More than 100 people, including 20 children, have been reported killed in airstrikes carried out by Syrian President Bashar al-Assad’s forces in a rebel-held area outside Damascus. The Syria Civil Defense—better known as the White Helmets—said the strikes took place over the East Ghouta area Monday and bombs were still falling as of Tuesday morning. East Ghouta is the only remaining major rebel holdout near the capital. Monday’s death toll makes it one of the deadliest days in the region since it came under siege five years ago and the BBC reported four makeshift hospitals, including one maternity ward, were also hit. The Syrian Observatory of Human Rights said, since Sunday, 194 people—including 52 children—have been killed in government bombings across the region.