Syrian government warplanes have carried out a sixth day of air strikes in rebel-held suburbs east of Damascus, killing 32 people, activists said, as the death toll from a week of bombardment soared over 400.

At the United Nations, a vote on a Security Council resolution demanding a 30-day humanitarian ceasefire across Syria was delayed until Saturday to try to close a gap over the timing of a halt to fighting.

The new bombings came a day after Syrian army helicopters dropped leaflets over the rebel-controlled areas of eastern Ghouta, urging residents of those suburbs to leave for their own safety and calling on opposition fighters to surrender because they were surrounded by government troops.

Opposition activists reported air strikes and artillery shelling on a string of towns on the edge of Damascus or eastern Ghouta.

At least 32 people were killed in raids on areas including Hammouriyeh, Zamalka, Douma and al-Marj, according to the Syrian Observatory for Human Rights, a Britain-based group that monitors the civil war through a network of activists in Syria.

The Ghouta Media Centre, an activist collective, also reported 32 killed, saying the victims included 13 people in the Damascus suburb of Douma, five in Ein Tarma and five in Shiefouniyeh.

Syrian state TV reported that insurgents fired 70 shells on Damascus, killing one person and wounding 60 others.

It said one of the shells hit a hospital, damaging its intensive care unit as well as cars parked nearby.

The opposition’s Syrian Civil Defence rescue group reported new air strikes in Douma, Arbeen and other towns east of Damascus.

At the White House, US President Donald Trump blamed Russia, Iran and the Syrian government for the recent violence in Syria, calling it a “humanitarian disgrace”.

President Donald Trump speaks during a news conference with Australian Prime Minister Malcolm Turnbull in the East Room of the White House (Carolyn Kaster/AP)President Donald Trump speaks during a news conference with Australian Prime Minister Malcolm Turnbull in the East Room of the White House (Carolyn Kaster/AP)

His comments came at a joint news conference with Australian Prime Minister Malcolm Turnbull.

UN Special Envoy for Syria Staffan de Mistura called again for an urgent ceasefire to relieve the “appalling suffering” of civilians in eastern Ghouta by stopping the bombing there and the “indiscriminate” shelling of Damascus.

He said the cease-fire must be followed by an “immediate, unhindered humanitarian access to eastern Ghouta and evacuation of sick and injured.”

UN Secretary-General Antonio Guterres also had urged an immediate suspension of “all war activities” in eastern Ghouta, saying 400,000 people are living “in hell on Earth”.

European Union foreign policy chief Federica Mogherini said “unhindered humanitarian access and the protection of civilians is a moral duty and a matter of urgency”.

The UN draft resolution demands that as soon as the ceasefire takes effect, all parties should allow humanitarian convoys and medical evacuations in areas requested by the UN.

It states that 5.6 million people in 1,244 communities are in “acute need”, including 2.9 million in hard-to-reach and besieged locations.

The Syrian government and its Russian allies want to continue attacking extremists from the Islamic State group and all al Qaida affiliates.

Russian Ambassador to the United Nations Vassily Nebenzia, left, speaks to Chinese Ambassador to the United Nations Ma Zhaoxu before a Security Council meeting on the situation in Syria (Mary Altaffer/AP)Russian UN Ambassador Vassily Nebenzia, left, speaks to Chinese UN Ambassador Ma Zhaoxu before a Security Council meeting on the situation in Syria (Mary Altaffer/AP)

Russia’s UN Ambassador Vassily Nebenzia has called an immediate ceasefire unrealistic and proposed an amendment to delay it.

But the Russian amendment was rejected by Sweden and Kuwait, sponsors of the proposed Security Council resolution that demands a 30-day ceasefire to start 72 hours after the measure’s adoption.

Kuwait’s UN Ambassador Mansour Al-Otaiba, the current council president, and Sweden’s UN Ambassador Olof Skoog told reporters on Friday evening after six hours of negotiations that members were very close to agreement on a text — but there was still a gap.

“We all agree there needs to be a ceasefire and it has to be urgent, immediately,” Mr Skoog told reporters. “There are still some discussions on exactly how to define that. So that’s what we’re working on.”

Mr Skoog said he was “extremely frustrated” that the council was unable to adopt the resolution on Thursday or Friday because the situation on the ground is dire.

Mr Al-Otaiba said the council will meet on Saturday at noon EST (1700 GMT) and there will be a vote.

The draft resolution demands that as soon as the ceasefire takes effect, all parties should allow humanitarian convoys and medical evacuations in areas requested by the UN. It states that 5.6 million people in 1,244 communities are in “acute need,” including 2.9 million in hard-to-reach and besieged locations.

AP