Updated

At least 22 civilians were killed in government airstrikes and shelling outside Syria's capital of Damascus, activists reported Sunday, as the fighting continued ahead of U.N. peace talks in Geneva.

The government's jets and artillery launched a wave of strikes on residential areas in the Eastern Ghouta suburbs of Damascus, said the Britain-based Syrian Observatory for Human Rights monitoring group. By midday, 23 people had been killed.

The locally-run Ghouta Media Center said 22 civilians had been killed.

Rescuers arriving at the scene in Misraba, a town in the eastern Ghouta region, picked up the wounded and the dead from where they'd fallen, in streets in a residential area in the town, as seen in a video posted by the Ghouta Media Center and the Syrian Civil Defense search-and-rescue group.

Conditions have deteriorated inside the region, which is suffering from shortages of food and medicine due to a government-enforced blockade. The U.N. says there are some 350,000 people in need of immediate humanitarian aid in Eastern Ghouta.

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A wounded boy reacts in a hospital in Douma after an airstrike on the rebel-held town of Mesraba, in the rebel-held besieged town of Douma, eastern Ghouta in Damascus, Syria, November 26, 2017. (REUTERS)

Rebels in Eastern Ghouta have held out against government forces throughout the nearly seven years of the country's civil war.

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Earlier this month, Syrian rebels attacked a nearby military installation in the area, seizing weapons and ammunition.

The U.N. is slated to resume peace talks between the government and the Syrian opposition in Geneva on Nov. 28. The opposition announced last week it was prepared to enter into direct talks with the government without preconditions, in a departure from earlier positions.

The government has not yet named its delegation to the talks.

The U.N.'s deputy envoy to Syria, Ramzy Ramzy, said after meeting Syrian Deputy Foreign Minister Faisal Mekdad Saturday in Damascus that the talks would cover four main topics, a new constitution, governance, elections and combating terrorism.

The Associated Press contributed to this report.