With nighttime temperatures just above freezing, the battle plunged the city into darkness late in the week, knocked out most phone services and raised the prospect of food and water shortages. Without phone connections, medics did not know where to take the wounded.
The Russian Defense Ministry said it was observing a temporary cease-fire to give civilians time to evacuate Mariupol and Volnovakha, a city to its north. A top official in Mariupol said the cease-fire there is to last until 4pm local time and an evacuation would begin at 11am.
Russia has made significant gains on the ground in the south in an apparent bid to cut off Ukraine's access to the sea. Capturing Mariupol could allow Russia to build a land corridor to Crimea, which it seized in 2014.
"We can make it!" the hospital worker shouts, urging on his co-workers as they race to pull a wounded six-year-old girl, already pale, from the ambulance in her bloodied pyjama pants adorned with cheery unicorns.
Her mother seems to know better.
The woman, in a knit winter cap that is also bloodstained, weeps in terror and disbelief as the medical team first tries to resuscitate the girl in the ambulance, then inside the hospital, where their efforts are both desperate and futile.
As the mother waits alone in a hallway, a nurse weeps while the trauma team tries a defibrillator, an injection, and pumping oxygen. A doctor looks straight into the camera of a videojournalist allowed inside.
He has a message: "Show this to Putin."
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Death comes to a soccer field
Flashes from shelling light up the medics as they stand in a parking lot waiting for the next emergency call.
In the hospital nearby, a father buries his face into his dead 16-year-old son's lifeless head. The boy, draped under a bloodstained sheet, has succumbed to wounds from shelling on the soccer field where he was playing.
Hospital staff wipe blood off a gurney. Others treat a man whose face is obscured by blood-soaked bandages.
The medics prepare to go out, strapping on their helmets.
They find a wounded woman in an apartment and take her in an ambulance for treatment, her hand shaking rapidly from apparent shock. She yells out in pain as the medics wheel her into the hospital.
On the darkening horizon, orange light flashes at the edge of the sky and loud bangs reverberate in the air.
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Children will play
The resting toddler, perhaps responding instinctively to the sight of a camera, raises an arm and waves.
"Now the same thing is happening — but now we're with children," says Anna Delina, who fled Donetsk in 2014.
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Tanks in a row
In a field in Volnovakha on the outskirts of Mariupol, a row of four green tanks hold their cannons at roughly 45 degrees.
Two of them fire, jolting the machines backward slightly, and sending clouds of white smoke skyward.
The tanks are painted with the letter "Z" in white, a tactical sign intended to quickly identify military units and help troops distinguish friend from foe in combat.
"I was anxious, anxious about giving birth to the baby in these times," the 30-year-old says, her voice shaking. "I'm thankful to the doctors who helped this baby to be born in these conditions. I believe that everything will be fine."
Above the basement, hospital staff labour to save people wounded in the shelling. A woman with blood streaming from her mouth cries out in pain, a young man's face is ashen as he is wheeled into the hospital. Another, who did not survive, is covered by a thin blue sheet.
"Do I need to say more?" says Oleksandr Balash, head of the anesthesiology department.