Number of Civilians Killed in Aleppo Tripled in Days After End of Cease-Fire

— LONDON -- The U.S.-Russia brokered Syrian cease-fire may have brought some peace to the people of Aleppo for the one week it lasted, but after it ended, the city saw much more violence and death than before the truce came into effect.

Three times as many civilians were killed in Aleppo in the 15 days after the cease-fire ended than in the 15 days prior to the truce, according to the Syrian Observatory for Human Rights. From Sept. 19 -- when the Syrian military declared the cease-fire over -- until today, at least 426 civilians, including 78 children, lost their lives in Aleppo, said the observatory. They were all killed in bombardments from the air targeting residential neighborhoods and hospitals.

Of the dead, 293 civilians, including 56 children, were killed by Russian airstrikes and government warplanes in the eastern part of Aleppo.

Airstrikes on the besieged eastern part of the city intensified after the Syrian military declared an offensive against the area on Sept. 22.

The largest trauma and ICU center in east Aleppo is now closed, following several bombardments in the past week. The latest attack on the facility happened yesterday when a bunker-buster bomb landed in front of the entrance, killing three maintenance workers and injuring a nurse and an ambulance driver, said the Syrian American Medical Society, which supports the medical facility. The attack completely destroyed the underground hospital, which was already closed due to prior attacks.

“There’s no life left in the hospital,” Mohamed Abu Rajab, a radiologist and managing director of the hospital, told ABC News. “We are only a couple of people left here trying to guard what’s left and protect the equipment. The hospital is now completely shut down. It’s no longer a hospital. It died. The hospital also died. The place is completely filled with dirt and rubble. It would take months before it could come back into service.”

Five hospitals are currently in service and only 29 medical doctors are left in east Aleppo attempting to meet the health needs of thousands of people, according to the United Nations. The U.N. estimates that 275,000 people live under siege in east Aleppo in need of medical supplies, food and clean water. Access to clean water was significantly reduced after a large part of the water networks in the besieged part of the city were damaged following airstrikes. Meanwhile, east Aleppo is still waiting for aid -- humanitarian assistance was supposed to reach its trapped residents weeks ago, but the increased violence and an attack on an aid convoy suspended the delivery.

Between Sept. 23 and 29, 338 people lost their lives in east Aleppo, 106 of them children, while 846 people were injured, 261 of them children, the U.N. said, citing health officials.

“Children are being killed and maimed. Airstrikes are hitting the few remaining hospitals. The use of bunker-busting bombs means children cannot even safely attend schools that are underground,” said Benyam Dawit Mezmur, chair of the U.N. Committee on the Rights of the Child, in a statement.

“Even if the war were to end today, it will take decades to recover from the destruction wrought on Aleppo and across Syria and the psychological wounds to heal from the trauma inflicted on these children. We are probably not talking of a lost generation, but quite possibly of lost generations.”

Yesterday, the U.S. announced it was suspending contact with Russia over Syria, saying the country had failed to live up to commitments made during the cessation of hostilities.