Syria's civil war has left the country's health system so severely crippled that some patients are "opting to be knocked out with metal bars for lack of anesthesia," according to a new report by international charity Save the Children.
The report, A Devastating Toll, details the impact of three years of war on the health of the country's children and adds that more than 10,000 children have been lost as a direct result of the violence.
"We received a little girl with critical injuries; we could do nothing but wait for her to die because we didn't have the equipment or the medicines. Till now I can't remove her face from my mind," said one health worker identified in the report only as Anas.
But Yarmouk is not alone in its suffering.
"Since the outbreak of war three years ago, it is probable that several thousands of children have already died as a result of greatly reduced access to treatment for life-threatening chronic diseases like cancer, epilepsy, asthma, diabetes, hypertension and kidney failure," it said.
"This is more than a crisis. It is the threatened collapse of an entire health system, which endangers the lives and well-being of millions of children."
Vaccine programs in Syria have collapsed, with a peacetime coverage rate of 91 percent falling to 68 percent just a year after the conflict began, said the charity. It said this rate was likely to be far lower today. Deadly diseases that were practically unheard of in the years before the conflict, such as measles and meningitis, are also on the rise.
Even polio, which was eradicated across Syria in 1995, is now being carried by up to 80,000 children across the country. This figure, the charity said, is so high that medical experts have raised concerns about a potential international spread of the virus.
"The breakdown of Syria's vaccination program has resulted in the re-emergence of polio in Syria," the report said. "Children born after 2010 have not been vaccinated for two years. There have been heavy restrictions in access to vaccines and health workers have not been able to reach children in need."
Factors including overcrowding and poor living conditions, water quality and sanitation have meant skin diseases including Leishmaniasis — a parasitic disease transmitted by sandflies — have spread. There were fewer than 3,000 cases before the war, and now there are more than 100,000.
Save the Children echoed the call for humanitarian groups to be given freedom of access to all areas and aid to be allowed across conflict lines, after ceasefires if necessary. Efforts to secure such access have been largely in vain due to the intransigence of Assad and his Russian backers, who claim that aid would support what they call a "terrorist" insurgency.
"Immediate investment in, and access to, child-focused health services is needed to ensure that children are not dying from preventable and treatable injuries and illnesses," Save the Children said.
Al Jazeera and wire services