The International Rescue Committee has given a damning indictment on the impact of 'de-escalation areas' in Syria since they were first implemented in July. Tom Garofalo, director of public affairs for the International Rescue Committee in the Middle East, said: “The safety of civilians has not improved with the establishment of these so-called de-escalation areas. With so many armed groups not covered by ceasefire agreements, we have even seen periods of increased aerial bombardment. The idea that peace has somehow broken out in Syria is far from the reality we see.”
 
Nearly 400,000 people have been besieged in East Ghouta for the past four years, but the situation has deteriorated rapidly in recent months. The area is now facing a malnutrition crisis, with the UN reporting nearly 1,200 children suffering from the effects of not enough food. Six hospitals supported by the IRC have also reported cases of malnutrition.
 
Air attacks, as well as the impact of fighting between groups has made it harder for food and medicine to get into East Ghouta. Prices of food have sky-rocketed and a kilogramme of bread can cost more than £1.5 — double what many are able to earn in a day. While the number of air attacks have reduced, an IRC survey found that of Syrians in East Ghouta who expressed fears, 92% were afraid of getting caught up in an airstrike.
 
Despite also being designated a “de-escalation area”, the northwest Syrian province of Idlib saw a dramatic increase in air attacks in September against armed groups not covered by any ceasefire agreement. Credible reports catalogue airstrikes against three hospitals and fighting between armed groups disrupted the IRC’s aid work several times during the past three months.
 
In Southern Syria, the introduction of the “de-escalation area” in Dar’a was followed by an increase in fighting between armed groups. In Eastern Dar’a the number one fear reported by people surveyed by the IRC is now kidnapings and targeted killings. Around a quarter of children in southern Syria aren’t in school, according to the IRC survey, with the fear of travelling to school as one of the main factors.
 
The IRC remains horrified that the rules of war continue to be flouted in Syria. Expressing his concern, Tom Garofalo, said: 'Tragically, civilians as well as hospitals and ambulances continue to be the targets of barrel bombs, mortars and airstrikes. The situation is made worse because of fighting between armed groups in these areas. Sadly, the defining characteristic of this war is its disregard for civilian life and international law. The powers meeting in Astana this week, and in Geneva soon, have to make the protection of civilians, whether from attacks or the consequence of besiegement, their number one priority. Until we see these improvements it is irresponsible for the global community to even begin to discuss, reconstruction, recovery or the return of refugees.'
 
Away from the de-escalation areas, the war against ISIS rages in the northeast of Syria. More than 200,000 people have fled fighting in the province of Deir Ez Zour, with as many again still living in areas under the control of ISIS. In the northeast of Syria, civilians still face the brunt of the war and the UN has expressed concern at alarming trend of increasing civilian casualties from air strikes, especially during the battle to take the city of Raqqa, which saw as many as 400 airstrikes in two days during the first two weeks of October.
 
Those who do manage to escape the fighting, face arduous journeys of up to four days to reach safety. However, displacement camps are overwhelmed, with people waiting more than a week to be registered to enter and finally receive food and healthcare. While they wait they have to make do without any help, living often in makeshift shelters, assembled from scraps of cloth, old tents, and anything that could provide some barrier to the elements. But as this video shows, there is almost no way to keep out sandstorms ravaging the region in recent days.
 
Over 1,000 IRC workers helped more than 1 million Syrians inside their country in 2016. The IRC provides medical care via clinics and mobile health teams, helps vulnerable women and girls, as well as support Syrians find ways to buy support their families through job training, direct cash or vouchers to buy food and other essential items.