BEIRUT — Doctors Without Borders pleaded on Monday for access to treat the wounded in the rebel-held part of Syria’s Aleppo as government forces pressed ahead with an offensive that has killed hundreds of people in recent weeks.

The international charity, also known by its French acronym MSF, said in a statement that medical workers in Aleppo are exhausted and that the overstretched facilities face an impending fuel shortage. MSF, which supports eight hospitals in Aleppo’s besieged eastern quarters, says just 35 doctors remain in the area, serving a population of 275,000.

Eastern Aleppo’s Health Directorate said the wounded were sleeping outside overcrowded hospitals, waiting for care. The U.N. has warned that the Aleppo bombardment by Syrian and Russian warplanes could leave thousands more dead by the year’s end.

“Russia and Syria must stop the indiscriminate bombing now and abide by the rules of war to avoid the extreme suffering of the unprotected civilian population,” said Pablo Marco, MSF’s operations manager for the Middle East.

The Britain-based Syrian Observatory for Human Rights, which monitors the conflict through local contacts, reported heavy fighting along the east-west Aleppo front lines. Another activist-run group, the Local Coordination Committees, said rebels were fighting to repel government forces from the city’s largest water facility, which serves over a million people.

In another besieged area near the capital, Damascus, doctors reported up to two dozen cases of kidney failure that they said resulted from malnutrition. Muhammad Darwish, a local physician, said doctors confirmed renal failure in 12 people in the town of Madaya and were investigating another 12 cases.

Government forces have laid siege to Madaya, home to some 40,000 people, since late last year. Last winter, MSF reported at least 16 deaths there resulting from malnutrition and lack of medical care.

“We are only eating carbohydrates. We aren’t receiving any vitamins or protein,” said Darwish.

The government has prohibited the U.N. from delivering seeds or dialysis kits to the town, in what the opposition says is a strategy aimed at forcing the town to surrender.

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