Fighting and shelling continued in eastern Ghouta on Tuesday, preventing any aid from reaching the besieged Syrian enclave during a five-hour pause "unilaterally" declared by Russia, the United Nations said.

"It is a question life and death - if ever there was a question of life and death - we need a 30-day cessation of hostilities in Syria as the Security Council demands," Jens Laerke, spokesman of the U.N. Office for the Coordination of Humanitarian Assistance (OCHA), told a Geneva briefing.

More than 1,000 sick and wounded are on a list of people needing medical evacuation by the Syrian Arab Red Crescent, World Health Organization spokesman Tarik Jasarevic said. "But we don't have any updates on something like that taking place or coming right now," he added.