Syrian children walk past heavily damaged buildings in the rebel-held town of Douma, on the eastern edges of the capital Damascus on February 27, 2016, on the first day of the landmark ceasefire agreement
Beirut (AFP) - At least 250,000 Syrian children are living under siege, with many forced to eat animal feed or leaves to survive, Save the Children said Wednesday, as the war's fifth anniversary looms.
"They and their families are cut off from the outside world, surrounded by warring groups that illegally use siege against civilians as a weapon of war," the charity said in a report.
"At least a quarter of a million children are living under brutal siege in areas of Syria that have effectively been turned into open-air prisons," it added.
With doctors operating without electricity and "sick children dying while the medicine they need is on the other side of a checkpoint", the report paints a grim picture based on the testimonies of families, aid workers, medics and teachers in besieged areas.
Doctors working in a rebel bastion east of Damascus have seen children die from preventable diseases.
"Some deaths resulted from malnutrition and others from the lack of medications and vaccines. Children here have died of rabies because the vaccine was not available," said one only identified as Dr Nizar.
"Skin and stomach diseases have spread because the regime cut off the water supply and people rely on surface water wells which are often polluted with sewage.
"Children are particularly affected by lung inflammation and infections from the large amount of smoke emitted from the explosions."
Obstetric care is often non-existent in besieged areas like in the north of Homs province.
"Many deaths have happened due to bleeding and the inability to perform surgery, as births occurred at home without the help of midwives," said Amira, a mother in the battered province.
"There are no incubators available for newborn children. Infants have died as a result," said Aboud, a health worker near Damascus.
- Children told grass edible -
Food is in short supply in besieged towns across Syria, with some areas completely cut off, leaving children with nothing to eat but animal feed or grass.
"When we didn't find food, we were eating grass. I used to lie to my children and tell them that the grass is edible. But who am I kidding? The grass wasn't edible," said Hassan, a father from Deir Ezzor near Iraq.
Many families interviewed by Save the Children said they were sometimes unable to eat even once a day.
"Since the siege began I've lost a third of my weight," said Marwan, a boy living under siege east of Damascus.
Syria's hunger crisis triggered global outrage when images of emaciated children emerged earlier this year from the besieged town of Madaya near Damascus.
But even when UN aid has reached Madaya and other besieged areas, it has barely been enough to cover the needs, said Save the Children.
"Sometimes my brothers and sisters and I go to bed and we haven't eaten anything at all since the day before, because there is no food," said Sami, a boy in rebel-held Eastern Ghouta.
With minors also being killed in air strikes and shelling "with shocking regularity", the charity says children under siege live in constant fear and with deep psychological wounds.
"When I hear the sound of a shell or a plane then I get very afraid and I hurry to escape and hide under my bed," said Ahmed, a boy in Douma east of Damascus.
Syria's civil war erupted in 2011 when security forces turned their weapons on protesters demanding President Bashar al-Assad's ouster, sparking the all-out conflict that has killed more than 270,000 people and displaced millions.