Distressing pictures of a baby on the brink of death have emerged from a rebel-held area of Syria, a tragic reminder of the horrors faced daily by civilians in the six-year-old war.

Acutely malnourished Samar Dofdaa was 34 days old when she was taken by her parents to a clinic in Hamouria in rebel-held east Ghouta on Saturday. She died the next day.

In photos and video from the hospital shared by activists, the baby is clearly in great distress but is too weak to make a noise when she cries. Her skin is stretched taut and translucent over her tiny frame and breathing is clearly a struggle.

Samar weighed just 1.9 kg (four pounds) when she was admitted by her also malnourished mother (AFP/Getty) (AFP/Getty Images)

A nurse said Samar weighed just 1.9 kg (four pounds) when she was admitted by her also malnourished mother, whose was unable to produce milk to feed her baby daughter.

The family’s tragedy is just one of many such starvation stories in east Ghouta, which has been under siege by government forces since 2013.

While the bloodshed caused by international efforts to destroy Isis’ caliphate is the focus of many of the news stories which emerge from Syria, elsewhere in the country, people are slowly dying under government sieges.

Syrians make fuel from plastic waste Show all 8 1 /8 Syrians make fuel from plastic waste Syrians make fuel from plastic waste Sifting through plastic: the workshop uses plastic from bottles and other waste materials to produce liquid and gas fuels. The liquid is refined into gasoline, diesel and benzene fuels, which in turn are sold for domestic and commercial use Reuters Syrians make fuel from plastic waste Khodor, 20, at the workshop in the rebel-held and besieged neighbourhood of Douma, Damascus Reuters Syrians make fuel from plastic waste Back to basics: a man checks the heat of a pipe pouring with fuel Reuters Syrians make fuel from plastic waste Khodor, 20, must keep an eye on the burning plastic inside the workshop in Douma Reuters Syrians make fuel from plastic waste A young man takes a container of the locally made fuel, which can be used for domestic heating and on farms and bakeries Reuters Syrians make fuel from plastic waste Abu Fahad on a rest break with his colleagues inside the workshop, where the air is heavy with toxic fumes Reuters Syrians make fuel from plastic waste Fuel drips into a container at the workshop. Most locals are glad of the family-run business, which has restored a degree of normality to the region Reuters Syrians make fuel from plastic waste Khodor extracts fuel from plastic in the workshop Reuters

Deliberate starvation of citizens is a war crime under the Fourth Geneva Convention, but the tactic has been effectively utilised by the regime over the years to inflame tensions between different rebel groups and turn civilians lacking food and medicine against opposition fighters.

While a deal brokered by Iran, Turkey and Russia earlier this year supposedly created four ‘de-escalation zones’ between various rebel factions and the government, monitors and rebels say fighting has continued on many fronts - and food and other vital supplies are still not reaching people in besieged communities.

The latest report on the situation from Siege Watch, a Syria monitor based in Washington DC, estimated that 821,200 people live in 34 areas without freedom of movement.