A generation of Syrian children face psychological ruin and ever increasing danger, with child deaths soaring by 50% last year and the number of young soldiers tripling since 2015.



A report by Unicef found 2017 was the worst year of the war for young Syrians, with 910 killed in a conflict that has spared them no mercy and has taken a vastly disproportionate toll on the country’s most vulnerable people.



The figures undermine claims that the war, which will soon enter its eighth year, is losing steam. Those most at risk face escalating threats of being permanently maimed by fighting, or emotionally scarred by a litany of abuses including forced labour, marriages, food scarcity and minimal access to health or education.



“There are scars in children and there are scars on children that will never be erased,” said Geert Cappelaere, Unicef’s director for the Middle East and north Africa. “The protection of children in all circumstances that was once universally embraced – at no moment have any of the parties accepted.”



More than 13 million people inside Syria need humanitarian assistance, more than half of whom are children, the UN says. Of the 6.1 million internally displaced, roughly half (2.8 million) are children. Figures for last year show an average of 6,550 people were displaced each day in Syria.



During the first months of 2018 there has been a sharp escalation in violence in Idlib, eastern Ghouta on the outskirts of Damascus and in Afrin on the Turkish border. The Syrian regime and Russia have been besieging Idlib and eastern Ghouta, while Turkey and a proxy Arab force launched an offensive against the Kurdish enclave of Afrin in January. There also remains a lethal threat from mines and unexploded bombs left over from fighting in Raqqa and Deir ez-Zor.

In eastern Ghouta a besieged population of almost 420,000 people, half of whom are children, are enduring a month of airstrikes from Russian and Syrian jets, which are attempting to oust opposition fighters and the communities that support them from Damascus’s doorstep. Estimated death tolls in Ghouta range from 1,000 to 1,300 people. Children are thought to account for at least several hundred casualties.

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Reaching children in need has been relentlessly difficult, the UN has said, with requests to deliver aid to opposition communities routinely denied and convoys allowed to enter often stripped of essential medicines. Humanitarian access was denied 105 times in 2017 alone – a year marked by sieges of east Aleppo and eastern Ghouta, which had both been strongholds of the anti-Assad opposition throughout the war.



Healthcare facilities, including hospitals and ambulance bases, have been repeatedly targeted in eastern Ghouta, repeating a pattern set elsewhere in Syria. In opposition-held east Aleppo, the healthcare network was destroyed before the area was overrun by pro-regime forces in late 2016. Last year alone, there were 175 attacks on health and education centres, the Unicef report says.



Médecins Sans Frontières says 15 of the 20 hospitals and clinics it supports in eastern Ghouta have been hit by airstrikes or shelling. Local authorities inside the enclave say the healthcare system is being systematically targeted and the capacity to care for high numbers of wounded has shrunk enormously as a result.



“Their [Assad regime’s] strategy is brutally clear,” said Ghassan Chamsi, a resident in the Douma neighbourhood of eastern Ghouta. “They want to terrorise everyone into running for the borders. Either submit, or die. But don’t expect to be treated by our own.”



On almost every economic indicator, children in Syria experienced worse conditions last year than in 2016. The scarcity of food has soared across the country, with the young again suffering most for the lack of adequate nutrition. Up to 12% of young Syrians are considered to be acutely malnourished, the report says.



The psychological effect on young generations who have spent at least half their lives in conflict, deprived of adequate food, education and healthcare, is among the most difficult risk categories to gauge.

“Their conditions require specialised treatment and services,’ said Cappelaere. “As children, their needs differ from those of adults: as their bodies and abilities change, so must their care. These children face a very real risk of being neglected and stigmatised as the unrelenting conflict continues.”



With fighting raging in north and central Syria, the majority of the population displaced and regional powers now more deeply invested in the war than before, there appears to be little hope of the humanitarian situation easing anytime soon.



Russia and Iran have both reinforced their support for Bashar al-Assad, who was losing on the battlefield until Vladimir Putin sent the Russian air force to prop up the Syrian leader in September 2015. Iranian-led ground troops have been central to clawing back lost ground, while opposition groups, splintered and divided, no longer pose a sustained threat to the regime.



However, Idlib and eastern Idlib, despite sustained attacks, remain formidable obstacles to a leadership that has pledged to return all of Syria to central control. As yet, there is no plan for what to do with eastern Ghouta’s population if they are forced to flee. In Idlib, more than 2.5 million people, many of them displaced from elsewhere in the country, are crammed into a small province faced with ever increasing humanitarian needs.

