Hundreds of thousands of children are paying a heavy price in the three-year conflict between the government of Ukraine and Russian-backed rebels in Donetsk and Luhansk in the eastern part of the country.
Although the war has taken thousands of lives and injured many more, the U.N. children's fund said the conflict has been all but forgotten by the world and become an "invisible crisis" to all except those forced to suffer from ongoing violence, abuse and deprivation.
Among those hardest hit are the more than 200,000 children living along the "contact line," a 15-kilometer zone that divides government and rebel-controlled areas where the fighting is most intense.
"These are children that are surviving death, that are living constantly with the sound of shelling, that have witnessed death. Some children have even witnessed the death of loved ones," said Giovanna Barberis, UNICEF's Ukraine representative.
Barberis has frequently traveled to the contact line and seen the hardships and suffering of the children, who live in a state of constant fear and uncertainty. The trauma has taken a huge emotional and psychological toll, according to Barberis.
"Parents, teachers, school directors and psychologists describe striking behavior changes among children as young as 3 years old," she said. "Children are very anxious. They wet their beds. They have nightmares. In some cases, they act quite aggressively and often withdraw from their families and friends."
Barberis said some children no longer seek safety in bomb shelters because they think such attacks are "normal now."
"Families and children are getting used to living in a very abnormal and exceptional situation," she said. "But this does not mean that they cope well with the situation."
There have been multiple violations of the Minsk peace agreement since it was signed in September 2014 by representatives of Ukraine, Russia and the Donetsk and Luhansk people's republics.
In its latest report on the situation in Ukraine, the U.N. Human Rights Mission found that a sharp escalation of hostilities between January 29 and February 3 had "a devastating impact" on all aspects of life for civilians living along the contact line. It said seven civilians were killed and 46 wounded in those six days.
In addition, "Several hundreds of people are isolated and deprived of basic necessities," according to the report. The nearest grocery store is seven kilometers away, and children crossing the contact line have "to walk up to three kilometers to go to school."
UNICEF's Barberis told VOA that it often was not safe to go to school, so children had difficulty gaining regular access to education.
"We have estimated that from the beginning of the conflict, something like 740 schools were damaged or destroyed," she said, "and just these last few weeks, when we had the deteriorating situation of the areas along the contact line … something like seven schools were damaged."
Barberis said children in eastern Ukraine require urgent and sustained support to help them come to grips with the daily trauma of war. However, she noted, UNICEF has received less than one-third of the $31.2 million it needs to support children and families affected by the conflict.
"Children should not have to live with the emotional scars from a conflict they had no part in creating," Barberis said.