a new draft.
This time German Chancellor Angela Merkel and French President Emmanuel Macron wrote to Putin to ask him to back the ceasefire.
The latest text softens language in a key provision to say that the council "demands" a ceasefire instead of "decides".
It also specifies that the ceasefire will not apply to "individuals, groups, undertakings and entities associated" with Al-Qaeda and the Islamic State group. A previous version simply mentioned the two groups.
World leaders have expressed outrage at the plight of civilians in Eastern Ghouta, which UN chief Antonio Guterres called "hell on earth", but have so far been powerless to halt the bloodshed.
"The UN says it is concerned and calls for a ceasefire, France condemns, but they have given us nothing," said Abu Mustafa, one of the few civilians on the streets of Douma Friday morning.
"Every day we have strikes, destruction. This would draw tears from a rock," said the 50-year-old, who was escorting a wounded person to hospital.
The enclave has been controlled by Islamist and jihadist groups since 2012.
The main rebel groups in Eastern Ghouta rejected in a statement released Friday any deal that would see them or other residents of the area transferred to a third location.
"We categorically reject any initiative providing for inhabitants to leave their homes and be transferred towards any other location," said the letter, which was addressed to UN chief Antonio Guterres.
The area is completely surrounded by government-controlled territory and residents are unwilling or unable to flee the deadly siege.
- Toothless response -
The dire images of civilian victims bleeding to death in understaffed hospitals and the scope of the urban destruction have shocked the world and drawn comparisons with the devastating 2016 battle for Aleppo.
The aid community has voiced its frustration at being prevented from assisting civilians in Eastern Ghouta, which has been under government siege since 2013.
"The blocking of this resolution is another failure to end human suffering in Syria, with the UN Security Council rendered impotent as this senseless war rages on," Thomas White, Syria director at the Norwegian Refugee Council said.
Government forces have this month reinforced their deployment around the enclave in preparation for a ground offensive that White said would spark an even worse humanitarian crisis.
"If aid agencies are unable to meet urgent needs now, how can we possibly be prepared to tackle what is yet to come," White said.