Twenty-five civilians are reported to have been killed in air strikes on two towns in the rebel-held Eastern Ghouta area outside Syria’s capital, Damascus.

The Syria Civil Defence said one of its rescue workers was among 18 people who died when what witnesses identified as Russian jets bombed Misraba.

Another six people died in suspected Russian strikes on Arbin, it added.

Some 400,000 people in the area have been under siege by Russian-backed Syrian government forces since 2013.

Last week, the government permitted Red Cross teams to evacuate 29 critically-ill patients from the Eastern Ghouta as part of a deal that saw rebels release the same number of prisoners.

Hundreds more patients are in urgent need of evacuation from the enclave, where there are only 107 doctors and severe shortages of medical supplies.

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The Syria Civil Defence said Russian jets fired “seismic missiles” on residential areas of Misraba overnight, causing several buildings to collapse.

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Dozens of civilians have been killed or injured in air and artillery attacks in recent weeks

Nine women and two children were among the 18 people killed, it said, adding that the number might rise because some of the injured were in a critical condition.

One of the organisation’s volunteer rescue workers – who are commonly known as the White Helmets – died after a “double-tap” strike on one building.

The Syria Civil Defence said two children and two women were among the six people killed in the air strikes on Arbin, and that another three civilians were killed by government shellfire in Beit Sawa.

The Syrian Observatory for Human Rights, a UK-based monitoring group, put the death toll from the three towns at 23, and also said the warplanes that attacked Misraba and Arbin were believed to have been Russian.