BEIRUT (AP) — At least five children and two rescue workers were killed Friday in a Damascus suburb during a government bombing campaign amid escalating violence in and around the capital despite a truce, activists reported.

State media said the rebels shelled government-controlled neighborhoods of Damascus, killing at least three civilians.

Friday marks the fourth day of violence in Damascus and its suburbs, despite a truce brokered by Russia, Turkey and Iran that went into effect in August. So far, over 40 people have been killed, mostly in rebel-held suburbs but also in the government-controlled capital.

The opposition Syrian Observatory for Human Rights and Ghouta Media Center said five children were killed Friday in the eastern Ghouta suburb of Douma from government shelling. The two groups said at least two volunteers from the Syrian Civil Defense, also known as the White Helmets first responders, were killed in airstrikes during search and rescue efforts in Douma, and that another two civilians were killed in Douma.

Meanwhile, Syria's state news agency SANA said three civilians were killed in the rebel shelling of al-Hal Souk neighborhood in Damascus. Rebels fired several mortars into a Damascus neighborhood a day earlier, killing at least 10 civilians, including the coach of the national Karate team, Fadhel Radhi.

Radhi, 69, was a veteran of the sport, establishing it in Syria. He was killed when a shell landed near him as he left al-Majd Club in the Bab Mosala district in Damascus.

Fighters from the insurgent Ahrar al-Sham group on Wednesday attacked a military compound in Harasta, a town in the eastern Ghouta suburbs, setting off intense fighting with government forces.

An aid warehouse was damaged by the fighting, spoiling food stocks.

Eastern Ghouta suburbs have been largely under a tight blockade by pro-government forces, despite the August "de-escalation" agreement that was supposed to allow in humanitarian aid. The U.N. estimates there are around 350,000 people trapped by the blockade.