In 2012, when Syrian rebel groups were flush with money and weapons from abroad and quickly capturing territory from the government, eastern Ghouta fell under the control of fighters backed by Saudi Arabia and Qatar.
For a time, it seemed like the area – a group of suburbs on the eastern edge of Damascus – could be the springboard for rebels capturing the Syrian capital.
It had been one of the first areas around Damascus where widespread demonstrations took place against Syrian President Bashar Al Assad in 2011, and later became a base for armed rebels as the uprising became a full-fledged war.
Even as nearby neighborhoods remained supportive of the government, eastern Ghouta became the site of some of the war’s worst fighting, including an alleged sarin gas attack that killed as many as 1,400 people in August 2013.
Having long lost territory, Iran increased its support to the Assad regime, sending Revolutionary Guards and then militias. But it was Russian intervention that decisively shifted the battle in favour of Mr Al Assad’s forces, leading to a four-year siege of eastern Ghouta that has left between 300,000 and 400,000 people in critical need of aid.
But the rebels have clung on in their stronghold, defying the regime's main military effort to take back ground.
The Syrian government's bombardment intensified this week, killing at least 335 people in four days amid threats to invade on the ground. The shelling and aerial bombing has left residents of an area used to hardship with the worst fighting they have experienced since the war began.
Humam Husari, a filmmaker who has lived in the area throughout the siege, was documenting an overcrowded hospital in Douma, the scene of rocket strikes on Thursday morning.
"There is nowhere for anyone to go," he said. "There are too many people at the hospital who are already injured from previous attacks."
The regime's various bombardments of eastern Ghouta have been the subject of international objections, and impotence, over the years. Mr Husari was also present in 2013, when the Syrian government was accused of carrying out the chemical attack.
US president Barack Obama had said before the attack happened that use of chemical weapons by the Syrian government was a "red line" that would trigger American military action, but despite widely broadcast video of dying children, the US did not follow through on its threat.
Many believe the US inaction emboldened the Syrian regime, which has been accused of using chemical weapons in eastern Ghouta multiple times since.
Last year, photos of a one-month-old baby who died from severe malnutrition in the area also drew international condemnations but no improvements on the ground.
Now there is a sense that eastern Ghouta is a lost cause as the rebels' backers have given up on overthrowing the regime and most other urban areas have fallen back under government control.
"Turkey in the north has an interest in the land, but Saudi and Qatar no longer have interest, so they are not really heavily involved," said Mouna Ghanem, vice president of Building the Syrian State, a political opposition group. "Ghouta has been abandoned by the two countries that supported" the rebels initially.
"The regime wants to seize Ghouta ahead of the next Sochi talks," Ms Ghanem added, referring to a political process backed by the Russian government.
But it may not yet be the end.
"We will defend eastern Ghouta to the last man," said Ammar Al Hassan, a spokesman for Jeish Al Islam, the dominant rebel faction in the area.