The Syrian Observatory for Human Rights said yesterday rockets fired by regime forces rained down on the towns of Douma, Harasta, Saqba and Arbin in the opposition-held Eastern Ghouta region.

Observatory head Rami Abdel Rahman said air strikes also hit the towns, but it was unclear whether they were carried out by Syrian or Russian warplanes.

At least 10 children and four women were among the dead and dozens of people were wounded, he said.

A small girl's body lay on an operating table in a field hospital, as doctors prepared to operate on her badly-wounded leg.

In one jarring photo, children's shoes, notebooks, and bags are strewn across the blood-stained floor of what the group said was a schoolyard in Douma.

Air strikes in the area are at times conducted by Russian warplanes, which began carrying out an air war in Syria in September. Suspected Russian strikes on Douma in November killed 23 Syrian civilians.

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