AFP - Syrian regime air strikes and artillery fire hit the rebel-held enclave of Eastern Ghouta for a sixth straight day Friday as the world struggled to reach a deal to stop the carnage.

More than 400 civilians have been killed in one of the seven-year Syrian conflict's bloodiest episodes and rescuers were finding more bodies buried in the rubble.

Russia, whose warplanes are also bombing the Eastern Ghouta region, stalled a deal at the United Nations for a 30-day humanitarian ceasefire late Thursday but a vote was rescheduled for later Friday.

Few of the enclave's estimated 400,000 residents -- mostly living in a scattering of towns across the semi-rural area east of the capital -- ventured out on Friday.

An AFP correspondent in Douma, Eastern Ghouta's main town, saw a handful of people stealthily crossing rubble-strewn streets to assess damage to their property or look for food and water.

But death has fallen from the sky relentlessly since government and allied forces intensified their bombardment on Sunday and rocket fire soon forced everybody to run for cover.

Exhausted and famished families cowered in cramped and damp basements, exchanging information on the latest casualties of the government's blitz.

Some of the only people braving the threat of more bombardment were medical staff in those hospitals still standing and rescuers sifting through the wreckage of levelled buildings.

- Trapped bodies -

The new strikes on Friday killed at least nine people, the Syrian Observatory for Human Rights said.

"The air strikes and the artillery fire are continuing on several towns in Eastern Ghouta," Rami Abdel Rahman, the head of the Britain-based monitoring group, told AFP.

He said that five of the nine people killed on Friday died in air strikes on Douma, the main town in the enclave east of Damascus, and that two of them were children.

The latest deaths brought to 426 the number of people killed since the Syrian regime and its Russian ally intensified their bombardment of the besieged area on February 18. More than 2,000 people have been wounded.

"The death toll is likely to go up, there are many wounded in critical condition and victims trapped in the rubble," said Abdel Rahman.

Diplomats at the United Nations failed to clinch Russian approval late Thursday on a resolution calling for a 30-day truce to allow for humanitarian aid and medical evacuations.

They then announced that a vote would take place on Friday but did not make clear whether they had rallied Moscow to a new draft.

The latest text softens language in a key provision to say that the council "demands" a ceasefire instead of "decides".

It also specifies that the ceasefire will not apply to "individuals, groups, undertakings and entities associated" with Al-Qaeda and the Islamic State group. A previous version simply mentioned the two groups.

World leaders have expressed outrage at the plight of civilians in Eastern Ghouta, which UN chief Antonio Guterres called "hell on earth", but have so far been powerless to halt the bloodshed.

"The UN says it is concerned and calls for a ceasefire, France condemns, but they have given us nothing," said Abu Mustafa, one of the few civilians on the streets of Douma Friday morning.

"Every day we have strikes, destruction. This would draw tears from a rock, there is nobody who hasn't lost a member of their family," said the 50-year-old, who was escorting a wounded person to hospital.

The enclave has been controlled by Islamist and jihadist groups since 2012.

The area is completely surrounded by government-controlled territory and residents are unwilling or unable to flee the deadly siege.

- Toothless response -

The dire images of civilian victims bleeding to death in understaffed hospitals and the scope of the urban destruction have shocked the world and drawn comparisons with the devastating 2016 battle for Aleppo.

At the United Nations on Thursday, Syrian representative Bashar al-Jaafari reminded his counterparts that rocket fire from Eastern Ghouta was also targeting civilian areas of Damascus.

According to state media, at least 16 civilians have been killed since February 18.

"Yes, Eastern Ghouta will become another Aleppo," he said, claiming however that, a year on, Aleppo was home to "millions of people living very normally."

The aid community has voiced its frustration at being prevented from assisting civilians in Eastern Ghouta, which has been under government siege since 2013.

"The blocking of this resolution is another failure to end human suffering in Syria, with the UN Security Council rendered impotent as this senseless war rages on," Thomas White, Syria director at the Norwegian Refugee Council told AFP.

Government forces have this month reinforced their deployment around the enclave in preparation for a ground offensive that White said would spark an even worse humanitarian crisis.

"It will be bloody, costing the lives of thousands of civilians and potentially the displacement of hundreds of thousands more," he said.

"If aid agencies are unable to meet urgent needs now, how can we possibly be prepared to tackle what is yet to come," White said.