Where you sleep. Whether your children go to school. When you can shop. The rhythm of bombardment dictates life in the besieged Syrian town of Douma, much of it spent underground.

The rebel-held town, the largest in the Eastern Ghouta suburb of Damascus with more than 100,000 residents, is surrounded and heavily shelled daily by advancing Syrian regime forces.

Residents say artillery fire and air strikes by Syrian warplanes determine when they can spend time above ground.

Some essential elements of daily life in Douma have completely shifted to below the surface -- with basements turned into schools and playgrounds, and even subterranean bakeries and makeshift clinics.

On days when skies are clear, Douma's residents live as normal a life as they can: gaggles of children walk to school across bombed-out streets and vegetable sellers peddle their goods in the open-air markets.

But once shelling begins, families are forced to take refuge in bomb shelters, hiding out there overnight and into the early morning if the bombing does not stop.

- 'No other place to hide' -

Abu Omar's makeshift one-room shelter is about four metres (yards) deep, its dirt walls lit by a single fluorescent bulb and lined with rugs and household items.

On mornings when the booms of air strikes can be heard, his nephews and nieces clamber down the rickety wooden ladder into the shelter instead of going to school.

They spend up to four hours there daily, doing schoolwork in lined notepads or making up games to play together.

We dug for about 15 days to make this shelter because there's no other place for us to hide from the shelling," a gaunt Abu Omar told AFP.

Thick floral carpets line the floor, where Abu Omar sets out a precious set of gold-rimmed cups for Arabic coffee.

"We go to school, but these last few days we haven't been able to because of the shelling," said Abu Omar's nephew Mohammad, who is in second grade.

- 'Tightening the noose' -

Morning bombardment prevents farmers with land on Douma's outskirts from harvesting their fields, so vegetable sellers in turn have no produce to display in their stalls and families have nothing to cook.

On such days, Douma's streets lie deserted -- except for the ambulances frantically transporting rescue workers and paramedics to the scene of an air strike.

The air attacks are part of a six-month offensive by government forces that has chipped away at rebel-held villages and farmland across Eastern Ghouta, according to the Syrian Observatory for Human Rights.

Backed by allied militia, Syria's army has advanced to within two kilometres (less than two miles) north of Douma, "tightening the noose" around the town, the monitoring group has said.  

Douma has been under government siege since 2013 and is a bastion of the powerful Jaish al-Islam (Army of Islam) rebel group. 

In June, aid agencies reached Douma for the first time in three years, bringing in desperately needed food and medical aid.

Source: AFP