“By any measure, the situation in Syria has worsened since the beginning of the year,” the UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Stephen O'Brien, told the UN Security Council during a briefing on the situation in the country.

The Office for the Coordination of Humanitarian Affairs (OCHA), which he leads, now estimates that some 13.5 million people in Syria are in need of some form of protection and humanitarian assistance, an increase of some 1.2 million in just ten months. More than six million of those in need are reportedly children.

“Rising levels of fighting and violence over the last few weeks have had an enormous humanitarian impact, resulting in large-scale death, injury and displacement to civilians, particularly in northern Syria,” Mr. O’Brien continued. “Indiscriminate attacks on civilian-populated areas continue with impunity.”

Meanwhile, OCHA’s latest findings indicate that over 120,000 people have been displaced in northern Syria since early October as a result of aerial bombardment, as well as ground offensives among the parties – and overall, well over 1.2 million people have been displaced so far this year, many for the second or third time.

The UN and partners have also recorded attacks on five hospitals in Hama, Idleb and Aleppo governorates since the launch of recent offensives, leading to a number of casualties and their immediate closure due to severe infrastructural damage. “Since the start of the conflict, Physicians for Human Rights has documented attacks on at least 313 medical facilities and the death of 679 medical workers,” said Mr. O’Brien, adding that these attacks must cease immediately.

Furthermore, OCHA estimates that that some 393,700 people are living under siege in Syria, in areas controlled by the terrorist group ISIL, the Syrian Government, as well as by non-State armed opposition groups and the Al-Qaida-affiliated Al-Nusrah Front.

“The 26,500 people in Nubul and Zahra, in Aleppo governorate, are no longer considered besieged following consistent and credible reports that access to and from the enclave for people and commercial goods have significantly improved over the last three months,” the UN official stated, nonetheless insisting that access to besieged areas remains “pitiful and wholly insufficient.”

“So far in 2015, the United Nations has only been able to reach 3.6 per cent of people with health assistance and only 0.5 per cent of people with food per month in besieged areas,” he informed members of the Council.

He added that last week, humanitarian operations begun under the framework of a recent ceasefire agreement affecting several cities and towns, reached in Istanbul at the end of September with the facilitation of the Office of the UN Special Envoy for Syria.

This reportedly allowed 31 trucks to deliver medical and humanitarian supplies on 18 October, simultaneously to 29,500 people in Madaya, as well as the besieged areas of Zabadani, Foah and Kefraya. In rural Damascus, two trucks crossed into Zabadani and 21 more entered Madaya and Bquine. Eight more trucks delivered health, food, nutrition, and sanitation supplies to Foah and Kefraya via a UN cross border operation through a Turkish border point.

“This complex mission shows once again that when there is the political will, there is a way to improve the situation for civilians trapped in conflict in Syria,” Mr. O’Brien underlined.

“Even as the political and military situation evolves, the immediate priority for humanitarian organizations remains to reach all people in need wherever they may be found in Syria,” he added. “To do this, we must have sustained, predictable and unimpeded access throughout the country.”

According to OCHA, so far this year only 23 of the 85 convoy requests made by the United Nations have been approved in principle by the Syrian Ministry of Foreign Affairs, and less than half of those approved have been able to actually proceed due to a combination of lack of final security clearances from Syrian authorities, lack of safe passage from non-State armed opposition groups, and insecurity.

“Winter is fast approaching and is likely to further exacerbate the situation for many families,” Mr. O’Brien warned, reminding the Security Council that “the crisis urgently requires a political solution which addresses the root causes of the conflict and meets the aspirations of the Syrian people who have suffered for far too long.”