The United Nations children's agency has called for an emergency evacuation of 137 sick children stranded in a rebel-held suburb outside the Syrian capital.
The Eastern Ghouta suburb, home to 400,000 residents, has been cut off from food and medical aid since 2013.
The U.N. Children's Fund (UNICEF) says five children have reportedly died there from a lack of medical care.
In its statement Sunday, UNICEF said its aid workers described seeing one of the worst health situations since the conflict began in 2011 during a rare international aid convoy to a neighborhood in the Eastern Ghouta district at the end of November.
UNICEF said 137 children, aged between seven months to 17 years, require immediate evacuation for conditions that include kidney failure, severe malnutrition and conflict wounds.
"Children are still living through so much horror,'' said UNICEF Representative in Syria Fran Equiza. "The situation is getting worse day by day. "
UNICEF called on "all parties" in the Syrian conflict to allow "unconditional" humanitarian access to the country's children. Airstrikes have destroyed hospitals and neighborhoods, which has contributed to the spread of malnutrition and disease.
UNICEF said nearly 12 percent of children under 5 years old in Eastern Ghouta suffer from acute malnutrition — the highest rate ever recorded since the start of the Syrian civil war.
"Children are still living through so much horror,'' Equiza said. "Now is the time for all sides to do the right thing and to stop the violence."