BEIRUT:RECOVERING in Turkey after a deadly air strike on a hospital in Aleppo, all Abu Abdu Tebyiah could think about was the six children he had been forced to leave behind.
Mr Tebyiah was critically injured when the Syrian regime dropped three bombs on the al-Quds hospital next to his house in the east of the city on Thursday.
He was one of a lucky few allowed over the border to receive treatment - for a broken ribs and pelvis, wounds that may otherwise have killed him.
But the 49-year-old shop owner was moved so quickly he had little chance to explain to his rescuers that he was a single parent with children waiting for him at home, the youngest just 4 years old.
"They are too young to be on their own," Mr Tebyiah told The Sunday Telegraph. "The government is using barrel bombs on our neighbourhood again, so I stopped them going to school. They are now in great danger."
Mr Tebyiah said the only way to bring his children to Turkey, which was closed to fleeing Syrians earlier this year, is to pay smugglers $500 for each child, money he does not have.
"I have to find a solution as soon as possible or I don't want to think what will happen."
Fighting intensified in Syria's second city this week, in violence which has left more than 250 dead and, to many eyes, effectively ended the much-publicised ceasefire which had largely been holding since February.
Now the opposition-controlled eastern side of Aleppo is braced for an all-out offensive by the Syrian government, and its Russian and Iranian allies, that could change the course of the conflict.
As the bombs dropped on the city's houses, hospitals and schools, residents wondered where their supposed protectors, the Americans, were. Many had been optimistic that the ceasefire, brokered by the United States and Russia, was the ray of hope the city needed after suffering an unparalleled, blistering four-year campaign of violence.
Just a few weeks in, they found the bombs were dropping once more.
Moscow had declared that as the east of Aleppo was under the control of jihadist rebels, such as the al-Qaeda-linked Jabhat al-Nusra, it should not be covered by the truce.
"The fighting there is very alarming," a US state department spokesman said when asked why the US did not try to get a halt to the growing violence in Aleppo, "but the situation is very complex."
Aleppo was Syria's commercial hub before the war broke out five years ago, home to some two million people. Because of its strategic location near the Turkish border, and symbolic significance, it is often said that whoever holds Aleppo wins the war.
Neither side has managed to fully control it since opposition forces took parts of the east in 2012.
President Bashar al-Assad and his troops have for months been working up to what they are calling a "war of all wars" to retake it from the rebels.
A victory there would convince regional powers the regime's fall is not imminent and would give it greater bargaining power at a negotiating table.
Thousands of Aleppans have fled in the past 72 hours, according to Ismail al-Abdullah, an activist living in the city, who said people are afraid of what is to come.
"Many gather between 5 and 6am under the cover of darkness, before they can be spotted by the planes," he told this newspaper.
The 7am regime air strikes which have recently been pounding the rebel side of the city - where some 200,000 still live - have become a grim routine, he said. More than 30 more strikes were counted before midday yesterday, adding six more lives to the mounting death toll.
Zahra al-Mansour and her three children were among those leaving. Carrying only a hastily packed bag of schoolbooks, snacks and clothes, she did not know exactly where they were going on Friday morning, but knew they could not wait for the Syrian and Russian bombs to start dropping.
Ms Mansour, a 38-year-old teacher, had stayed out of loyalty to her husband - a rebel fighter who was killed in battle last Christmas - and out of commitment to the only city she has called home.
"No matter how bad it got, I somehow always had faith we would be okay," she told The Sunday Telegraph.
"This time it is different. Every street is marked by war, I realise now Assad will not stop until there is no one left."
But leaving does not offer safety. The only way out - through the once porous Bab al-Salam crossing into Turkey - has been closed by its northern neighbour, which wants to create a safe zone inside Syria rather than admit around 100,000 people waiting at the border.
John Kerry, US Secretary of State, had said if the ceasefire and peace talks in Geneva collapsed, America would move to "Plan B", which included supplying moderate rebels with weapons, such as shoulder-fired anti-aircraft missiles, to counter Russian warplanes.
But US officials continue to claim the truce remains alive. "I think we would still maintain that it has largely held," John Kirby, the State Department spokesman, said on Thursday, as rescuers pulled children from the ruins of the al-Quds hospital's paediatric ward.
Kyle Orton, a Middle East analyst at the Henry Jackson Society, believes America's inertia shows that Russian President Vladimir Putin, Assad's loyal ally, is now calling the shots.
"Russia has always had a clear idea of what this ceasefire is - a cover for them to consolidate and plan what we are now seeing," he said.
On the US's lack of action, he said: "It just looks like they've sided with Russia by allowing them to claim the city is full of terrorists which they need to purge. The Americans have effectively signed off on Russia taking over the city."
There is a sense of abandonment felt on the ground too.
"When we heard Mr Kerry say Aleppo was run by al-Qaeda, we realised we were on our own," said activist Mr Abdullah "There are no terrorists where the government is bombing - it is a lie that everyone is agreeing to accept for the sake of the ceasefire agreement."
With only one road out of Aleppo for those who live in the rebel-held east, residents worry that if government forces manage to wrest back control, thousands will be besieged.
Fadi Hakim, a doctor from Aleppo, said: "This offensive will leave thousands encircled, without food and without medicine. The regime has already bombed the hospitals and its doctors, so when the casualties mount up there is no one left to treat them.
"It will be a massacre, the likes of which we haven't seen before."