Syrian government bombardment and Russian airstrikes killed at least 46 people in a besieged towns close to Damascus on Friday.
Syrian and Russian jets struck the town of Kafr Batna with cluster bombs, napalm-like incendiary weapons, and conventional explosives, the Syrian Observatory for Human Rights said.
The assault was part of an indiscriminate campaign by President Bashar Assad’s forces to retake the towns of Eastern Ghouta and the rest of the enclave from the rebels.
Meanwhile, thousands of civilians poured out of Eastern Ghouta on Thursday after a month-long bombardment brought the Syrian regime closer to recapturing the devastated rebel enclave outside Damascus.
UN special envoy to Syria Staffane De Mistura said that UN teams were not coordination the civilian evacuation fro eastern Ghouta towns.
A war monitor said regime forces now control 70 percent of the area, splitting the remaining rebel territory into three shrinking pockets.
After a fierce air and ground assault, regime forces on Thursday captured Hammuriyeh town, in an isolated southern part of Ghouta.
The Syrian Observatory for Human Rights, a Britain-based monitor, said rebels later launched a counter-attack and regained parts of the town, killing 14 regime fighters.
Elsewhere, however, it said the regime overran Al-Rihan town in an assault led by Russian officers and advisers.
The regime’s advance into Hammuriyeh had punched a corridor through the town into government-controlled territory.
Streams of women and children escaped through that corridor on Thursday, carrying plastic bags stuffed with clothes and pushing strollers piled high with suitcases and rugs.
They reached a regime checkpoint in Adra district, where ambulances and large green buses waited to take them to temporary shelters.
The Observatory said nearly 20,000 people fled the enclave in 24 hours before the flow stopped on Thursday evening.
It called the exodus “the largest displacement since the beginning of the assault on Ghouta.”
The United Nations said it was trying to determine how many people have left the enclave.
“The UN has not observed the evacuations, but is visiting collective shelters where some of the evacuees are arriving,” a UN spokesman said.
Eastern Ghouta had been the main rebel bastion on the outskirts of Damascus since 2012 and came under a devastating regime siege the following year.
That left the area’s roughly 400,000 residents struggling to secure food and hospitals crippled by shortages of medicine and equipment.
On Thursday, a joint convoy of food supplies for some 26,000 people entered Douma, the largest town in Ghouta and part of a separate rebel-controlled pocket.
“This is just a little of what these families need,” said the International Committee of the Red Cross, which delivered the aid alongside the Syrian Arab Red Crescent and the UN.
ICRC President Peter Maurer went with the convoy, the first time he had accompanied such an operation.
Twenty-five trucks were delivering food parcels and flour bags to hunger-stricken Douma residents when mortar rounds hit nearby.
Aid workers scrambled for cover, an AFP correspondent said, but were able to resume deliveries shortly afterwards.
Thursday’s aid operation came after two consecutive days of medical evacuations from Douma, which saw dozens of civilians bussed out for treatment in Damascus.