DW: How would you describe the humanitarian situation in eastern Ghouta?

Marten Mylius: The humanitarian situation has been very stressful and difficult in eastern Ghouta for some time now. The suburb of Damascus has been more or less under siege by government forces for four years. The siege has been tightened in recent months. This means that the tunnels and checkpoints have been destroyed and you can't even get in. And now, in the past few days, this military offensive has escalated to a level that is very dramatic for the people. Hospitals are being attacked and civilians have died to an extent that we have not seen in the last four or five years. This is a situation that has intensified dramatically.

How many people live in eastern Ghouta? And when you speak of siege, what is needed the most?

We assume that around 400,000 people are trapped there. After the tunnels were destroyed and the crossings closed, the price of basic foods skyrocketed. One kilo of rice now costs $4.50 (€3.66). A lot of people cannot afford that anymore. In other words, we are witnessing a rapid spread of malnutrition. We see women who lose their hair; their teeth fall out. We assume that more than 10 percent of the children are acutely malnourished. It is really about the essentials: food and medicine. It is just about safety and mere survival these days.

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Could people leave besieged eastern Ghouta if they wanted to?

That is absolutely impossible. You cannot get in or out. You cannot leave. You can only move within eastern Ghouta. It is a relatively densely populated satellite state with an area of around 100 square kilometers. But there are not many safe places left - and you cannot even get out of those places.

Do you expect humanitarian access to be restored at some point?

It is very difficult in eastern Ghouta because there is no direct access from neighboring countries. It is surrounded by the regime's troops. The situation is different in Idlib, for example, where you can get in directly from the Turkish border. You can wait with supplies at the border and then bring in the convoy. It is much more difficult in eastern Ghouta because we have to negotiate with the Syrian regime and are at the mercy of its decisions. We still have employees and partners in eastern Ghouta. But because of the security situation, the whole program has now been temporarily stopped.

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What can the international community do to force access?

On Tuesday, the UN called for a one-month ceasefire and immediate access for humanitarian aid. Now diplomatic pressure must be built up. This is difficult, of course. We are familiar with the structures at the UN Security Council. And the conflict has become so complicated and internationalized in recent years that the means are now very limited. Diplomatic pressure with regard to the humanitarian situation and international humanitarian law is the way to begin a forced ceasefire.

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Marten Mylius is the emergency relief coordinator at CARE for the Middle East and works in Jordan's capital, Amman.