The United Nations says 2016 was the worst year yet for children affected by Syria's six-year-long civil war, with at least 652 being killed and many millions more suffering as refugees.
Verified instances of killing, maiming, and recruitment of children increased sharply last year in a drastic escalation of violence across the country, the United Nations International Children's Emergency Fund (UNICEF) said in a report published March 13.
UNICEF's report comes two days before the sixth anniversary of the civil war, which began in March 2011 when protests broke out against President Bashar al-Assad.
An estimated 300,000 people have been killed and millions more have been displaced by fighting that has created one the largest migrant crises in Europe since World War II.
Turkey and the United States support various rebel groups fighting against Assad, while Russia and Iran back Assad.
The conflict also involves fighters of the Islamic State (IS) militant group, which is opposed by all sides.
"The depth of suffering is unprecedented," said Geert Cappelaere, UNICEF's Middle Eastern regional chief. Millions of children in Syria come under attack on a daily basis, their lives turned upside down.
The report said the 652 killed from conflict-related causes last year represent a 20 percent increase over 2015. At least 255 of the children were killed in or near schools, it said.
Many of the children were killed directly from the conflict, but many others died because of a lack of access to doctors and basic services.
UNICEF verified 850 cases of children being recruited to fight in the conflict, about double the 2015 figure.
Children are being used and recruited to fight directly on the frontlines and are increasingly taking part in combat roles, including in extreme cases as executioners, suicide bombers,or prison guards, it said.
UNICEF warned that social and medical services are continuing to deteriorate, forcing many children into child labor, early marriage, and combat.
Dozens are dying from preventable diseases, it said.
At least 6 million children rely on humanitarian aid and 2.3 million are refugees in Turkey, Lebanon, Jordan, Egypt, and Iraq, it said. About 280,000 are living under siege, cut off from any humanitarian aid.
"Each and every child is scarred for life with horrific consequences on their health, well-being and future," Cappelaere said.
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