Syrian doctors in Aleppo plea to US President Barack Obama

Letter says doctors need action, not tears, sympathy or prayers.

Fighting in Aleppo has intensified in the past month. Picture / AP

Syrian doctors in opposition districts of Aleppo have accused the United States of inaction in the face of repeated atrocities in the devastated city.

In a heart-wrenching letter addressed to US President Barack Obama, 15 of the 35 doctors in eastern neighbourhoods of Syria's second city warned the situation would be desperate for civilians if regime forces reimpose a siege.

On Sunday, rebels and allied jihadists broke a three-week government encirclement that had left residents of eastern Aleppo reeling from skyrocketing prices and food shortages.

But the paediatricians, surgeons, and other physicians who signed the letter said the situation remained dire.

"Unless a permanent lifeline to Aleppo is opened it will be only a matter of time until we are again surrounded by regime troops, hunger takes hold and hospitals' supplies run completely dry." The letter lambasts the US, saying it had seen "no effort on behalf of the United States to lift the siege or even use its influence to push the parties to protect civilians".

An estimated 250,000 people still live in the rebel-held eastern parts, with about 1.2 million in the government-controlled west.

"We do not need tears or sympathy or even prayers, we need your action. Prove that you are the friend of Syrians." The World Health Organisation said Syria was the most dangerous place for healthcare workers to operate last year, with 135 attacks on health facilities and workers in 2015.

Rebels and regime forces are amassing fighters around Aleppo ahead of what is likely to be a protracted battle for the northern city, whose hospitals and other civilian infrastructure have been ravaged by violence since mid-2012.

In late July, four makeshift hospitals and a blood bank in Aleppo city were hit by air raids in a single day.

Many of the signatories to the letter worked at those hospitals, where medicine is scarce and sandbags line the entrances.

"What pains us most, as doctors, is choosing who will live and who will die," the doctors wrote.

"Young children are sometimes brought into our emergency rooms so badly injured that we have to prioritise those with better chances, or simply don't have the equipment to help them." The doctors lamented that for five years, they had "borne witness as countless patients, friends and colleagues suffered violent, tormented deaths".

One attack two weeks ago left four newborn babies dead after the force of the blast cut off the oxygen supply to their incubator.

"Gasping for air, their lives ended before they had really begun." Meanwhile, the rebel advance at the weekend that broke through government territory south of the divided city opened a new route for trucks carrying goods and fuel, though the road has not been fully secured.

Nearly-incredulous shoppers scurried through the vegetable markets yesterday, buying as quickly as possible in case a siege is reimposed or prices rise again.

Owners of shops and restaurants that had shuttered their doors because they had no goods to sell excitedly reopened them.

"This morning, a number of trucks carrying vegetables and other food entered the markets in my neighbourhood," 38-year-old Abu Omar told AFP in the rebel-held Sukkari district.

"The stalls were full of all kinds of things I hadn't seen in a month."

Fighting between government forces and rebels in Aleppo has intensified in the past month, with both sides sending in reinforcements for an all-out battle that could mark a turning point in the five-year war.

Russia's military announced a three-hour daily halt of fighting starting today to allow humanitarian convoys to reach the city.