Hunger is stalking the people of rebel-held east Aleppo.
While Russia has urged the rebels to leave and take their weapons with them, they are determined to stay and fight to break the government’s siege on the city.
United Nations agencies are scrambling to strike a deal that will deliver aid to the quarter of a million people living there.
The Syrian government, backed by Russian airstrikes and Shiite militias from Syria, Iraq and Lebanon, has rebel-held east Aleppo surrounded, and rejected a UN plan to ship aid in this month.
Aleppo resident Ibrahim Abu Laith, from the White Helmets civil defence unit, says the siege is biting hard.
“There is not much left to eat,” he says.
After an international outcry Russia and Syria suspended their airstrikes in Aleppo.
But they are still bombing other rebel strongholds and Russia is moving an aircraft carrier to the coast of Syria.
Many fear an escalation in the air campaign.
And Ibrahim Abu Laith says those inside rebel-held Aleppo are focused on fighting to break the siege.
“Concerning the Russian ship, we are used to being bombarded by a variety of weapons so we don’t care anymore,” he says.
Jan Egeland, the UN’s humanitarian coordinator for Syria, says food aid is running out.
“The report we have now from within east Aleppo is that the last food rations are being distributed as we speak,” he says.
“Some families have not had any distributions, families in need of relief have not had any distributions now for several weeks already.”
But he is optimistic a deal for humanitarian access will be reached soon.
“I do believe we will be able to avert mass hunger this winter,” he says.
“I think we will be able to get both supplies in and evacuations out, and none of the two should be conditioned on the other.”
The residents of east Aleppo are living in horrible conditions and they face a series of terrible choices.
The UN refugee agency, the UNHCR, says its survey of 400 people in east Aleppo shows 44 per cent of people want to leave.
But few have used the so-called “humanitarian corridors” opened by the Russians and the Syrian government.
Rebels oppose people leaving the city.
There is no trust in the Government, and the corridors are not supervised by the UN.
The 40 per cent who want to stay said they do not know of a safe place to go, want to stay with family, could not afford to move, or fear they will not be allowed to return to their homes.