Just a day after the first aid convoy reached the besieged towns of Saqba and Kafr Batna in over a year, shelling slammed into a kindergarten in the rebel enclave. Ten people were killed, including five children, and over thirty were injured.

The aid convoy and the attack followed a familiar pattern in the regime’s brutal siege playbook. Government forces have besieged Eastern Ghouta for four years and over 300,000 people remain trapped there. Blocking the entry of the majority of food and goods into the area, while preventing the besieged population from escaping, the regime continuously rejects humanitarian organisations’ requests to send aid to malnourished civilians. It is often only as international peace talks begin that the regime allows aid trucks to enter, apparently in an attempt to demonstrate goodwill. It is no coincidence, then, that the aid convoy arrived just as the newest round of the Russia-sponsored talks at Astana began this week.

The subsequent attack on the kindergarten also fits the pattern. After besieged populations receive aid, pro-regime forces punish them with indiscriminate shelling or air strikes. Shelling is not uncommon in Eastern Ghouta – it has been an almost daily occurrence throughout October despite being included in a de-escalation zone – but it is often especially intense after the delivery of an aid convoy.

Conditions in Eastern Ghouta are currently among the worst they have been during the conflict. Medical supplies are extremely low and UNICEF estimates that at least 1,200 children suffer from malnutrition, with a further one and a half thousand at risk. A few months ago, government advances intensified the siege when the main checkpoint into the besieged area was cut off and rebel groups lost access to some of the tunnels they had used to smuggle in goods. Prices inside the besieged area rocketed. The price of a bag of bread soared to £1.60, while costing less than 20p just miles away in central Damascus, and many simply cannot afford to feed their families.

Rebel infighting further compounds civilians’ misery. With two main rival opposition groups vying for control, the besieged area has essentially been cut in two. In part, infighting has facilitated the government’s recent advances. As the Free Syrian Army-affiliated group Faylaq al-Rahman fought off government advances on two fronts, the hard-line Jaish al-Islam seized the advantage and moved against it for territorial gains. Jaish al-Islam’s offensive further weakened Faylaq al-Rahman’s ability to defend its front lines against the regime, losing territory.

For civilians living in Eastern Ghouta, this infighting brings new obstacles to daily life. Prevented from leaving the besieged area by regime forces, opposing rebel groups also place restrictions on civilians’ travel based on the area from which they hail. Some farmers are not able to access their land. Some teachers cannot reach the schools in which they teach. Those trying to get to a hospital in an area controlled by another group risk harassment or arrest at checkpoints.

With the regime slowly chipping away at the territory held by rebels in Eastern Ghouta, infighting weakening opposition groups, and their backers beginning to acknowledge that the Assad regime will survive the conflict, it remains to be seen how long those in Eastern Ghouta will be able to hang on. What seems sure is that, after having endured four years of siege, it is civilians that will continue to suffer the most.

* / Will Todman is an associate fellow in the CSIS Middle East Program and a fellow at the Centre for Syrian Studies, University of St Andrews.

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