Five died and over 200 were injured early on Wednesday in the area, hammered by one of the heaviest bombardments in seven years of war that has killed at least 250 people in 48 hours, a war monitor said.
The pace of the bombardment appeared to slacken overnight, but its intensity resumed later on Wednesday morning said the Britain-based Syrian Observatory for Human Rights. It followed a massive escalation in strikes that began late on Sunday. The enclave is home to 400,000 people.
Pro-government forces fired rockets and dropped barrel bombs from helicopters on the towns and villages of the rural district just outside Damascus, where rebels fighting President Bashar al-Assad have their last big redoubt near the capital, it added.
"We are waiting our turn to die. This is the only thing I can say," said Bilal Abu Salah, 22, whose wife is five months pregnant with their first child in the biggest eastern Ghouta town Douma.
They fear the terror of the bombardment will bring her into labour early, he said.
"Nearly all people living here live in shelters now. There are five or six families in one home. There is no food, no markets," he said.
The United Nations has decried the assault on eastern Ghouta, where hospitals and other civilian infrastructure have been hit, as unacceptable, warning that the bombings may constitute war crimes.
Conditions in eastern Ghouta, besieged since 2013, had increasingly alarmed aid agencies even before the latest assault, as shortages of food, medicine and other basic necessities caused suffering and illness.
Rebels have also been firing mortars on the districts of Damascus near eastern Ghouta, wounding two people on Wednesday, state media reported. Rebel mortars killed at least six people on Tuesday.
"Today, residential areas, Damascus hotels, as well as Russia's Center for Syrian Reconciliation, received massive bombardment by illegal armed groups from Eastern Ghouta," Russia's Defence Ministry said late on Tuesday.
Eastern Ghouta is one of the "de-escalation zones" agreed by Russia, Iran and Turkey as part of their diplomatic efforts. But a former al Qaeda affiliate is not included in the truces and it has a small presence there.
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