Describing those clashes, Mr. Adel said: “Pro-government forces are trying to storm the front.”
Sana, Syria’s state news agency, said that “terrorist groups targeted five missiles at the designated passage for the exit of civilians to prevent them from leaving and continue to use them as human shields.”
Ghouta has been devastated by years of warfare, including a 2013 poison gas attack that killed hundreds of people, sickened thousands, and was blamed by Western authorities on the Assad regime. The eastern part of Ghouta is the last major rebel-held area near Damascus, and the Islamist groups that control it — labeled terrorists by the Syrian and Russian governments — have fired shells at government-held areas in and around the capital, though not nearly on the same scale as the incoming bombardment.
United Nations officials confirmed that there had been shelling in eastern Ghouta on Tuesday morning, and said there were also reports of shelling toward Damascus during the preceding night, before the cease-fire was to begin. Aid convoys cannot enter, they said, until conditions become safer.
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Robert Mardini, the Middle East regional director at the International Committee of the Red Cross, said the most pressing need in eastern Ghouta is for medicine and medical care, but that the five-hour daily window promised by Russia is inadequate.
“It is impossible to bring a humanitarian convoy in five hours,” he said. “We have a long experience of bringing aid across front lines in Syria, and we know that it may take up to one day to simply pass checkpoints, despite the previous agreement of all parties. Then you need to offload the goods.”
In other formerly rebel-held areas, like Aleppo, Homs and Daraya, the government has bombed heavily and often indiscriminately, and choked off supplies, before allowing some evacuation and sending in troops. The government denies targeting civilians, insisting that the rebels inflict most of the suffering, which Western observers and aid groups dispute.
Dmitri S. Peskov, a spokesman for the Kremlin, said that whether the pauses will continue depends on the rebels and “whether they continue to open fire and whether provocations continue and so on.”
Civilians say that if they leave besieged areas, they risk permanent displacement from their homes, or arrest, conscription or even death at the hands of the government. At the same time, rebel groups have at times prevented them from leaving.
Mr. Adel, in Douma, said that he and his acquaintances did not trust the government, and had no plans to leave. He asked, “What will guarantee our lives outside?”