What happened that day?It was a shocking incident that reportedly claimed the lives of 43 children, 23 girls and 20 boys, and as many as 100 people were taken to the hospital with severe injuries.It was a horrendous tragedy. It happened around noon, right around Akrama al-Makhzomi elementary school. It's a new school, a crowded area, with a Palestinian camp close to the school and a mixed population, so I have no idea who the target was, but children end up being the collateral damage to the violence.How are children bearing the brunt of this conflict?It's unspeakable. It's an impossible situation to be a child right now in Syria. This is war in its most horrendous form.Children are at the center of this crisis. Half of the population of the 6.5 million displaced are children. Children are paying with their lives. Even in the act of simply going to school they get killed. Last heard there have been over 10,000 children killed. So many of them have died in the simple act of crossing the road, going to school.The education infrastructure is severely affected: One in three schools have either been destroyed or been taken over by the military or internally displaced persons (IDPs).Many children have now dropped out of school and have nothing to look forward to. Everything that affects adults also affects children, like schools and health services. The livelihoods of their parents and needs for sustenance have been completely depleted, so children are forced to work instead of going to school.What has been the psychological impact on Syrian children?There is a whole gambit of psychological and physical abuse. There are issues of children being kidnapped, attacked, used as currency in business exchanges, tortured, sexually abused, recruited as combatants. This is a reality that is worse than fiction.Each time I go into a school in rural Damascus or anywhere outside the governate, I see how scared these children are, how they cling to their mothers. Most of these children have lost at least one parent. It's a very fearful and lonely life they live.Children are going to keep this toxicity in their hearts for a long time. It will be impossible for them, and for society and generations, to avoid paying the price for them carrying these wounds. The need for psychosocial support is tremendous. Keeping children safe from the monstrosity of war has to be at the forefront of our minds.There is a need to have a response system for child protection, to see how we can engage them back into a certain degree of sanity.They are so scared and scarred that we need to constantly engage them so that they can retain a semblance of normalcy.Has aid access improved since the resolution passed that allows aid to Syria without government approval?Resolution 2165 has had an effect on the ground. There has been an attempt by the government to enable more missions to deliver aid. I've seen an increase in an effort to cooperate with the U.N. to allow us to go to areas that need services. It's extremely slow and torturous progress, but there has been a marginal if not discernible progress in access to those in need.The humanitarian situation continues to deteriorate. The latest estimates suggest that close to 11 million in Syria are in need. About 6.5 million are displaced within the country; they are no better or worse than being refugees in their own land. Three and a half million are living in absolutely impossible conditions. There are 240,000 people who live in besieged areas. There has been a massive flight of doctors out of this country. There are hardly enough doctors left that are proportionate to the need for healthcare.I worked in Sudan and Afghanistan, but I came to a completely different reality in Syria. Syria looks like a World War II set in motion, except that it's not a movie, it's reality.