Despite orders for a five-hour daily humanitarian truce from Tuesday, the attacks have continued.

Here is a timeline:

- New round of rockets, raids -

Government forces open their latest military campaign against Eastern Ghouta with a volley of more than 260 rockets and intense air raids.

The strikes continue on February 19 when 127 civilians are killed in the highest death toll over a single day there since 2013, when it was besieged by regime forces.

On February 20 Russian air strikes reportedly target Eastern Ghouta for the first time in three months, hitting the key regional Arbin hospital.

Six other hospitals are also hit in the bombardments over a 48-hour period, putting three out of service, according to the United Nations.

Hundreds of injured flock to makeshift hospitals where the beds run short and patients are treated on the floor.

- 'Hell on Earth' -

On February 21 raids target several areas and planes drop barrel bombs -- crude, improvised munitions that cause indiscriminate damage.

Several residential buildings are destroyed. People take cover in basements and underground bomb shelters.

The Kremlin denies involvement in the air strikes as "groundless accusations".

UN chief Antonio Guterres calls for an immediate ceasefire, saying the region's 400,000 residents "live in hell on Earth".

- 'Another Aleppo' -

The chaos deepens on February 22 as the Syrian regime rains rockets and bombs on the enclave, killing at least 19 people.

After weeks of talks at the United Nations on a truce, Russian ambassador Vassily Nebenzi says there is no progress.

Russia has been pressing for a negotiated withdrawal of rebel fighters and their families, like the one that saw the government retake full control of Aleppo in December 2016.

"Yes, Eastern Ghouta will become another Aleppo," says Syria's US representative Bashar al-Jaafari.

Doctors Without Borders says 13 of the facilities it supports in Eastern Ghouta were damaged or destroyed in three days.

- Ceasefire agreed -

On February 23 US President Donald Trump slams the actions of the Syrian government and its Russian and Iranian backers.

"What those three countries have done to those people is a disgrace," he says.

In February 24 the UN Security Council finally gets unanimous backing for a 30-day ceasefire to allow for aid deliveries and medical evacuations.

But there are new air strikes the following day and the Britain-based Syrian Observatory for Human Rights monitor reports that Syrian forces engaged in heavy fighting with rebels, with many dead.

There are also claims of the use of "chemical weapons, probably a chlorine gas attack", a doctor says, with one dead. Russia dismisses this as "bogus".

- Daily 'pause' ordered -

On February 26 the regime carries out more bombings, in spite of the UN-agreed truce, killing at least 22 civilians.

Frustrated, the UN and European Union demand the immediate implementation of the ceasefire.

Moscow then announces that President Vladimir Putin has ordered a daily five-hour "humanitarian pause" from February 27 and the opening of protected corridors to allow people to leave.

Hours after the truce is meant to come into effect, the United Nations says fighting continues, making relief operations impossible.

The Observatory reports air raids, including the dropping of two barrel bombs, as well as rocket fire, even if the intensity of the bombardment was reported to have eased.

State media says rebel forces shelled humanitarian corridors to keep civilians hostage.