Fatimah, 25, was at her home in eastern Aleppo with her three children when the first barrel bomb struck.

Her husband, who was at work at the time, heard the explosion from his office.

Saudi Arabia has no such reservations, but its proxies in Syria have mostly been defeated and it can’t do anything more there except play spoiler and encourage what will amount, after the war is over, to mere terrorism. Russia has clear motivations and clear goals there, a strong ally with most of the population under its control, and a practical plan for accomplishing them, which has worked well if sanguinarily so far. 78 mn., GDP 0 bn), by its alliance with the small PYD Syrian Kurdish population of some 2 million, for the instrumental purpose of rolling up Daesh. But neither of them is likely to be able to dictate to Trump, who likely hasn’t given up on better relations with Putin and doesn’t need either of those groups to be reelected.

According to the Syrian Observatory for Human Rights, more than 1,000 civilians have been killed during Russia’s four month bombing campaign.

By comparison, the strikes had killed 893 Islamic State of Iraq and the Levant (Isil) fighters, and 1141 militants from other factions, the monitoring group said.

They flew to Syria in June 2016, to spend five days working in hospitals that were bombed daily.

When asked what he remembers about first arriving in east Aleppo, Kahler said it was the smell of decomposing bodies buried under rubble and trapped in bombed-out cars.

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He knew instantly the sound had come from the direction of his house.

He waited for the "double-tap" – the second round of barrel bombs that would drop from the Syrian and Russian warplanes – before sprinting toward home.

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