LONDON (Thomson Reuters Foundation) - Nearly three years of fighting has subjected Syrian children to unspeakable suffering, and inflicted widespread trauma - "invisible scars" - which have received little attention, aid workers say.
The conflict, which began in March 2011 with peaceful street protests and descended into civil war after a fierce crackdown, has displaced an estimated 3 million children within the country.
More than 1 million others are not displaced but living in battlegrounds between President Bashar al-Assad's forces and rebel fighters. A further 1.2 million children have fled to neighbouring countries such as Lebanon and Jordan.
"The violence, the plight of these children ... is often portrayed and reported. It's the invisible scars that children have in their heads and in their hearts and in the way they hold themselves that are under-reported," UNICEF spokeswoman Juliette Touma said by telephone from the Jordanian capital Amman.
"It's always obvious that every single child I speak to is traumatised and has seen horrors and has seen things that no one should see," she added. "(There is) the constant speaking about death, about the fear of death, dreaming about death."
Some children wanted to tell Touma and her colleagues about what they had felt and seen - almost as a means of coping.
"In some other cases we've seen extreme reactions. For example, children who've lost their ability to speak completely or who are unable to sleep, unable to eat," Touma said.
"We worry for the long term about untreated psychological stress when it's untreated that could lead to long-term illnesses such as depression and other mental illnesses."
UNICEF has joined forces with the United Nations Refugee Agency, Mercy Corps, Save the Children and World Vision to launch the #NoLostGENERATION campaign asking the public to petition for an end to violence against Syrian children.
The appeal, which aims to get at least 1 million signatures by March 15 - the third anniversary of the start of the conflict - also seeks an end to the blocking of humanitarian assistance and attacks on aid workers. It calls for a commitment to reconciliation and more funds to educate and address the psychological needs of all children affected by the conflict.
BRUTALISED BY ALL SIDES
"The Syrian conflict has something quite unique about it - that is the degree to which children are being targeted by both sides of the conflict," Kate Adams, policy and advocacy manager at War Child UK told the Thomson Reuters Foundation.
"I don't mean targeted by just a sniper, I'm talking sexual violence, arbitrary detention and all of the violations that are going on ... These have all been happening since the very beginning of the conflict," Adams said.
A recent U.N. report has recorded grave violations against children such as the forced recruitment of children to fight on the frontlines.
The report also detailed the arrest of a 16-year-old boy and five friends in March 2012 at a checkpoint near their school. The boy said he witnessed one of his friends, a 14-year-old male, being sexually assaulted by guards before being killed.
Intimidation, humiliation, physical abuse, sexual assault and rape have also been used against countless children by the Syrian intelligence services to extract confessions or pressure relatives to surrender, the report found.
"Children have been constantly targeted from the beginning of the revolution until now," Bassam al-Ahmed, press officer at the Violations Documentation Center, a Syrian opposition monitoring group.
"There is not a day without children killed in the Syrian armed conflict but of course they are not all being killed in the same way," he added.
The Violations Documentation Center has recorded the deaths of over 11,000 children since the fighting started. While the majority have died from shelling or gunfire - including at close range - the group has recorded the deaths of 120 children from chemical attacks, the killing of over 150 child soldiers and the disappearance of as many as 1,200.