At least four civilians have been killed during a truce in Syria's Eastern Ghouta, activists said, as Syrian government forces launched fresh attacks in the rebel-held Damascus suburb.
Syrian warplanes launched several air raids in Douma and Harasta on Tuesday, Mahmoud Adam, a spokesman for Syria's Civil Defence, also known as the White Helmets, told Al Jazeera.
In Douma, one of Eastern Ghouta's main towns, four people, including a woman, lost their lives and several others have been wounded, Adam said.
Alaa al-Ahmed, a local activist, told Al Jazeera that the attacks started at 9:30am (7:30 GMT) on Tuesday, 30 minutes after a Russia-backed ceasefire began.
The truce was meant to allow civilians to evacuate from the rebel-held enclave, which has been under continuous aerial bombardment since February 18.
Russia's President Vladimir Putin had ordered the ceasefire from 9am to 2pm (7:00 to 12:00 GMT) on Tuesday, as air raids and ground operations killed more than 550 civilians in the last eight days, according to the Syrian Observatory for Human Rights (SOHR).
According to al-Ahmed, Russia did not provide a guarantee or a "trusted third party" to help evacuate the injured out of the area.
"How could people trust Russia - the same people bombing us - with assisting in the safe evacuation of the injured?" he said. "There is huge contradiction."
The bombardment of the Damascus suburb, home to some 400,000 people, has been one of the most intense in Syria's seven-year war.
"What happened this morning is a clear violation of the truce - which is merely propaganda," al-Ahmed said.
The suburb's humanitarian situation has been deteriorating, causing widespread international condemnation, with UN secretary-general describing the situation in the enclave as "hell on earth".
On Monday, a suspected chemical attack killed one child, according to Syria's Civil Defence.
The reported chlorine gas attack injured at least 18 others when it hit Eastern Ghouta's al-Shifaniyah town close to the front lines, where rebels are fighting Syrian ground forces who have been trying to penetrate into the besieged enclave since Sunday.
Nour Adam, a local journalist based in Douma, told Al Jazeera that warplanes also struck the al-Marj area on Tuesday morning, a town near the outskirts of Douma.
"Tens of people have been injured," he said.
And in the town of Misraba, at least seven people have been wounded as a result of surface-to-surface missiles, Nour added.
"The medical facilities are in a state of chaos - either because of the shelling or due to the high number of admitted injuries," he explained.
No 'safe corridors'
The truce was supposed to establish "safe corridors" to facilitate the evacuation process, but activists say there has been no attempt at doing so.
"To this moment, not a single person inside Eastern Ghouta has been evacuated," Mahmoud Adam said, describing the truce as "dishonest".
"Shelling is ongoing, and there have been barrel bombs used in the outskirts of Douma," he added.
Syrian state news agency, SANA, said rebels had fired several rockets in the path of a "safe corridor" that was supposed to allow for the evacuation of civilians.
Syria's Civil Defence team have started transferring people to medical facilities.
Similarly, Firas al-Abdullah, an activist in Eastern Ghouta, confirmed that at least three towns were hit on Tuesday after the ceasefire was set to take effect.
"No one left, no one entered - there has been nothing of this sort," he said of the proposed evacuation plan.
Locals have also noted that several government warplanes are flying over villages on the outskirts of Douma.
On Saturday, an earlier attempt to implement a 30-day ceasefire in Syria failed, when a UN Security Council resolution was not upheld.
Eastern Ghouta has been under rebel control since 2013, after which President Bashar al-Assad's government imposed a siege on the area in an attempt to drive out opposition fighters.
The blockade has caused a food and medicine shortage, has caused inflation rates to soar and aid convoys have not been able to deliver much of the desperately needed supplies.