Of the 13 million Syrian people in need of humanitarian assistance, it is estimated six million are children.
While much focus has been on those fleeing the war-ravaged country - there are eight million internally displaced and unable to leave.
In Syria, gala events are few and far between. So, in the plush Four Seasons Hotel in central Damascus, the ballrooms have been converted into open-plan offices – and it’s there that some aid agencies co-ordinate their important work: distributing humanitarian assistance.
UNICEF’s representative in Syria Hanna Singer says the situation for children is dire.
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“One out of three children are developing mental disorders because of trauma,” she said.
It is one of many sobering statistics when it comes to Syrian children. One in four schools have been destroyed and two million children have fallen out of the education system, so learning is the major focus at most shelters.
The Syrian Arab Red Crescent oversees several shelters for displaced children in Damascus. The programs include sporting pursuits, music, tuition and and induction counselling where the level and type of trauma experienced is assessed by trained volunteers.
Nabeh Allaham is a volunteer manager at the centre in Jaramana, Damascus and says gaining an understanding of the child’s needs and what they have been exposed to over almost five years of fighting is crucial.
“[It is important] to help him get through from the violent scenes they have sensed or watched in their country,” he said.
‘A safe place’
Co-manager Dima Kikoloff says offering a safe environment for displaced children is the first step in helping them overcome trauma and re-enter education.
“They have this safe place to do these activities because the streets and the schools and the other places are not safe anymore,” Ms Kikoloff said.
Despite witnessing some horrendous experiences, the children - some of them orphans - happily participate in the activities.
The government also runs residential shelters to cater for some of Syria's eight million internally displaced. Many structures not damaged by the fighting have been converted to provide accommodation, food and provide medical assistance.
Mothers mourn the loss of children
In one former tertiary complex on the outskirts of Damascus, handfuls of pasta, vegetables and other ingredients are carefully stirred to feed the 450 residents.
The food and shelter are welcome for the occupants, most of whom have fled the fighting.
One woman lost five of her eight children in a mortar attack, another managed to escape with six of her eleven children – the other six remain in an IS controlled precinct.
She did not wish to be identified, but speaking through an interpreter she says the tragedies are hard to process.
“We don't think about the future because we don't know what will happen,” she said.
