Over the last three weeks, at least 321 children have been wounded in Syrian and Russian airstrikes. Medical authorities also fear a rise in the number of children suffering from water-borne diseases while medical supplies still can’t reach the besieged city.

The indiscriminate bombing by Syrian and Russian forces is taking its toll on the children of east Aleppo. At least 320 children have been wounded and 114 have died as a result of airstrikes in the last three weeks alone. In addition, children have not been able to receive essential vaccinations, and water-borne diseases are reportedly on the rise.

According to data from the Directorate of Health, since the resumption of the airstrike campaign on 23 September after a brief ceasefire, 17 children on average have been injured every day. This figure does not, however, take into account the casualties registered in the last 48 hours, during which the bombing campaign has intensified. Between the beginning of the Syrian war in 2011 and April of this year, the Directorate of Health has registered 5,200 child deaths in Aleppo.  

“The international community has become immune to images of dead children being recovered from the rubble of buildings ravaged by bombs. This has become a daily occurrence. All sorts of civilian spaces are being hit; schools are being damaged. The reality is that children die every day in what appears to be a ‘kill box’,” said Carlos Francisco, MSF Head of Mission for Syria.

Hospitals report that because patients struggle to access medical facilities, some people with easily treatable wounds develop complications or reach late to the facilities given the volatility of the conflict and this can be fatal. Children are particularly susceptible to this.

“As a result of the airstrikes and the siege in east Aleppo, a large number of children have lost their parents. Some have been badly injured and will be disabled for the rest of their lives. Others are suffering from trauma. What we are seeing are consequences that will affect for years to come,” said Pablo Marco, MSF Operational Manager in the Middle East.

Children are not only at risk of death due to airstrikes, but also because essential paediatric healthcare programmes have been limited or stopped.

“Previously there were door-to-door polio vaccination campaigns and expanded programmes on immunisation in east Aleppo, but these are no longer possible as vaccines and logistic supplies can´t reach the area,” said Dr Hassan Nerabani, from the Aleppo Directorate of Health. “The number of medical teams working in east Aleppo is also insufficient. They are overwhelmed by the huge number of war-wounded and their priority is to save lives. Many paediatric health programmes are on-hold.”

As clean water sources become scarcer, hospitals report that children in east Aleppo are suffering from diarrhoea and dehydration. Some water pumps have been hit in airstrikes, and for the others the necessary fuel to make them work is running low. “We are seeing many children with hepatitis A due to a lack of clean drinking water. The shortage of food and baby milk is also leading to some severe cases of malnutrition,” said Dr Nerabani.

Education has also suffered during this siege. Since school resumed in September, at least seven out of the remaining 100 schools in east Aleppo have been hit by bombs, one of them twice and one teacher has been killed, according to data compiled by the local authorities. “Families are afraid of sending their children to school,” said Mohammed Bakir, from the Teachers Committee of east Aleppo.

“All parties to the conflict must facilitate safe and free passage for medical and humanitarian personnel, as well as the timely evacuation of the seriously ill and wounded to areas where they can access specialised medical treatment and feel safe,” Marco said.