The United Nations Children's Fund is calling attention to the affect that three years of conflict has had on Syria's young people, saying the crisis is the "most damaging conflict for children in the region's recent history."
According to a new UNICEF report released Tuesday, 5.5 million Syrian children now need assistance because of the war -- a number that has more than doubled in the past year. Among the hardest hit, it says are one million children living under siege and in hard to reach areas in Syria.
The report says of January, violence has killed more than 10,000 children in Syria, who are often are not accidental victims of war, but rather deliberately targeted. Witnesses say children and infants have been killed by snipers, or become victims of summary executions or torture. Schools have been bombed.
UNICEF highlighted what it called "deep developmental and emotional scars" left by the fighting.
The report notes 1.2 million refugee children living in camps and host communities in neighboring countries also suffer from the war. They have limited access to clean water, nutritious food or opportunities for education.
Jane MacPhail, a UNICEF child protection specialist who works with refugees in Jordan, said many of the Syrian children "are in pure survival mode" and "forget normal social and emotional responses" to what they have seen.
UNICEF says thousands of Syrian refugee children have to work to support their destitute families and many girls are forced into early marriage.
Simon Ingram, UNICEF’s Middle East and North Africa Regional Chief of Communication, says many Syrian internally displaced and refugee children are suffering profound emotional and psychological distress from the war.
“Here we are talking about the hidden injuries, the hidden wounds that have been inflicted on children because of what they have experienced; the behavioral changes, the nightmares that they carry around with them - the way in which they can no longer function as normal children do. And, this is an aspect of the crisis, which has been too often overlooked, but which is growing all the time," he explained.
The report says the millions of children affected by the crisis are at risk of becoming a "lost generation."
It cites the trouble kids have accessing education, both among those who have been forced to flee their homes and those who remain in areas where schools have been damaged, destroyed or taken over by fighters.
UNICEF said half of Syria's school-age population cannot go to classes on a regular basis and that about one in five schools cannot be used.
Another big risk facing Syrian children is the lack of adequate healthcare. The report says an estimated 60 percent of Syria's hospitals have been damaged or destroyed.
The result has been an increase in the number of pneumonia and diarrhea cases, as well as a greater vulnerability to diseases like the measles.
Last year, the U.N. started a massive, months-long vaccination campaign after Syria's first polio outbreak since 1999.
UNICEF said many of the children fleeing Syria arrive at the border malnourished as well.
The report sums up the threats facing Syria's kids by calling the country "one of the most dangerous places on Earth to be a child."
The report also called for a number of steps to help alleviate the crisis which include ending the violence, increased access to children in besieged or hard-to-reach areas, more funding for psychological support and aid to help provide services in countries hosting Syrian refugees.
The fighting in Syria has continued despite international efforts to find a political solution to the crisis. Two rounds of peace talks in Geneva between the Syrian government and rebels trying to oust President Basher al-Gassed have yielded little progress, but those trying to mediate the process say they will continue to seek an agreement.
The U.N. estimates the total number of people killed in the fighting is well over 100,000, with 6.5 million people displaced within Syria and nearly 2.5 million refugees in neighboring countries.